How Safe Are Statins?

Millions of people are taking statins, and we have espoused their effectiveness (and safety) in these pages, frequently. Although their safety is widely recognized, occasional case reports appear that make it logical to review the actual safety profile of statins from a quantitative point of view. Authors at Bandolier, an independent UK journal about evidence-based healthcare, have done such a review.

This review examined all available good-quality information, and estimated the statin-specific risk per 100,000 patient-years for the known and suspected side effects. They covered simvastatin (Zocor®), atorvastatin (Lipitor®), and pravastatin (Pravachol®), but not cerivastatin (withdrawn from the market). The only serious side effect is rhabdomyolysis, a muscle disorder that can prove fatal; a lesser form (maybe unrelated to rhabdomyolysis) is called myopathy, and is reversed on stopping the satin. Here are the results of the analysis, with some comparisons:

Death from an auto accident: 1 in 20,000

Rhabdomyelosis: 1 in 29,000/year, 10% of cases fatal = 1 in 300,000/year.

Death from a firearm: 1 in 300,000

Myopathy (reversible): 1 in 9,100

Peripheral neuropathy: 1 in 8,300

Minor muscle pain: 1 in 5 - same as in those taking placebo in trials

Liver failure: same as in people not taking statins or placebo

Stroke: overall, same as those not taking statins, but maybe hemorrhagic stroke very slightly more common.

Brain function: same as in people not taking statins or placebo

So, you can see that, compared with their benefits, statins are clearly very safe drugs. Good candidates for the polypill.