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VOLUME 8 NUMBER 4 • NOVEMBER 2011
PATIENT INFORMATION LEAFLET
SA JOURNAL OF DIABETES & VASCULAR DISEASE
level. Generally, your doctor will start on a lower dose of statin, called
simvastatin (10/20 mg), raising it to 40 mg if needed. He/she will not
prescribe an 80-mg dose of simvastatin as this has been shown to be
at a disadvantage to newer statins such as atorvastatin and rosuvastatin
(the newest and most powerful statin available).
HOW WILL I KNOW IT IS WORKING?
Studies have shown that statins reduce the risk of heart attacks and
strokes. For this reason, there is no need to have a routine blood test to
check your lipid levels once your doctor is satisfied that your cholesterol
levels are at the target level you and he/she have set. However, your liver
function will be tested at three and 12 months to ensure that the drug is
suiting you, and your lipid profile will be checked annually.
HOW LONG SHOULD I TAKE IT FOR?
Your cholesterol level will be lowered by taking the tablets. If you stop
taking them, it will rise again. For this reason, we advise that you keep
taking the tablets as long as possible, and ideally, for life.
One exception may be if you make significant changes to your diet or
lose a lot of weight. Substantial lifestyle changes may keep on lowering
your cholesterol level without you continuing to take the medication, but
don’t make any changes to your lifestyle or medication without speaking
to your doctor/clinic sister first.
WHAT COMMON SIDE EFFECTS MIGHT I EXPECT?
Side effects from statins are surprisingly rare. However, all drugs have
side effects. Even ‘dummy’ pills used in medical trials have been shown
to cause side effects in some people, so it is not always the tablet that
is to blame.
With statins, rare side effects include muscle or joint pains, lack of
energy, constipation and indigestion and you should let your doctor, nurse
or pharmacist know if these occur. It is important to remember, however,
that the likely benefits from statins are greater than the risks, certainly for
the majority of people.
WHAT IF I TAKE OTHER MEDICINES?
It is important to check whether statins interact with any other medicines
the doctor has prescribed, or with over-the-counter drugs or supple-
ments. These include herbal and ‘home’ remedies.
WHAT IF I DECIDE THAT I DO NOT WANT TO TAKE THESE PILLS?
Your doctor or nurse will have advised you to take these tablets because
you are likely to benefit from reducing your risk of a heart attack or
stroke. High cholesterol does not make you feel unwell so it can some-
times be difficult to understand why you should take a tablet for the rest
of your life. Nonetheless, it is worth remembering that large medical
trials have proven the benefit of these pills in reducing the risk of heart
attack or stroke.
EZETIMIBE
Ezetimibe is a drug that inhibits absorption of cholesterol by the small
intestine. In South Africa, this medicine is often used in a single-tablet
combination with simvastatin. The advantage of this statin/ezetimibe sin-
gle pill is that it is associated with fewer side effects than the equivalent
statin-based cholesterol-lowering dosage. For some patients who experi-
ence muscle pains on statins, this combination is very useful.
FIBRATES (FENOFIBRATE)
Fibrates, particularly fenofibrate, are added to statin therapy when cho-
lesterol targets are not reached, but mainly to lower triglyceride levels.
While there is more than one fibrate formulation available in South Africa,
the cardiovascular and microvascular protection of fenofibrate has led to
an evidence-based usage of this agent.
Fibrates lower blood triglyceride levels by reducing the liver’s produc-
tion of the carrier of the triglyceride particle (VLDL) and by speeding up
the removal of triglycerides from the blood.
Diabetic patients are frequently prescribed a combination of a statin
plus ezetimibe/fibrate.
Source: Medline Plus
It's the
shell that
makes
safer.
Safety-Coated
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81mg
The ORIGINAL low dose aspirin
for optimum cardio-protection
Hp
Each tablet contains Aspirin 81mg. Reg.No.: 29/2.7/0767
Pharmafrica (Pty) Ltd, 33 Hulbert Road, New Centre, Johannesburg 2001
Under licence from Goldshield Pharmaceuticals Ltd. U.K.
