Statins are the most widely prescribed medication in the U.S. today. You may have been prescribed a statin if your doctor told you that you have high cholesterol. These drugs have been around for decades, and are well known as a first-line therapy for the management of high cholesterol, particularly, low-density lipoprotein cholesterol (LDL-C), or ‘bad cholesterol’.
Statins, while taken by millions of Americans each year, are not without their risk of side effects. The most commonly reported side effects for statin medication are various forms of muscle pain, muscle cramps and/or muscle weakness. In real-world practice, statin side effects have been reported up to 20% of the time.
What causes statin muscle pain?
Statin side effects are not well understood. What we do know is that the risk of statin side effects increase as the dose of the statin increases. As a rule of thumb, the higher the dose of statin you take, the higher the concentration of statin in your blood. This leads to a higher risk of a side effect such as muscle pain.
The concentration of statin medication circulating in your blood depends on quite a few factors, including:
- Other medications you are taking: Statins can interact with other medications. Be sure to tell your doctor about any and all over-the-counter products, supplements, and prescription medications you are currently taking.
- The time of day you take your statin: Some statins need to be taken in the evening. This is because the cholesterol-making enzyme in our body is more active at night. Because some statins are removed by our body very quickly, you may need to take your statin in the evening to ensure the best results. Newer statins, like pitavastatin, tend to be more stable in our bodies and as a result, can be taken at anytime of the day.
- Taking a statin with or without food: Food intake can change the availability of statins. Some statins need to be taken with a meal, whereas others should be taken on an empty stomach. Pitavastatin can be taken with or without food.
Why do statins interact with food we consume?
One of the first lessons they teach doctors in medical school is that drugs can interact with other drugs as well as foods and nutritional supplements. Drug interactions are something doctors want to avoid for their patients, as they can increase the risk of side effects.
A notable interaction most people don’t think about is with grapefruit juice. So why is this a problem for some statins?
Well, the problem occurs when someone drinks grapefruit juice in combination with some of the first-generation statins. What this does is block the CYP3A4 enzyme in your liver, preventing your body from processing the statin in the normal way. This results in a very large increase in the concentration of statin in your blood, and as alluded to earlier, too much statin in your blood increases your risk of side effects.
Newer Statin Medications Are Available
The good news is that there are now newer statins available in the U.S., including Zypitamag (pitavastatin). Zypitamag is a third-generation statin. It’s unique in that is bypasses the common pathways used by the liver for statin metabolism. This means it won’t interact with grapefruit juice and has a reduced potential to interact with other medications you may also be taking!
Zypitamag has been shown to reduce LDL-C, or ‘bad cholesterol’ by 45%. It should be taken once daily, with or without food, at the same time each day. Click to learn more about Zypitamag (pitavastatin).
This article contains information about an FDA-approved product, Zypitamag (pitavastatin) tablets. This medication is available by prescription only. Talk to your doctor to see if Zypitamag is right for you. Please refer to the Zypitamag (pitavastatin) tablets Important Safety Information below and Prescribing Information for more information.
IMPORTANT SAFETY INFORMATION for ZYPITAMAG® (pitavastatin) tablets
Who should NOT take ZYPITAMAG?
ZYPITAMAG is not right for everyone. Do not take ZYPITAMAG if:
- You have a known allergy to ZYPITAMAG or any of its ingredients.
- You have active liver problems, including some abnormal liver test results.
- You are nursing, pregnant or may become pregnant, as it may harm the baby.
- You are currently taking cyclosporine or gemfibrozil.
What is the most important information I should know and talk to my doctor about?
- Call your healthcare provider or get help right away if you experience any symptoms of an allergic reaction, such as rash, itching, or hives.
- Muscle problems may be an early sign of rare, serious conditions. Tell your doctor right away if you have any unexplained muscle pain, weakness, or tenderness, particularly if accompanied by malaise or fever, or if these muscle signs or symptoms persist after discontinuing ZYPITAMAG.
- Serious liver problems have been reported rarely in patients taking statins, including pitavastatin. Your doctor should do liver tests before you start, and if you have symptoms of liver problems while you are taking ZYPITAMAG. Tell your healthcare provider right away if you feel more tired than usual, have a loss of appetite, upper belly pain, dark-colored urine, or yellowing of the skin or eyes.
- Tell your doctor about all your medical conditions and medications you take including nonprescription medicines, vitamins, or herbal supplements.
- Increases in blood sugar levels have been reported with statins, including pitavastatin.
- Tell your doctor about your alcohol use.
- Tell your healthcare provider of a known or suspected pregnancy.
What are the most common side effects of ZYPITAMAG?
The most common side effects of ZYPITAMAG in clinical studies were:
- Back pain
- Muscle pain
- Pain in the legs or arms
This is not a complete list of side effects. Talk to your healthcare provider for more information.
You are encouraged to report negative side effects of all drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
How should I store and take ZYPITAMAG?
- Store ZYPITAMAG tablets at room temperature, in a dry place, and out of the reach of children.
- Take ZYPITAMAG orally once daily with or without food at the same time each day.
- Swallow the tablet whole. Do not split, crush, dissolve, or chew.
- The maximum recommended dosage is ZYPITAMAG 4 mg once daily.
- If you take too much ZYPITAMAG or you or someone else takes an overdose, call your doctor and/or local Poison Control Center.
Other important information I should know about ZYPITAMAG.
- ZYPITAMAG has not been studied to evaluate its effect on reducing heart-related disease or death.
- ZYPITAMAG is available by prescription only.
For additional information, please see the full Prescribing Information.