Lipid-lowering agents (statins)
- First-line LDL lowering / ASCVD prevention
- Atorvastatin/rosuvastatin: high-intensity tools
- Proven MI/stroke/mortality benefit
- Myalgia common; rhabdomyolysis rare
- Small diabetes-risk increase
- CYP3A DDIs: simvastatin/lovastatin
- Add ezetimibe/PCSK9 if LDL remains high
Class at a glance
- First-line LDL lowering / ASCVD prevention
Pharmacology
- CYP3A DDIs: simvastatin/lovastatin
Members / distinctions
- Atorvastatin/rosuvastatin: high-intensity tools
- Proven MI/stroke/mortality benefit
- Myalgia common; rhabdomyolysis rare
- Add ezetimibe/PCSK9 if LDL remains high
Safety / monitoring
- Small diabetes-risk increase
Pearls
- Routine CK and liver tests unnecessary; check CK if severe symptoms
- No link to cognitive decline, depression, or neuropathy
- Short-acting statins (simvastatin, lovastatin) work best taken in the evening
- Stop 1–2 months before planned conception unless high risk
- All available as inexpensive generics
Self-check
- Which drug class is first-line for LDL lowering / ASCVD prevention?
Lipid-lowering agents (statins).
- Which statins are high-intensity tools?
Atorvastatin and rosuvastatin.
Drugs in this class (7)
Lipid-lowering agents (statins) prescription history
Animated chart of estimated U.S. prescriptions per year, Lipid-lowering meds (1955–2026). Statins highlighted from 1987.
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