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Statins with shorter half-lives are more effective when taken in the evening, so their peak effect occurs when the body's natural cholesterol production is at its highest. A recent meta-analysis suggested that statins with longer half-lives, including atorvastatin, may also be more effective at lowering LDL cholesterol if taken in the evening. [38]
A risk exists of muscle damage (myopathy and rhabdomyolysis) with statins. Hypercholesterolemia is not a risk factor for mortality in persons older than 70 years and risks from statin drugs are more increased after age 85. [2] Fibrates are indicated for hypertriglyceridemia. Fibrates typically lower triglycerides by 20% to 50%.
The most important adverse side effects are muscle problems, an increased risk of diabetes mellitus, and increased liver enzymes in the blood due to liver damage. [5] [65] Over 5 years of treatment statins result in 75 cases of diabetes, 7.5 cases of bleeding stroke, and 5 cases of muscle damage per 10,000 people treated. [34]
1. What is osteoporosis? Osteoporosis is a disease of the bones. People with osteoporosis have bones that are weak and break easily. Osteoporosis is called a “silent” disease.
While muscle pain (myalgia) is seen in 9-20% of patients treated with statins, it typically occurs in the first month of treatment. SAAM has a later onset, occurring years after uncomplicated statin use. In some cases even after statins have been discontinued for several years. [5]
Statins may improve quality of life when used in people without existing cardiovascular disease (i.e. for primary prevention). [74] Statins decrease cholesterol in children with hypercholesterolemia, but no studies as of 2010 show improved outcomes [76] and diet is the mainstay of therapy in childhood. [39]
Ezetimibe/atorvastatin (trade names Liptruzet, Atozet) is a cholesterol lowering combination drug.In the United States, it was approved in May 2013, by the Food and Drug Administration for the treatment of elevated low-density lipoprotein (LDL) in patients with primary or mixed hyperlipidemia as adjunctive therapy to diet. [1]
The US National Osteoporosis Foundation recommends pharmacologic treatment for patients with hip or spine fracture thought to be related to osteoporosis, those with BMD 2.5 SD or more below the young normal mean (T-score -2.5 or below), and those with BMD between 1 and 2.5 SD below normal mean whose 10-year risk, using FRAX, for hip fracture is ...