Long-term use of statins requires regular checkups to prevent medication risks. How often should they be checked?

A friend asked Huazi that he had been taking statins for a long time, but had never had a follow-up check. Would there be any risks? If he did go for a follow-up check, what items would he mainly check?

Huazi told him that long-term use of statins requires regular review to determine the efficacy of the drug and prevent adverse drug reactions. The review mainly checks blood lipids, liver function (transaminase), creatine kinase and blood sugar levels.

1. What are the risks of long-term use of statins?

Statins can significantly reduce cholesterol levels, and the body's cholesterol is mainly synthesized in the liver, so statins need to enter liver cells to work. The main adverse reaction is that it may affect liver function . Statins may also affect the metabolism of muscle cells, causing adverse reactions such as myalgia and fatigue .

Adverse reactions caused by statins, such as abnormal liver function and effects on muscles, are usually reversible . As long as they are discovered and the drug is stopped in time, they can basically recover on their own and will not cause serious harm to the body.

Some people may experience adverse reactions such as gastrointestinal irritation and sleep disorders when taking statins, which are generally mild and do not affect medication. Statins may also affect blood sugar , but abnormal blood sugar is not an indication for discontinuation of statins.

2. Review intervals for taking statins

For those who are taking statins for the first time, it is recommended to have the first review after taking the medicine for one month . After a month of regular medication, the blood lipid level is relatively stable, and the efficacy of the drug can be evaluated and the medication can be adjusted according to the blood lipid situation. At the same time, transaminase and myokinase should be reviewed to evaluate the adverse reactions of the drug.

A second review will be conducted after 3 months of medication . Because adverse reactions to statins usually occur within the first 3 months of medication, a review at this time can prevent serious adverse reactions.

After six months of medication, the third review will be conducted . After six months of continuous medication, blood lipid levels and tolerance to the drug have reached a stable balance point, and the overall medication effect can be evaluated.

If after several follow-up examinations, the blood lipids are under stable control and no serious adverse reactions occur, you can have a follow-up examination every 6 to 12 months .

3. Key items on the test sheet

During the follow-up examination, special attention should be paid to the level of **low-density lipoprotein cholesterol (LDL-C)** in blood lipids.

LDL-C level is an important indicator for evaluating the effectiveness of medication. For healthy people, it should be controlled below 3.37mmol/L . For people with "three highs" chronic diseases and smokers, it is recommended to control it below 2.6mmol/L . For people who have suffered myocardial infarction, cerebral infarction, and coronary heart disease, it is recommended to control it below 1.8mmol/L , and it is best to control it at around 1.4mmol/L .

Transaminase (ALT, AST) is an important indicator for evaluating liver function, and the normal value is usually 5~40U/L. When taking statins, there may be a slight increase, but as long as it does not exceed 3 times the normal upper limit (i.e. 120U/L) , it will not affect continued medication.

Creatine kinase (CK) is an important indicator for assessing muscle damage, and the normal value is usually 40~200U/L. When taking statins, as long as it does not exceed 4 times the normal upper limit (i.e. 800U/L) , it will not affect continued medication.

4. Other inspections that require attention

Statins usually do not affect kidney function , but people with poor kidney function may slow down the excretion of certain statins, resulting in accumulation and poisoning. Therefore, it is recommended to check kidney function before taking the medicine and choose the appropriate statin according to the actual situation.

If there are symptoms of myalgia and fatigue, but creatine kinase is not elevated, it is common in the "anti-placebo effect". The reason is the fear of the adverse reactions of statins, which leads to negative psychological suggestions and a stress response.

Blood sugar needs to be monitored during medication. If blood sugar rises, it can be dealt with by adjusting diet and increasing exercise, or adjusted to statins that have less impact on blood sugar. People with diabetes can adjust the dosage of hypoglycemic drugs, but discontinuation of statins is not recommended .

To summarize, when taking statins, blood lipids, liver function, and creatine kinase need to be rechecked at 1, 3, and 6 months to evaluate drug efficacy and adverse reactions, and then rechecked every 6 to 12 months.

Drugs must be used under the guidance of a doctor. If you have any questions about medication, please consult a doctor or pharmacist. I am pharmacist Huazi, welcome to follow me and share more health knowledge.