Now that blood lipids have returned to normal, can statins be taken every other day? Will it affect the treatment effect?

Several people asked Huazi, if blood lipids are normal, can statins be taken every other day? Some people have already taken statins every other day, but they don’t know whether this will affect the therapeutic effect of the drug. Huazi told them that when blood lipids are controlled to normal, on the basis of maintaining a healthy lifestyle, the dosage of statins can be reduced, but it still needs to be taken every day, and it is not recommended to take it every other day.

1. Do you really understand the effects of statins? Many people think that statins are lipid-lowering drugs. This understanding is not wrong. From the perspective of pharmacological classification, statins are lipid-regulating drugs that can inhibit the body's cholesterol synthase and reduce the level of cholesterol in the blood. Among the risk factors for cardiovascular and cerebrovascular diseases, the level of low-density lipoprotein cholesterol (LDL-C) is closely related to the risk of the disease. Reducing LDL-C means reducing the risk of the disease.

However, if people think that statins can only lower blood lipids, then this is one-sided because statins are not only used to regulate blood lipids, but are also an important anti-atherosclerotic drug.

The pathogenic mechanism of atherosclerosis is the result of a series of complex biochemical processes, including damage to the arterial intima, invasion of LDL-C, phagocytosis of LDL-C by macrophages, oxidation and inflammatory stimulation of the arterial intima by LDL-C, and rupture of unstable plaques inducing platelet aggregation, which ultimately leads to thrombosis.

Statins can not only directly reduce the level of LDL-C in the blood and reduce the invasion of LDL-C into the intima, but also improve the metabolism of the arterial intima, reduce the damage to the intima, fight the stress response, and reduce the oxidation and inflammatory response of the arterial intima. Ultimately, they increase the density of the lipid core in the plaque, reduce the size of the plaque, increase its stability, make it less likely to rupture, and prevent thrombosis.

2. What is the key to the efficacy of the drug? Statins not only lower blood lipids, but also shrink plaques when taken for a long time, which can reverse the plaques. And there is no other drug that can replace the effect of statins in reversing plaques. However, to produce the effect of reversing plaques, two points need to be achieved.

First, you need to take the medicine for a long enough period of time.

The second point is to ensure that the medication is effective.

Regarding the duration of medication, atherosclerotic plaques are not formed overnight. Similarly, the reversal of plaques cannot be achieved in a short period of time. In related studies, when taking statins, the stability of plaques increased and the size of plaques decreased in people who took the medication for more than 2 to 4 years. Therefore, statins need to be taken for at least 2 years to achieve treatment needs.

Whether the medication is effective is measured by the level of LDL-C. Generally speaking, for people who only suffer from chronic diseases but have not suffered from cerebral infarction, myocardial infarction, coronary heart disease and other related diseases, it is sufficient to control LDL-C at 2.6mmol/L. For people who have already suffered from related diseases, LDL-C should be controlled at 1.8mmol/L. For extremely critically ill people, LDL-C can be controlled at 1.4mmol/L.

For people whose initial LDL-C value is too high and difficult to reach the standard, taking statins to lower the LDL-C level by more than 50% can have the effect of preventing cardiovascular and cerebrovascular diseases.

3. Why it is not recommended to take statins every other day If you want statins to have the effect of treating atherosclerosis, you need to take the medicine for a considerable period of time (at least 2 to 4 years). Even if the blood lipid level is normal, statins cannot be stopped, and the blood concentration needs to be maintained at a high level to be effective.

The half-life of statins (the time it takes for blood drug concentration to drop by half) is no more than a dozen hours at the longest and only a few hours at the shortest. You need to take the medicine every day to continuously maintain effective blood drug concentration. If you take the medicine every other day, the blood drug concentration curve will form obvious peaks and troughs. There will be a period of time when statins cannot reach effective concentrations and lose their therapeutic effect.

The treatment of atherosclerosis is like "rowing against the current", if you don't move forward, you will move backward. When the drug does not reach the therapeutic concentration, the plaque will continue to progress. When the drug reaches the therapeutic concentration, the plaque will reverse. When the drug concentration always fluctuates greatly, it will form a "tug-of-war" with the disease. You may take the drug for several years, but the plaque will remain the same and will not reverse.

Some people worry about side effects, so they take the medicine every other day. Huazi's suggestion is that if you want to reduce the dosage because you are worried about side effects, then breaking the pills and taking them every day will be more effective in preventing side effects than taking them every other day. This is because the incidence of drug side effects is closely related to the drug concentration.

For example, a person who can drink half a catty of alcohol can drink half a catty of alcohol every day, but will get drunk if he drinks one catty of alcohol the next day. The same is true for taking medicine. There is no problem taking it every day, but if you put two days' worth of medicine together and take it every other day, it may cause a single dose to be too large, and the incidence of side effects will increase.

In summary, statins can not only lower blood lipids, but also treat atherosclerosis. Their role is irreplaceable and requires long-term use to see the effect. It is not recommended to take statins every other day. They need to be taken every day to work better, and the incidence of side effects will be lower. I am pharmacist Huazi, welcome to follow me and share more health knowledge.