What is the method of action of Statins?

inhibit the action of HMG-CoA reductase, the rate-limiting enzyme in hepatic cholesterol synthesis

What are the main adverse effects of Statins?

• myopathy
• liver impairment
• there is some evidence that statins may increase the risk of intracerebral haemorrhage in patients who've previously had a stroke

What are the main contraindications of Statins?

• macrolides (e.g. erythromycin, clarithromycin)
• pregnancy

What increases the risk of myopathy in statin use?

• advanced age
• female sex
• low body mass index
• presence of multisystem disease

Which statin group has a higher risk of myopathy?

more common in lipophilic statins (simvastatin, atorvastatin) than relatively hydrophilic statins (rosuvastatin, pravastatin, fluvastatin)

What patient groups should receive a statin?

• all people with established cardiovascular disease
• anyone with a 10-year cardiovascular risk >= 10%
• patients with type 1 diabetes mellitus who were diagnosed more than 10 years ago OR are aged over 40 OR have established nephropathy

Why should statins be taken at night?

this is when the majority of cholesterol synthesis takes place