"A few days ago, I had a physical examination and found plaque in the carotid artery, and the doctor prescribed atorvastatin and aspirin, but I heard an old friend say that this statin medicine cannot be eaten, and people will die if they eat it, is there such a thing?"
A few days ago, I received a question from a fan, saying that the doctor prescribed atorvastatin, and he didn't dare to take it after taking it for a day, just because of a patient's words, saying that this medicine will kill people. If you ask it carefully, this fan doesn't know anything, he doesn't know why people take statins, and he doesn't know why people died, but he decided that this statin must not be eaten.
To be honest, it's not surprising to encounter such a problem, because there has always been a lot of controversy about statins.
"Taking statins can hurt the liver and cause liver damage"
"Taking statins will hurt the kidneys, and if you don't do it, it will cause kidney failure"
"Eating statins will raise blood sugar and make diabetes"
"Taking statins can damage blood vessels and induce heart disease"
……
Wait, this is really more and more outrageous, and if you continue to talk about it, this statin is estimated to really become a "poison", and it is not surprising to say that it can eat the dead. But is this statin really that scary? Isn't it a cornerstone drug in the cardiovascular field?
Statins are "poison", can they really eat the dead?
As the saying goes, "it is a medicine that is poisonous", although statins are not "poison", they do have certain side effects. For example, transient elevation of aminotransferases and creatine kinase is very common in the early stage of medication, and it may seem to some patients that this is evidence that statins hurt the liver and kidneys, but in fact this is just a normal reaction, as long as the elevation is not serious, it can return to normal on its own. There is also the problem of muscle soreness and increased blood sugar caused by taking statins, which is generally not a big problem, and it can be effectively reversed by stopping losses in time.
However, I am afraid that the patient's own medication method is wrong, and the problem is not found in time, and the consequences will be very serious.
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Case 1: What is wrong with taking statins to cause acute kidney failure?
62-year-old Uncle Li started taking atorvastatin after a mild cerebral infarction, and after taking it for about half a year, he would have muscle soreness from time to time. Later, during a free physical examination for the elderly organized by the community, Uncle Li checked for dyslipidemia and asked the community doctor to take statins.
Uncle Li thought to himself that he had been taking this medicine all along, and his blood lipids were still high, so the dose must not be large enough, and then he went home and found that the maximum dose could be increased to 80mg, and he only ate 10mg, so Uncle Li directly added to the maximum dose. As a result, after Uncle Li ate like this for about a month, he found that his muscles were more sore, he felt weak, his food was not fragrant, and he was always nauseous, until he found that the color of his urine was wrong, like a strong brown color, Uncle Li panicked and hurried to the hospital.
Final findings: rhabdomyolysis, acute renal failure.
The doctor said that if Uncle Li came a few days late, he might be dead. In fact, Uncle Li's mistakes are also obvious, mainly in two points.
One is that he didn't go for regular check-ups, and even after his body had sent out warning signs, he still didn't pay attention to it. In fact, when many patients take statins for the first time, the doctor will clearly warn that they will come for a follow-up examination after a month, which is not only the key to evaluating the effect of the medication, but also the key to timely detection of potential drug side effects and timely stop loss, but Uncle Li ignored this, and even in the case of existing muscle soreness, he still did not go for a follow-up, which led to more and more serious until it developed rhabdomyolysis. This is one of the most serious side effects of taking statins.
The second is to increase the dosage without the guidance of a doctor. After discovering that he had dyslipidemia, Uncle Li increased the dose of atorvastatin to 80mg without authorization, but although this is the maximum dose given in the instructions, the dose is not clinically recommended because of the lack of experience in mainland patients. For mainland patients, experts recommend taking low and medium doses, which is also the best choice given by weighing the pros and cons, for which Lunan Pharmaceutical has also specially developed 5mg rosuvastatin, the purpose is to facilitate the use of Chinese people. Uncle Li took a large dose of atorvastatin when he already had muscle damage, which eventually led to the aggravation of the condition, which deteriorated into rhabdomyolysis and induced acute kidney failure.
In the final analysis, Uncle Li did not listen to the doctor, which led to the final tragedy.
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Case 2: Sudden cerebral infarction after taking statins, what's wrong?
