Q: I am a 53 years old male, have elevated cholesterol for the last 15 years. Without medicine the readings are Total Cholestrol - 164 mg/dl, LDL - 170 mg/dl, HDL - 45 mg/dl. For the last 3 years, I have been taking FIBROVAS (Finofibrate and Atorvastatin) tablet. With it my total cholesterol came down to 165 mg/dl and LDL to 120 mg/dl. For last one year, I am taking it on alternate days and my cholesterol reading is at 180 mg/dl and LDL at 130 mg/dl. It has been reported that taking statins for long term basis causes serious side effects. Kindly guide me if I should take this medicine regularly or should I take 1-2 months break in between to the reduce side effect without any effect on cholesterol readings.

A:Statins include the following drugs lovastatin, pravastatin, simvastatin, fluvastatin, and rosuvastatin including atorvastatin, which you are taking.

Statins are used to prevent heart attacks, prevent strokes, to lower cholesterol and other harmful types of cholesterol in the body. Good cholesterol (HDL) levels increase. This medicine is used to decrease triglycerides and to slow the progress of heart disease. One of the reason heart disease's in western world is steadily going down is because of the use of Statins along with Aspirin.

Statins have fewer side effects than other cholesterol-lowering medications. It is important to closely follow the dosing instructions for when to take statins; some are more effective when taken before bedtime while others should be taken with a meal.

Side effects includes headache, belly pain. Diarrhea, muscle weakness, joint pain and rarely they can affect liver. Liver function test should be checked on a 6 monthly basis. In case you get muscle pain (mainly in the thigh and shoulder) then stop this medication get your CPK done and contact your doctor. Most of these side effects are reversible even if they occur.

Long term safety data is excellent and the beneficial effect outweighs the side effects. For lowering cholesterol, you can take only atrovostatin rather than taking both fenofibrate and atrovastatin as fenofibrate is mainly used to lower triglyceride level.

Statins should be taken on a daily basis and not on alternate days.