What Is Considered a Low-Dose Statin?
Medically reviewed by Femi Aremu, PharmD
Statins are a class of medications used to treat hypercholesterolemia (high cholesterol). They primarily work by lowering the "bad" type of cholesterol in your blood, called LDL cholesterol.
Statins are classified not only by the type of drug they contain—such as atorvastatin and lovastatin—but also by how much of the drug they contain. Based on the amount per dose, the statin drug may be classified as being low-dose, moderate-dose, or high-dose.
Low-dose statins can benefit many people with high cholesterol. The aim is to reduce cholesterol using the lowest possible dose. This, in turn, reduces the risk of side effects.
This article explains what low-dose statins are, how and when they are used, and how effectively they lower cholesterol and the risk of heart disease.
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What Are Statins?
Hypercholesterolemia is defined as having total cholesterol greater than 200 milligrams per deciliter of blood (mg/dL).
The two main types of cholesterol are "bad" low-density lipoprotein (LDL) cholesterol which can build up in arteries and "good" high-density lipoprotein (HDL) cholesterol which helps remove bad cholesterol from the body.
Statins work by slowing cholesterol production in the liver, thereby lowering LDL levels. This, in turn, reduces the risk of atherosclerosis, heart attack, and stroke.
Statins are categorized as being either low-, medium-, or high-intensity. There are currently four classified as low-intensity:
Drug | Low-Intensity | Moderate-Intensity | High-Intensity |
Crestor (rosuvastatin) | Not available | 5-10 mg | 40-80 mg |
Lescol (fluvastatin) | 20-40 mg | 40 mg twice daily | Not available |
Lipitor (atorvastatin) | Not available | 10-20 mg | 40-80 mg |
Livalo (pitavastatin) | Not available | 1-4 mg | Not available |
Mevacor (lovastatin) | 20 mg | 40-80 mg | Not available |
Pravachol (pravastatin) | 10-20 mg | 40-80 mg | Not available |
Zocor (simvastatin) | 10 mg | 20-40 mg | Not available |
Low-dose statins may be ideal for those who are unable to tolerate higher doses. Even at lower doses, statins may be just as effective in lowering LDL levels.
Benefits of Low-Dose Statins
Low-dose statins help manage cholesterol by reducing LDL and increasing HDL. Statins are the most effective treatment option for lowering cholesterol.
They also aid in reducing cardiovascular disease risk by lowering cholesterol levels. Doing so reduces the amount of fat buildup in the arteries.
Research suggests that there may be some non-cholesterol benefits associated with statin use, such as improving outcomes related to atrial fibrillation (AFib) following heart surgery, chronic obstructive lung disease (COPD), acute respiratory distress syndrome (ARDS), and pneumonia.
Some studies also suggest that statins can help prevent dementia in older adults.
Recommendations for Use
Clinical studies support the benefits of low-dose statins, particularly for older adults. A 10-year study published in the Annals of Internal Medicine reported that low- to moderate-intensity statins reduced LDL levels even more effectively in older adults than younger adults.
Based on these and other findings, the U.S. Preventive Services Task Force (USPSTF) recommended low-dose statins as the preferred, first-line treatment for certain adults.
According to the USPSTF, low- or moderate-dose statins should be used in adults 40 to 75 who haven't had a heart attack or stroke but have at least one risk factor for heart disease (such as diabetes, high blood pressure, or smoking) and a calculated 10-year risk of heart disease of at least 7.5%.
Conditions Treated With Low-Dose Statins
High levels of LDL correlate with a higher risk of plaque buildup in the arteries. Low-dose statins can prevent a primary or secondary heart event such as heart attack and stroke by lowering the LDL.
In addition to lowering cholesterol, statins decrease vasculitis (blood vessel inflammation), manage plaque buildup, and prevent blood clots.
Through various pathways, statins can even lower blood pressure, especially in those with high blood pressure who are on stable blood pressure lowering therapy.
