The Truth About Statin Safety

How much alcohol can I drink while taking statins?

There are no guidelines prohibiting alcohol consumption while taking statins, but Dr. Desai suggests discussing your typical weekly alcohol intake with a healthcare professional before starting medication.

There is no absolute contraindication to alcohol consumption when taking a statin, but it is important to drink within the recommended limit of 14 units per week, thus ensuring alcohol-free days by distributing drinks on three or more days during the week, she says.

However, you need to be a little careful about grapefruit juice or consuming these fruits. This may seem unusual, but grapefruit can actually react with certain statins, causing severe muscle or joint pain. You should avoid them completely if you are taking simvastatin, while consumption should be minimized when taking atorvastatin. Other statins are not known to react with grapefruit.

Is there an alternative to statins?

For those wondering if they will be able to tolerate statins, there is a much wider range of cholesterol-lowering alternatives than ever before.

The most widely used are PCSK9 inhibitors, a class of drugs that includes drugs like inclisiran, alirocumab, and evolocumab, and which have been shown to reduce LDL cholesterol by about 50 to 60 percent. a hundred or more.

PCSK9 inhibitors reduce the activity of a protein called PCSK9 that normally blocks cholesterol receptors in the liver. By inhibiting this protein, the receptors are able to continue extracting cholesterol from the blood.

These drugs are usually used as an add-on treatment for people whose cholesterol levels do not fall sufficiently with statins or who are intolerant to statins, says Sir Nilesh.

Dr. Wamil explains that while these injections tend to be well tolerated by patients, the downsides are that not everyone likes having to receive regular injections and that these injections cost health care providers more. Their effectiveness compared to statins depends on each individual’s specific health conditions, she says.

Should I take statins?

Ultimately, whether a person should start taking statins depends a lot on their individual health.

For anyone, the risk is a third lower with a statin, says Dr Iqbal Malik, consultant cardiologist and medical director of One Welbeck Heart Health in London. If your risk is close to zero, it’s not worth it, but if your risk is very high, it’s definitely worth it.

Sir Nilesh Samani says statin treatment should always be the result of a shared decision-making process between cardiologist and patient, and a two-way conversation about disease risk and the relative benefits the drug might offer them. .

There’s always a balance between trying to reduce the overall number of heart attacks and strokes and the issue of medicalizing more of the population, he says. It is therefore an individual and shared decision-making process. If the patient is a frail 85-year-old with several other health problems, a statin may not be the right solution. But if they have a family history of the disease and a 10 percent risk of having a stroke in the next decade, most doctors say the benefits are probably there.