How to take statins correctly? Is it okay to take them every other day?

A friend told Huazi that he was taking atorvastatin. In order to reduce the adverse reactions of the drug, he took the medicine once every other day. Is this okay?

Hua Zi said that the drug instructions for all statins clearly state "oral, once a day" . Therefore, taking statins every other day is not a common way of taking them. However, this method is not completely wrong, because studies have shown that some people have poor tolerance to statins. When choosing long-acting statins, taking them every other day can reduce the occurrence of adverse reactions.

1. Most people cannot stop taking statins

Many people asked Huazi, "I heard that you can't stop taking statins after you start taking them. Is that drug dependence?" Huazi said, "That's not the case. Statins are not addictive, and there is no withdrawal reaction after stopping the medication ."

20% to 30% of the cholesterol in the human body comes from diet, and 70% to 80% comes from self-synthesis. Therefore, even if many people do not consume cholesterol in their diet, the cholesterol level in their blood will still be excessive.

At present, the cause of primary hypercholesterolemia is still unclear, so it cannot be cured and can only be controlled by taking statins regularly for a long time . Moreover, statins can not only lower cholesterol, but also stabilize and reverse atherosclerotic plaques, and prevent the formation of blood clots.

2. Most statins should be taken at night

There are currently seven types of statins in clinical use, namely simvastatin, lovastatin, pravastatin, fluvastatin, atorvastatin, rosuvastatin and pitavastatin.

Human cholesterol is mainly synthesized at night, and the half-life of simvastatin, lovastatin, pravastatin, and fluvastatin is short (1 to 2 hours), so taking the medicine before bedtime can produce the best effect . The half-life of pitavastatin is about 11 hours, so it is also recommended to take it at night . If you need to take other medicines at night, you can also adjust pitavastatin to take at other times.

Atorvastatin and rosuvastatin are long-acting statins. Their lipid-lowering effect can last for more than 20 hours after taking it once. The time of taking it will not affect the efficacy of the drug, and they can be taken at a fixed time every day .

3. Can statins be taken every other day?

Cholesterol is synthesized in the human body every day. In order to suppress cholesterol to the maximum extent, statins need to maintain a certain blood concentration, so taking the medicine once a day is the most reasonable method of medication . Moreover, statins can stabilize and reverse the effect of plaques. There is currently no other drug that can replace it. People at risk of cardiovascular disease should try to maintain statin treatment.

However, when using statins, some people may experience an increase in liver transaminases (ASL, ALT) exceeding 3 times the normal upper limit; as well as muscle fatigue and pain, accompanied by an increase in creatine kinase (CK) exceeding 5 times the normal upper limit, which is called "statin intolerance" . Some people can tolerate small doses of statins, which is called "partial statin intolerance" ; some people cannot tolerate any dose of statins, which is called "complete statin intolerance".

For people who are partially intolerant to statins, they can first be replaced with other statins, or the dosage can be reduced and used in combination with other lipid-lowering drugs (ezetimibe, eloumab, etc.).

You can also consider using long-acting statins (atorvastatin, rosuvastatin) and taking the medication every other day (once every two days). This can reduce the incidence of serious adverse reactions and maintain statin treatment.

Everyone should note that taking statins every other day is not a routine medication regimen for statins. It is only a special method for special patients and is not recommended for ordinary patients. This is because taking statins every other day will reduce blood drug concentrations, affect the intensity of cholesterol control, and lead to reduced cardiovascular benefits.

To sum up, the conventional use of statins is once a day. Only when special groups have partial intolerance to statins, it is recommended to take the medicine every other day under the guidance of a doctor, but it is not recommended for ordinary people to take the medicine every other day, that is, "not recommended unless it is special." 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.