Statins are cholesterol-lowering drugs. Some statins work best in the evening while others work just as well in the morning. The best time to take statins depends on the specific drug.
There are several different types of statin on the market, which the body may process differently. People may need to take some statins at specific times of the day to get the most benefit from them.
In this article, we look at the effects of statins at different times of the day and discuss the best times to take certain types. We also cover side effects and how a person can choose the right statin to suit their needs.
Statins are also called lipid-lowering medications or HMG-CoA reductase inhibitors. They reduce the levels of LDL cholesterol in the blood.
LDL cholesterol, which people sometimes refer to as bad cholesterol, can build up in the arteries and form plaque. This plaque can block blood flow in the arteries, leading to heart attack and stroke.
Statins block an enzyme in the liver that makes cholesterol, which reduces the risk of plaque buildup. Statins may also help the body remove cholesterol that has started to accumulate in the arteries.
Conversely, high-density lipoprotein (HDL), or good, cholesterol can reduce the risk of heart attack and stroke. Doctors consider HDL cholesterol to be beneficial because it can transport other forms of cholesterol from the blood to the liver, which helps the body get rid of bad cholesterol.
Studies have shown that statins are effective in improving a person's cholesterol levels:
- A large-scale 2017 study found that statins can reduce the risk of heart disease by 27 percent by decreasing LDL levels.
- The authors of a 2010 meta-analysis concluded that statins might raise HDL levels, which can further protect a person from heart disease.
- In a 2015 study paper, researchers reported that the effects of statins vary depending on a person's genetic risk factor. These drugs reduced the risk of heart disease by 13 percent in people at low risk, 29 percent in those at medium risk, and 48 percent in the participants whose risk was high.
It is important that a person taking statins follows the advice of their prescribing doctor regarding the time of day to take them. The recommended time, which is something that a person should discuss with their doctor, will vary depending on the type of statin.
A systematic review found that short-acting statins worked best when people took them in the evening. The people who took these statins toward the end of the day had lower total cholesterol and LDL cholesterol levels compared with the people who took them in the morning. Another review came to the same conclusion.
Short-acting statins work better at night because the liver enzyme that produces cholesterol is more active at this time. Most short-acting statins have a half-life of 6 hours. A medication's half-life is the time that it takes for the body to process and remove half of the medication.
Short-acting statins include:
- lovastatin (Mevacor)
- fluvastatin (the standard-release tablet)
- pravastatin (Pravachol)
- simvastatin (Zocor)
It takes longer for the body to process long-acting statins, which may have a half-life of up to 19 hours.
The two reviews above noted that long-acting statins worked equally well whether a person took them in the morning or the evening. Therefore, people taking long-acting statins can choose which time of the day best suits them.
The authors recommend that people using long-acting statins take them at a time of day that is easy for them to remember. It is important to be consistent with the timing of doses, so if a person prefers to take statins in the morning, they should take them in the morning every day.
Long-acting statins include:
People who are taking statins may need to take them indefinitely. In many cases, when a person stops taking statins, their cholesterol levels increase again. People should not stop taking statins without a doctor's approval.
Some people might be able to stop taking statins or reduce their dosage if they significantly lower their risk of heart disease. A person may do this by losing a significant amount of weight, quitting smoking, or making other major lifestyle changes that improve their health. Even in these cases though, a person should talk to a doctor before they stop taking statins or any other medications.
Statins come in a range of types and dosages. A person can discuss with their doctor which type of statin may work best for them. The doctor's recommendation will depend on many factors, including the person's:
- current cholesterol levels
- other risk factors for heart disease
- other medical conditions, such as diabetes
- family history of heart disease
- other medications
If a person has an increased risk of heart disease, their doctor may prescribe a higher dosage or a long-acting statin. Conversely, a person with less risk of heart disease may start on a lower dosage or a short-acting statin.
Recent evidence suggests that many people can benefit from taking statins, even if they do not have high blood cholesterol levels. The American Heart Association say that statins can benefit people who have an average risk of heart disease, especially when they take them in combination with medications to lower blood pressure.
Statins do not cause serious side effects for most people. According to the American College of Cardiology, as many as 90 percent of people taking statins do not experience bothersome side effects. For those who do experience side effects, these may include:
- muscle aches, weakness, or cramps
- constipation or diarrhea
- muscle inflammation, or myositis, which can be serious
- new-onset diabetes, especially in people with other risk factors for diabetes
The Food and Drug Administration (FDA) state that the risk of these side effects is small and that the benefits of statins usually outweigh this risk.
Some reports have warned that statins can cause severe memory loss, but an investigation found inconsistent evidence of this side effect. Another review states that there is evidence to suggest that statins do not affect memory.
In rare cases, a person taking statins may have serious side effects, such as liver damage or an allergic reaction. The following side effects require immediate medical attention:
- upper abdominal pain
- yellow skin or eyes
- dark-colored urine
- unusual bleeding or bruising
- extreme fatigue
- rash, hives, or itching
- swelling of the face, lips, tongue, eyes, or throat
- difficulty speaking
Statins can interact with some medications. People who take statins will need to make their doctor aware of any medicines, vitamins, herbs, or other supplements that they take to help prevent dangerous interactions.
Statins may also interact with grapefruit and grapefruit juice. Therefore, it is important to avoid eating grapefruit or drinking grapefruit juice while taking statins unless a doctor says it is safe.
People who have a higher risk of heart disease can work with a doctor or nutritionist to modify their diet. In many cases, a medical professional is likely to advise the person to eat a diet that is low in cholesterol and saturated fat, free of trans fats, and rich in fruits and vegetables.
In addition, a person may need to increase their weekly exercise and work toward a healthy weight. In this way, they can further lower their risk of heart disease.
Smoking is a significant risk factor for heart disease. A doctor may advise a person to get help with quitting if they do smoke.
Whether or not they are taking statins, people can help keep their cholesterol in check by maintaining a healthy weight, exercising regularly, and eating a healthful diet that contains plenty of fruits and vegetables.
Doctors have been prescribing statins for more than 30 years, and these medications are generally safe and effective with a low risk of serious side effects.
Short-acting statins are most effective when a person takes them at night, but a person can take long-acting statins at any time of the day. The most important point to remember is to take them every day, ideally at the same time.
As with any medication, a person should take it according to their prescription. They should also tell a doctor if they notice any side effects.