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Statins side effects guide

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 4 minutes read
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Statins are a type of medication used to lower your cholesterol. They work by converting the bad cholesterol in the blood. To learn more about statins and how they work read our article on Statins.

In the US, there are three types of statins available on prescription. These are:

  • First generation - pravastatin, lovastatin, & fluvastatin. These have the greatest risk of side effects. They are not so commonly used.
  • Second generation - simvastatin & atorvastatin. Of these, atorvastatin is newer, more effective and has a lower side effect profile in comparison to simvastatin.
  • Third generation - rosuvastatin & pitavastatin. They are effective and have a low side effect profile.

All medicines can cause side effects. Statins are no different, but depending on which one you are one the risk of a side effect may be more likely. Below we will look at some of the main side effects you can experience. You should speak with your doctor for advice if you develop any bothersome side effects. Your doctor may want to lower your dose. Alternatively, they might switch you to another statin as side effects can vary.

What are the side effects?

Some common side effects from statins may include muscle cramping, feeling sick, constipation, diarrhea, flatulence, indigestion, headache, dizziness, and difficulty sleeping.

Less common side effects may include memory problems, hair loss, vomiting, erectile dysfunction, reduced sex drive, inflammation of your pancreas (pancreatitis), pins and needles, and acne.

Some people can also develop depression, raised blood sugar levels, and lung problems. However, it is not clear how often these side effects occur and if this is a direct effect of the medication.

If you develop any bothersome side effects, you should speak with your doctor. Options include looking at lowering your dose. Alternatively, they might discuss switching you to another statin as side effects can vary between different statin types.

Statins and the liver

Statins can cause liver damage in some people. Therefore, before you start treatment with a statin, your doctor will want to carry out a blood test to check if your liver is working correctly. If your doctor thinks a statin is appropriate for you, they will also test your liver function regularly to ensure no changes. As well as having these blood tests, you should also report any symptoms of liver damage to your doctor. These include yellowing of your skin or eyes, dark-colored urine, upper abdominal pain, loss of appetite, and extreme unexplained tiredness and weakness. Note that generally, it is uncommon for statins to cause liver problems.

Muscle pains

Muscle problems are a side effect to look out for when taking a statin as they can indicate a severe medical condition called rhabdomyolysis. Rhabdomyolysis occurs when there is a breakdown of muscle tissue and can subsequently lead to life-threatening kidney damage, not to be confused with delayed-onset muscle soreness (DOMS). For this reason, you should promptly report to your doctor any unexplained muscle pain, tenderness, or weakness. Your doctor may want to carry out a blood test for creatine kinase - an enzyme increased in your body when your muscles are damaged or inflamed.

Although muscle pain is a common complaint among people taking statins, rhabdomyolysis rarely occurs. However, it is best to get any muscle complaints checked out to err on the side of caution. Interestingly, researchers have found that there may be a ‘nocebo effect’ associated with statin use. People with negative expectations about statins are more likely to experience muscle problems because they expect to get them.

Statins interactions

Certain medications can make you more likely to experience side effects from some statins. Examples of drugs that can cause this effect include:

  • amiodarone for arrythythmias
  • clarithromycin & erythromycin for infections
  • cyclosporin for reducing immune response

These medications can increase the level of statin in your bloodstream by inhibiting enzymes needed in removing the medication from your body. Grapefruit can have a similar effect (however, this only applies to atorvastatin and simvastatin). If your doctor wants you to take two medications that interact with each other, they will discuss this with you.

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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