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Nowadays, statins have an irreplaceable role in reducing blood lipids and primary and secondary prevention of coronary heart disease. Although statins have the reputation of “safety” and “efficiency”, they still need to be ruled when applied.

I. There are rules for statin types

There are many types of statins, and statins currently on the market include simvastatin, lovastatin, pravastatin, fluvastatin, atorvastatin, and rosuvastatin. Different types of statin drugs are usually used in different oral doses. Different manufacturers have different specifications for the same statin. When changing the type and manufacturer of statins, be sure to pay attention to the specifications and dosage of the drugs.

 

II. When to use drugs with rules

Statins are less affected by food. Eating has little effect on the drug, and statins have no serious gastrointestinal adverse reactions. Therefore, as long as they are regularly dosed, they can be taken before or after eating.

Most statins are best taken before going to bed at night, because the peak of cholesterol synthesis is around 12 o’clock in the middle of the night, and the medication before going to bed can make the drug reach the peak at midnight, thus achieving better cholesterol-lowering effect. Atorvastatin and rosuvastatin can be taken at any time of the day because of their long half-life.

If you miss the medication time, you should make it up immediately when you remember it. If you are close to the next medication time, you don’t need to make up the supplement. Do not use double dose once.

 

III. There are rules for elevated liver enzymes

In general, patients taking statins are safe and effective, but a small percentage of patients will have elevated liver transaminases after taking statins. For patients with mild to moderate aminotransferase abnormalities, if they have severe liver disease such as active hepatitis, they should not be treated with statins. If the patients have non-alcoholic fatty liver, the application of statins is not only safe and effective, but also improves liver function. Therefore, for patients with statin indications, if there is no evidence of organic liver damage such as hepatomegaly, jaundice, and elevated direct bilirubin, statins should be actively and fully used. After taking the statin, as long as the patient does not have a progressive increase in transaminase (≥ 3 times the upper limit of normal), continue taking the drug.

 

IV. There are rules for myalgia response

Muscle soreness is one of the common adverse reactions of statins. According to whether the creatine kinase (CK) value is normal, it can be divided into myositis and myalgia. If CK is greatly increased, it may be rhabdomyolysis, and even serious. life threatening. When a patient applies statin, as long as there is a symptom of suspected muscle discomfort, he should immediately stop taking the medicine and seek medical advice in time to avoid delaying the illness.

 

V. There are rules for joint use

Combination therapy is an important risk factor for liver damage and muscle toxicity caused by statins. If you take azithromycin, amiodarone, roxithromycin, fenofibrate and other liver drug enzyme inhibitors at the same time, the blood concentration of statins can be increased, increasing the probability of adverse reactions.

Some patients have a large increase in triglycerides and need to take fenofibrate and statin at the same time. They can take fenofibrate in the morning and take statins before going to bed at night, which can greatly reduce the incidence of adverse reactions. .

Do not overdose grapefruit or grapefruit products during statin use, which can delay the metabolism of statins and induce adverse reactions.

 

VI. Lifestyle has rules

While taking statins, you should also pay attention to improving lifestyle, low-salt and low-fat balanced diet, and reducing cholesterol intake. In addition, moderate exercise is also very recommended.

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