Statins may be recommended if you have cardiovascular disease (CVD) or a high risk of developing it in the next 10 years.

Cardiovascular disease (CVD)

Cardiovascular disease (CVD) is a general term for conditions affecting the heart or blood vessels.

It's often caused by high cholesterol and is the most common cause of death in the UK.

The main types of CVD are:

• coronary heart disease – when the blood supply to the heart becomes restricted as a result of the hardening and narrowing of the arteries (atherosclerosis)
• angina – chest pain caused by reduced blood flow to the heart muscles
• heart attacks – when the supply of blood to the heart is suddenly blocked
• strokes and transient ischaemic attacks (TIAs) – when the supply of blood to the brain becomes blocked or disrupted
• peripheral arterial disease (PAD) – when a build-up of fatty deposits in the arteries restricts blood supply to the limbs

Statins cannot cure these conditions, but they can help prevent them getting worse or recurring in people who have been diagnosed with them.

They can also reduce the chance of CVD developing in the first place in people at risk.

Statins are usually used in combination with lifestyle measures, such as: 

• eating a healthy diet low in saturated fat
• exercising regularly
• stopping smoking
• moderating your alcohol consumption

People at risk of CVD 

If you do not have any form of CVD, statins may still be recommended if you're thought to be at a high risk of developing the condition in the future.

The current recommendation is that you should be offered statins if:

• you have at least a 1 in 10 chance of developing CVD at some point in the next 10 years
• lifestyle measures, such as exercising regularly and eating a healthy diet, have not reduced this risk

A GP may recommend carrying out a formal assessment of your CVD risk if they think you may be at an increased risk of CVD, based on your personal and family medical history.

For this formal assessment, the GP or practice nurse will use CVD risk assessment computer software that takes into account factors such as:

• your age
• if you're male or female
• your ethnic group, as some have an increased risk of CVD
• your weight and height
• if you smoke or have previously smoked
• if you have a family history of CVD
• your blood pressure
• your blood cholesterol levels
• if you have certain long-term conditions – such as diabetes, chronic kidney disease, rheumatoid arthritis and atrial fibrillation (a heart condition that causes an irregular and often abnormally fast heart rate)

Find out more about NHS screening.

Other uses

Statins can also be used to treat familial hypercholesterolaemia.

This is an inherited condition caused by a genetic fault that leads to high cholesterol levels, even in people who have a generally healthy lifestyle.

Statins should not be taken if you have severe liver disease or if blood tests suggest that your liver may not be working properly.

This is because statins can affect your liver, and this is more likely to cause serious problems if you already have a severely damaged liver.

Before starting to take statins, you should have a blood test to ensure your liver is in a relatively good condition. You should also have a routine blood test to check the health of your liver 3 months after treatment begins, and again after 12 months.

Pregnancy and breastfeeding

Statins should not be taken by anyone who is pregnant or breastfeeding, as there's no firm evidence on whether it's safe to do so.

Contact a GP for advice if you become pregnant while taking statins.

People at an increased risk of side effects

Statins should be taken with caution if you're at an increased risk of developing a rare side effect called myopathy, which is where the tissues of your muscles become damaged and painful. Severe myopathy (rhabdomyolysis) can lead to kidney damage.

Things that can increase this risk include:

• being over 70 years old
• having a history of liver disease
• regularly drinking large quantities of alcohol
• having a history of muscle-related side effects when taking a statin or fibrate (another type of medicine for high cholesterol)
• having a family history of myopathy or rhabdomyolysis

If one or more of these apply to you, you may need to be frequently monitored to check for complications. A lower dose of statin may also be recommended.

If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

Read more about the side effects of statins.

Interactions

Statins can react unpredictably with certain other substances (known as "interacting"), potentially increasing the risk of serious side effects, such as muscle damage.

Medicines that can interact with some types of statin include:

• certain antibiotics and antifungals
• certain HIV medications
• warfarin – a medicine commonly used to prevent blood clots
• ciclosporin – a medicine that suppresses the immune system and is used to treat a wide range of conditions, including psoriasis and rheumatoid arthritis
• danazol – a synthetic (manmade) hormone medicine used to treat conditions such as endometriosis
• verapamil and diltiazem – types of medicine called calcium channel blockers, which are used to treat various conditions affecting the heart and blood vessels
• amiodarone – a medicine sometimes used to treat irregular heartbeats
• fibrates – medicines that, like statins, help reduce cholesterol levels in the blood

If you're taking statins and need to take one of these medicines, a doctor may prescribe an alternative statin or your current statin at a lower dosage. In some cases, they may recommend that you temporarily stop taking your statin.

Food and alcohol

Grapefruit juice can affect some statins and increase your risk of side effects. A doctor may advise you to avoid it completely or only consume small quantities.

The doctor will also ask you how much alcohol you drink before prescribing statins. People who regularly drink large amounts of alcohol are at increased risk of getting more serious side effects.

If you're prescribed a statin, you may be able to continue drinking alcohol. However, you should not drink more than 14 units of alcohol a week.

Researching your medicine

For full details of cautions and interactions relating to your specific medicine, check the patient information leaflet that comes with it.

If in doubt, contact a GP or pharmacist for advice.

Like all medicines, statins can cause side effects. But most people tolerate them well and do not have any problems.

You should discuss the benefits and risks of taking statins with your doctor before you start taking the medicine.

If you find certain side effects particularly troublesome, talk to the doctor in charge of your care. Your dose may need to be adjusted or you may need a different type of statin.

The main side effects of statins are listed here. Some of these will not necessarily apply to the specific statin you're taking.

For details of the side effects of a particular statin, check the information leaflet that comes with your medicine.

Common side effects

Side effects can vary between different statins, but common side effects include:

• headache
• dizziness
• feeling sick
• feeling unusually tired or physically weak
• digestive system problems, such as constipation, diarrhoea, indigestion or farting
• muscle pain
• sleep problems
• low blood platelet count

Uncommon side effects

Uncommon side effects of statins include:

• being sick
• memory problems
• hair loss
• pins and needles
• inflammation of the liver (hepatitis), which can cause flu-like symptoms
• inflammation of the pancreas (pancreatitis), which can cause stomach pain
• skin problems, such as acne or an itchy red rash
• sexual problems, such as loss of libido (reduced sex drive) or erectile dysfunction

Rare side effects

Rare side effects of statins include:

• muscle weakness (myopathy)
• loss of sensation or tingling in the nerve endings of the hands and feet (peripheral neuropathy)
• tendon problems (tendons are tough cords of tissue that connect muscles to bones)

Muscle effects

Statins can occasionally cause muscle inflammation (swelling) and damage. Speak to your doctor if you have muscle pain, tenderness or weakness that cannot be explained – for example, pain that is not caused by physical work.

Your doctor may carry out a blood test to measure a substance in your blood called creatine kinase (CK), which is released into the blood when your muscles are inflamed or damaged.

If the CK in your blood is more than 5 times the normal level, your doctor may advise you to stop taking the statin. Regular exercise can sometimes lead to a rise in CK, so tell your doctor if you've been exercising a lot.

Once your CK level has returned to normal, your doctor may suggest you start taking the statin again, but at a lower dose.

Reporting side effects

The Yellow Card Scheme allows you to report suspected side effects from any type of medicine you're taking.

It's run by a medicines safety watchdog called the Medicines and Healthcare products Regulatory Agency (MHRA).

See the Yellow Card Scheme website for more information.