58-year-old Lao Wu first took rosuvastatin because of high blood lipids, and went for a follow-up examination about 3 months after taking it, and the report showed that the blood lipids had reached the standard. However, the doctor told Lao Wu that because he had high blood pressure and plaque in the carotid artery, the lipid lowering requirements should be higher, and this statin must be taken for a long time. Although Lao Wu agreed, he couldn't help muttering in his heart, what do you have to eat for a long time, and let you eat it even though your blood lipids have reached the standard, isn't this just to make more money!
So, after Lao Wu went home, he finished the box of statins prescribed by the doctor, and then never ate it again. It wasn't until some time ago that after the cold weather, one morning, Lao Wu got up as usual and went to the morning exercise, but as soon as he arrived in the small square, he suddenly fell to the ground. By the time he was found and taken to the hospital, he was unconscious. Later, the doctor diagnosed Lao Wu as a sudden cerebral infarction, although he tried his best to save him, but after all, he was unable to return to the sky, and the 58-year-old Lao Wu died like this.
Although Lao Wu's death seems to have nothing to do with statins, if you look closely, it is actually related.
Lao Wu mistakenly thought that taking statins was to lower blood lipids, and when the blood lipids reached the standard, there was no need to take them. As everyone knows, the effect of this statin is far more than lowering blood lipids, but also anti-arteriosclerosis, stabilizing plaques, delaying plaque growth, and preventing cerebral infarction, myocardial infarction and other cardiovascular and cerebrovascular diseases, and this is the purpose of the doctor to let Lao Wu take statins for a long time. Furthermore, for cardiovascular high-risk people like Lao Wu, it is not enough for LDL cholesterol to fall below 3.4mmol/L, at least to below 2.6mmol/L, so the standard shown in the report may not really meet the standard.
Lao Wu's mistake was not to listen to the doctor's words and stopped taking statins without authorization, which eventually led to the occurrence of cerebral infarction.
Reminder again: If you take statins for a long time, you must pay attention to 4 problems!
With the tragedy of the two patients, I would like to remind all patients who are taking statins or who are hesitating whether to take statins or not, they must insist on taking statins and eat them correctly, especially pay attention to the following issues.
1. Find out the purpose of taking your medicine: As mentioned above, statins are not only used to lower blood lipids, but also to prevent cardiovascular diseases. However, for most middle-aged and elderly people, taking statins is to prevent cardiovascular diseases, or patients who have already suffered from cerebral infarction, coronary heart disease, myocardial infarction and other diseases, this statin must be taken for a long time and must not be stopped without authorization.
2. Pay attention to regular re-examination during the period of taking the drug: For patients who take statins for the first time, they must go for re-examination after 1 month of medication, and the re-examination items include the detection of blood lipids, as well as the monitoring of possible abnormal indicators such as aminotransferases, creatine kinase, blood sugar, etc., so as to find problems in time, stop losses in time, and stop the drug if necessary. In addition, patients should also be alert to abnormal physical manifestations during the medication, such as muscle aches, fatigue and discomfort, nausea, etc., which may be side effects of statins, and must seek medical attention in time to prevent it from becoming more serious.
3. Do not adjust the dosage without authorization: the side effects of statins are obviously positively correlated with the dose, the larger the dose, the higher the risk of side effects, and the effect is not obvious with the increase of the dose, so it is recommended for mainland patients to take low-dose drugs, do not take large doses, and do not increase the dosage without authorization, even if you do need to adjust the dose, you must follow the doctor's advice.
4. Be wary of drug compatibility and contraindications: For statins that need to be metabolized by liver CYP3A4 enzymes such as atorvastatin, simvastatin, lovastatin, etc., it is especially necessary to avoid using them with other liver enzyme inhibitors, such as ketoconazole, fluconazole, erythromycin, clarithromycin, warfarin, cyclosporine, amiodarone, etc., should be used with caution. In addition, the combination of furanocoumarin contained in grapefruit will inhibit the activity of this liver enzyme, so it cannot be used together with statins. Of course, you can't drink alcohol when taking statins, and you can't eat high-fat and high-cholesterol foods, which are very basic requirements.