Statin Adverse Effects

The statin drugs are known by their trade names as well as their generic names. For example the cholesterol lowering drug Lipitor is also known by its generic name atorvastatin; Mevacor is also know as lovastatin, Zocor is also known as simvastatin; Pravachol is also known as pravastatin; Lescol is also known as fluvastatin, Baycol is also known as cerivastatin and Crestor is also known as rosuvastatin.

In addition some statins have recently been combined with other chemicals, for example Vytorin is nothing but Zocor combined with Zetia (ezetimibe) and Advicor is nothing but Mevacor combined with Niacin, an old cholesterol fighter plagued with the irritating side effect of facial flushing.

I receive many reports of people switched from Zocor to Vytorin for muscle pain with neither the patient nor the doctor suspecting that Vytorin may only aggravate the condition. Vytorin now has the dubious distinction of causing the greatest number of adverse statin drug reports to me.

The statin class of drugs is also known as HMG-CoA reductase inhibitors, short for 3-Hydroxy-3-Methyl-Glutaryl Coenzyme A reductase inhibitors. The reader will not be comforted to know that different countries have different names for their statin drugs and many statins will become combined with other chemicals in the near future and assume even different names.

Many people wonder why their physicians have such a difficult time believing that their physical problems might be an adverse effect of the statin they are taking. Strangely enough the answer is mostly economic and the result of years of subtle brainwashing of the medical community, many of whom are now their staunchest allies. Statins are now the most widely prescribed of all prescription drugs, making them very big business.

The Wall Street Journal Online, in a June 13, 2003 article, "As Drug Sales Teams Multiply, Doctors Start to Tune them Out; 'Arms Race' by Pfizer and Rivals Boosts Pill Prices, Ire, but No One Dares Retreat", reported that Pfizer's sales of Lipitor alone were $8 BILLION for the year 2002. That is just for Lipitor alone. The article states that in 2002 the drug companies spent over $12 Billion on their sales forces.

According to the article, "Last year, a few Pfizer reps brought along a guest speaker who was both a doctor and lawyer to a lunch meeting with doctors at Clinical Associates, a group practice in suburban Baltimore. He said they risked being sued if their patients didn't reach their cholesterol goals". Doctors are the ones who are primarily targeted by the advertising blitz to make the expectations of increased sales come true. In addition, consumers are marketed to directly with commercials and ads.

Doctors are very busy, and they are inundated with positive statin spin. They may think that, since everyone is taking it, if there were problems they would have heard about it. They may not take the time to dig out negative information, and there are no major sponsors to fund equal time for negative reports. Only in 2002 did the Journal of the American Medical Association begin annotating publications with the author's ties to the company studied, citing potential conflict of interest.

The British Journal of Medicine in their May 31, 2003 issue on the theme "Time to untangle doctors from drug companies", ran no less than 6 articles saying that too many of the published drug studies are no more than industry-sponsored infomercials, and cited the selective reporting bias whereby only pro-industry studies are published. These articles were entitled: "Research sponsored by drug companies is biased"; " Drug representatives may increase unnecessary GP prescribing"; "Reporting of clinical trials of drugs shows bias"; "Characteristics of General Practicioners who Frequently see Drug Industry Representatives: National Cross-Sectional Study "; "No more free lunches; Patients will benefit from doctors and drug companies disentangling"; "Information from drug companies and opinion leaders; Double standards in information for medical journals and practitioners should go."


The Canadian CBC News ran a series of consumer articles on March 25, 2003, on the prevalent problem of medical ghostwriting. In this scheme, drug companies write a study favorable to their product and then "reward" a doctor who prescribes the drug by listing his name as the "author" in the publication.

Your physician should look into your physical adverse effects, regardless of suspected cause. Do not permit your physician to put you off when you express a concern. Too many people are reporting long-term, perhaps permanent, damage when statin therapy is continued despite the appearance of adverse effects. In some cases, like rhabdomyolysis, death results.

Oddly, people are reluctant to report doctors who are dubious of reported problems being due to statins, even when the problem is listed by the manufacturer on the Physicians' Information page for the drug. It may help, if you identify your problems with the findings of a published study, to print out a copy and take it with you to the doctor's appointment. That is the purposes for this piece - to give people an additional tool help them to communicate with their doctors.

Addendum:
These articles documenting or speculating on adverse effects of statins are in the vast minority. Hundreds, even thousands, of articles and research have praised statins. Certainly the people with side effects are in the minority, and the anti-inflammatory benefits of statin have been well documented. The reality that statins appear to work independently of cholesterol have been largely ignored but drug companies have been quick to promote statins for their anti-inflammatory efficacy.

Still, the doctors who do attempt to publish about problems associated with statins as currently used in excessive, cholesterol busting doses, are often very bitter: They feel they are up against a tremendous political bias and going against an incredibly powerful industry. Medical journal editors tend to insist that all negative findings be couched in terms of how, overall, the statins are doing tremendous good, and the major studies finding problems with statins have been the subject of a pro-statin editorial in the same journal.

Duane Graveline MD MPH
Former USAF Flight Surgeon
Former NASA Astronaut
Retired Family Doctor


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