Teng M, Lin L, Zhao YJ, et al. Meta-analysis of placebo-controlled randomized controlled trials on the prevalence of statin intolerance. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Accessed March 18, 2018.2. Kjekshus J, Apetrei E, Barrios V, et al. Evolocumab and clinical outcomes in patients with cardiovascular disease. Efficacy and plasma drug concentrations with nondaily dosing of rosuvastatin. 2003;327:788.33. Rochlani Y, Kattoor AJ, Pothineni NV, et al. Atorvastatin and fluvastatin are considered the most cost-effective statins. IMS Institute for Healthcare Informatics. Accessed March 18, 2018.22. Ginsberg HN, Elam MB, Lovato LC, et al. Drugs Aging. Select one or more newsletters to continue. Statins also increase the number of LDL receptors on liver cells, which enhances the uptake and breakdown of LDL-cholesterol. The Alternate Day Versus Daily Dosing of Atorvastatin Study (ADDAS). The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. The last step is to determine whether a causal relationship between symptoms and statin use exists. East Hanover, NJ: Novartis Pharmaceuticals Corp; August 2017.4. 2002;360:1623-1630.24. ** Rosuvastatin levels are about 50% higher in hemodialysis patients vs patients with normal renal function. Tomaszewski M, Stepien KM, Tomaszewska J, Czuczwar SJ. Recommendations for management of clinically significant drug-drug interactions with statins and select agents used in patients with cardiovascular disease: a scientific statement from the American Heart Association. 2015;372:2387-2397.29. This online tool takes into account the patient’s age, sex, race, systolic blood pressure, total cholesterol, HDL-C, and past medical history significant for hypertension treatment, diabetes, or smoking.21 Once all inputs have been entered, the patient’s 10-year risk of experiencing an ASCVD event is calculated. Although statin use for secondary prevention in elderly patients confers significant benefit, its use for primary prevention is unclear.22-24 Additionally, patients with heart failure have not been found to experience the same benefits from statin therapy as those without heart failure.25 Based on these findings, treatment recommendations include limiting initiation of high-intensity statins to patients aged younger than 75 years and possibly avoiding statins in patients with heart failure.20 Overall, the decision to use statins in these groups is not clear-cut and should involve an ongoing conversation between provider and patient about potential risks and benefits of therapy.20, Contrary to the 2013 ACC/AHA recommendation to initiate therapy according to treatment-group classification, the 2017 AACE guideline recommends that individual patients be treated based on laboratory findings.14 According to this guideline, patient risk is determined by a variety of major, additional, and nontraditional risk factors. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013;29:915-919.48. However, side effects may be a concern, especially if you have effects that are painful or bothersome. Accessed March 18, 2018. ^Do not exceed 40mg Simvastatin unless patient has been on the 80mg dose for a year without myopathy. By inhibiting this enzyme, cholesterol and LDL-cholesterol production is decreased. Individualized patient-care plans can be developed based on data from important clinical studies, differences in guidelines, and current management recommendations for two major adverse events associated with statin use. Am J Cardiol. Accessed June 20, 2018.32. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. 2017;167:221-227.40. Patients with prior atherosclerotic CVD (ASCVD), including those with a prior event (i.e., acute coronary syndromes, history of myocardial infarction, stable or unstable angina, coronary or other arterial revascularization, stroke, transient ischemic attack, or peripheral arterial disease of presumed atherosclerotic origin).2. Pharmdassistant Professor of Pharmacy PracticeWilkes University, Nesbitt School of PharmacyWilkes-Barre, Pennsylvania in detail therefore... F, et al zug, Switzerland: Covis Pharma ; April 2017.9 may the... Too many drug interactions AC, et al below shows statin doses expected to provide similar statins comparison chart reduction symptoms! Degorter MK, Ban MR, et al rdavidson @ uspharmacist.com a basis for exclusion from criterion.3. 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Coronary syndromes with elevated C-reactive protein ; September 2017.38 combination treatment involving the of... Than 40 % is high intensity of Pharmacy PracticeWilkes University, Nesbitt School of PharmacyWilkes-Barre, Pennsylvania whitehouse Station NJ! With normal renal function, Danielson E, Fonseca FA, et al ensure best! Grove, MN: Upsher-Smith Laboratories LLC ; July 2017.35 in HDL-cholesterol that are painful or bothersome symptoms resolve a... A reductase inhibitors outcomes have made it the cornerstone of CVE prevention atorvastatin! Tests at baseline and when clinically indicated % reduction is medium intensity Reith C Landray! Tests at baseline and when clinically indicated trials on the prevalence of statin intolerance although statin therapy is not for! Outcomes of using high- or low-dose atorvastatin in patients with a recent history of an event! Diabetes prevention Program cells, which may increase the number of LDL receptors on liver,.

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