Statins are currently only approved to treat cholesterol and prevent heart disease. Nonetheless, more research is needed to determine if other conditions can be treated with low-dose statins.
Some healthcare providers may use low-dose statins off-label to treat some inflammatory and neurologic conditions.
Managing Low-Dose Statin Therapy
Because no symptoms are associated with high cholesterol, regular check-ups, and blood tests can help identify the condition proactively.
Your healthcare provider, however, can check your cholesterol levels through a blood test called a lipid panel.
Cholesterol monitoring should begin at 9 years old and continue every four to six years in healthy people with no complications. Your health history will determine whether you should check your cholesterol more frequently.
Older adults and people with risk factors such as heart disease and diabetes should have their cholesterol checked more often.
Routine monitoring is essential because it detects elevated cholesterol levels, allows time for intervention and treatment if necessary, and assists healthcare providers in determining if you are at high risk for other conditions.
Role of Diet and Exercise
Pursuing a healthy, balanced diet and engaging in physical exercise are important practices that can improve your cholesterol and lower your risk of heart disease.
Adding heart-healthy foods such as fruits, vegetables, whole grains, beans, and seafood is recommended.
Additionally, finding ways to become more active and increase physical activity will play an important role in lessening the severity of heart disease.
Side Effects and Safety
Statin therapy is safe, and low-dose statins are typically well tolerated.
Low-dose statins are recommended when people experience side effects on higher statin doses.
The most common side effect associated with low-dose statin use is muscle pain.
Common Side Effects
Some common side effects associated with the use of low-dose statins include:
Severe Side Effects
A rare but severe side effect associated with the use of low-dose statins is rhabdomyolysis, which results in a painful breakdown of the muscle and often results in dehydration and requires immediate discontinuation of statin therapy.
Moreover, liver and kidney dysfunction can occur long-term on high statin doses.
Safety for At-Risk Populations
Statins should not be used in pregnant or nursing people.
Statins are pregnancy Category X, meaning they have shown evidence of human risk in clinical trials. Statin use can cause harm and should be avoided during pregnancy as the risks of using the medication outweigh the benefits.
This warning also applies to people who are breastfeeding.
Low-dose statins are safe and approved for use in children. However, lifestyle management should typically be considered first before prescription.
Low-dose statins are safe for older people, but individual risk should be evaluated to determine if there is a benefit.
Low-dose statins are often better tolerated by older individuals (people generally 65 years and older) but should be used with caution regardless of age range.
Summary
Low-dose statins are set apart by their dose and LDL-lowering effect. Low-dose and non-low-dose statins can significantly reduce LDL.
Low-dose statins are used to help manage cholesterol and improve long-term cardiac outcomes. They also provide therapy options to people who may not be able to tolerate higher statin doses.
Low-dose statins are specifically recommended for adults 40-75 years old who are at risk of having a heart attack or stroke. Zocor (simvastatin), generic pravastatin, and generic lovastatin are commonly used low-dose statins.
Statins at all doses should be avoided in pregnant or breastfeeding people due to fetal risk.
If you have questions regarding your cholesterol or if you should be taking a low-dose statin, discuss your treatment options with your healthcare provider.
Frequently Asked Questions
How should orally administered low-dose statins be stored?
Low-dose statins should be stored in a secure, dry area at room temperature (68–77 degrees F). Do not store low-dose statins in an area susceptible to high levels of heat or moisture, such as a bathroom.
Finally, if applicable, keep all medications out of reach of children and pets.
Can statins cause memory loss or diabetes?
There is no clear evidence to support the claim that statins cause memory loss. However, the Food and Drug Administration (FDA) updated statin drug labels to include a warning that memory loss and confusion have been reported with statin use.
In comparison, research suggests that the risk of statins causing diabetes is low and primarily associated with high-dose statins. As such, the benefits of low-dose statin therapy far outweigh the perceived risks in people with diabetes.
How quickly should I expect my low-dose statin to begin working?
Cholesterol levels should improve within two months of starting a statin or increasing the dose.
Read the original article on Verywell Health.
