Statins/HMG-CoA Reductase Inhibitors

What are Statins/HMG-CoA Reductase Inhibitors?

Statins work by lowering the level of cholesterol or other fats in the blood. They may also reduce the amount of cholesterol made in the liver. Statins are used in addition to a medically recommended and carefully supervised diet for the long-term treatment of high cholesterol. Statins have been shown to decrease the chances of heart attack and stroke by preventing too much cholesterol from building up and blocking the arteries.

There are different kinds of statins, for example atorvastatin and pravastatin. You may also hear these statins called by their brand names, Lipitor (Atorvastatin) or Pravachol (Pravastatin). Statins come in tablet forms.

Before giving Statins/HMG-CoA Reductase Inhibitors to your child

Tell your child's doctor if your child has:

• An allergy to statins

Talk with your child's doctor or pharmacist if your child has any of the following conditions. Precautions may need to be taken with this medicine if your child has:

• A family history of muscle disorders
• Liver disease or unexplained increases in liver enzymes
• Kidney disease
• Diabetes
• Thyroid disease
• Is or may become pregnant

How should you give your child statins/HMG-CoA Reductase Inhibitors?

• Give this medication regularly, exactly as your doctor or pharmacist tells you.
• Statins may be given with or without food. Taking with food may help reduce stomach upset.
• Give your child the statin at around the same time every day to avoid missing doses. Usually this is done in the evenings.
• Your child's doctor may start your child on a low dose of statin and gradually increase the dose, not more than once every 2–4 weeks.
• Do not stop this medicine without talking to the doctor first.

What should you do if your child misses a dose of Statins/HMG-CoA Reductase Inhibitors?

• Give the missed dose as soon as you remember.
• If it is almost time for the next dose, skip the missed dose. Give the next dose at the regular time.
• Do not give your child two doses to make up for one missed dose.

How long does this medicine take Statins/HMG-CoA Reductase Inhibitors to work?

Statins produce their cholesterol-lowering effect over a period of weeks or months. How well they work also depends on how well your child follows dietary advice given by their doctor.

What are the possible side effects of Statins/HMG-CoA Reductase Inhibitors?

Your child may have some of these side effects while they take statins. Check with your child's doctor if your child continues to have any of these side effects, if they do not go away, or if they bother your child:

• Stomach pain or upset
• Constipation
• Diarrhea
• Nausea
• Loss of appetite
• Vomiting or throwing up
• Heartburn
• Headache
• Trouble sleeping
• Depression

Call your child's doctor during office hours if your child has any of these side effects:

• Unexplained muscle pain, muscle tenderness or weakness

Most of the following side effects are not common, but they may be a sign of a serious problem. Call your child's doctor right away or take your child to Emergency if your child has any of these side effects:

• Shortness of breath
• Fevers, chills
• Flu-like symptoms
• Generalized weakness, especially if your child feels unwell
• Dark urine
• Yellowing of the skin or eyes
• Pain in the upper right part of the stomach
• Unusual bleeding or bruising
• Rash, hives or itching
• Difficulty breathing or swallowing
• Facial swelling or swelling anywhere else

What safety measures should you take when your child is using Statins/HMG-CoA Reductase Inhibitors?

• Avoid drinking grapefruit juice with statins. Grapefruit juice may increase blood levels of statins and increase the risk of side effects. Check with the pharmacist or doctor about other fruit juices to avoid.
• If your child is having surgery, including dental surgery, inform the doctor or dentist that your child is taking a statin.

There are some medicines that should not be taken together with statins, or in some cases the dose of the statin or the other medicine may need to be adjusted. It is important that you tell your doctor and pharmacist if your child takes any other medications (prescription, over the counter or herbal) including:

• Corticosteroids (prednisone, dexamethasone)
• Immunosuppressants (cyclosporine, tacrolimus, sirolimus)
• Other cholesterol-lowering medications (fibrates, niacin)
• Heart medications (diltiazem, digoxin)
• Antibiotics (erythromycin, clarithromycin)
• Azole antifungals (ketoconazole, voriconazole or itraconazole)
• Antivirals (nelfinavir, ritonavir, efavirenz)
• Rifampin
• Antacids

What other important information should you know about Statins/HMG-CoA Reductase Inhibitors?

• While your child is on a statin, his or her doctor may order regular blood tests to check for changes to liver enzymes.
• Keep a list of all medications your child is on and show the list to the doctor or pharmacist.
• Do not share your child's medicine with others and do not give anyone else's medicine to your child.
• Make sure you always have enough statins to last through weekends, holidays, and vacations. Call your pharmacy at least 2 days before your child runs out of medicine to order refills.
• Keep statins at room temperature in a cool, dry place away from sunlight. Do NOT store it in the bathroom or kitchen.
• Do not keep any medicines that are out of date. Check with your pharmacist about the best way to throw away outdated or leftover medicines.
  

Keep statins/hmg-coa reductase inhibitors out of your child’s sight and reach and locked up in a safe place. If your child takes too much statins/hmg-coa reductase inhibitors, call your local Poison Information Centre at one of these numbers. These calls are free. 

• Call 1-844 POISON-X, or 1-844-764-7669, from anywhere in Canada except Quebec.
• Call 1-800-463-5060 if you live in Quebec.