Everything You Need to Know About Starting a Statin

High cholesterol is a huge deal—almost four in 10 Americans have it and it can raise your risk for heart disease and stroke. That’s why statins, which are a type of prescription medication to treat high cholesterol, are so crucial.

“Statins shut off the mechanism in the liver that produces cholesterol and promote your body’s ability to get rid of “bad” cholesterol called low-density lipoprotein cholesterol,” says Suzanne Steinbaum, D.O., a preventive cardiologist and LIVALO spokesperson based in New York City. “After we try diet and exercise, statins are the first line medication to treat high cholesterol—especially in patients with multiple risk factors of heart disease, like obesity, family history, high blood pressure, and diabetes.”

But almost half of the people who could benefit from a medication that lowers their cholesterol don’t take one, which means they are putting their health at risk. “Cardiovascular disease, which is the number one killer in the U.S., is preventable 80 percent of the time—you do not have to get this disease,” says Dr. Steinbaum. “Reducing risk factors like high cholesterol can be lifesaving.”

There’s not a one-size-fits-all approach to lowering your cholesterol. You and your doctor can work together to find a regimen that works right for you. Read on to learn how to do just that.

Find your statin.

There are multiple statins available, and that variety is a good thing. “Not all statins are alike,” says Dr. Steinbaum. Your doctor can check your cholesterol levels and assess your risk factors to figure out the right statin for you. For example, if you’re taking another prescription for a different condition, your doctor may prescribe a statin like LIVALO^® (pitavastatin). (LIVALO has not been studied to evaluate its effect on reducing heart-related disease or death.) Due to the way it’s broken down in the body, there is less potential for certain drug interactions when taking multiple medications.

LIVALO is not right for everyone. Do not take LIVALO if: you have a known allergy to LIVALO 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, or you are currently taking cyclosporine or gemfibrozil.

Learn about possible side effects.

“There’s a potential for side effects, but with statins the most common is achy muscles,” says Dr. Steinbaum. If you think you’re experiencing a less common side effect, such as feeling more tired than usual, talk about it with your doctor. “Communication is key—don’t just stop taking the medication without talking to your doctor,” says Dr. Steinbaum. “There are other statins out there you can try.”

Keep up the healthy diet and exercise.

A statin is not a quick-fix pill that means you can ignore your lifestyle choices. “I always tell my patients: By giving you this medication, I’m not telling you to eat poorly,” says Dr. Steinbaum. “It’s a partnership—you do your part with diet and exercise, and I will do my part with giving you the most appropriate statin and dose I can, and keeping track of your cholesterol.”

For exercise, the American Heart Association recommends 150 minutes a week of moderate-intensity exercise, such as brisk walking or gardening. And when considering what you eat, Dr. Steinbaum is a fan of the Mediterranean diet, which is mostly vegetables, grains like farro, fish, and olive oil and other heart-healthy fats.

Know you can still drink, but in moderation.

When you take a statin, you don’t have to give up your glass of red wine on date night, but you do want to monitor your alcohol consumption. “Both alcohol and statins are metabolized by the liver, and the more strain you put on your liver, the more issues you might have,” says Dr. Steinbaum. Talk to your doctor about how much is safe for you to drink on your specific medication and dose. Patients who consume substantial quantities of alcohol and/or have a history of liver disease may be at an increased risk for liver injury.

Ask exactly how to take it.

As with any medication, there might be specific instructions to follow to make sure you’re getting the most benefit. “On some statins, you can't drink grapefruit juice, because it's metabolized by the same enzyme in the liver as those statins,” says Dr. Steinbaum. “Other statins, like LIVALO, are metabolized in a different pathway in the liver than most statins, so they don't have that issue. There are also some statins you need to take at night, but others you can take in the morning.” For guidance, check in with your doctor and pharmacist.

While nobody wants to be on a daily medication, it’s comforting to know that by combining a statin with a healthy diet and exercise, you’re doing what you can to protect your heart.

It’s important to keep an open dialogue with your healthcare provider about your heart health and your current cholesterol medications. If you want to speak to your provider about your treatment options, this customizable doctor discussion guide can help you begin the conversation.