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STATINS

Statins are cholesterol-lowering agents that consistently rank among the most commonly prescribed drugs. Their use has long been associated with decreased mortality rates in various groups. A meta-analysis even found that treatment with statins was associated with reduced risk for a severe or fatal course of COVID-19. Although highly effective and safe for most individuals, the medications have been linked to some significant adverse effects and have important considerations for use.
Are you familiar with key clinical aspects of STATIN use, including adverse effects and contraindications, as well as recommendations for prescribing?
1.Statin use for primary prevention has been associated with decreased risk for cardiovascular events and cardiovascular-related death in individuals older than 70 years
2. Atorvastatin is among the most commonly prescribed medications in its class. ARTHRALGIA(Arthralgia literally means joint pain. Specifically, arthralgia is a symptom of injury, infection, illness, or an allergic reaction to medication) is typically considered the most common adverse event.
3. Active hepatic disease is considered a contraindication to statin use
4. For patients aged 20-75 years with a low-density lipoprotein cholesterol (LDL-C) level ≥ 190 mg/dL, maximally tolerated statin therapy is recommended
5. Drugs that have the most significant interaction with statins: Coadministration of cytochrome P450 3A4 (CYP3A4) substrate statins (eg, atorvastatin, lovastatin, simvastatin) with medications that inhibit CYP3A4 (eg, erythromycin, diltiazem, the azoles) can lead to increased serum concentrations and result in a higher risk for adverse effects.
Source: Mary L. Windle, PharmD, May 2021
Author
Paddy Kalish OD, JD and B.Arch

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