HomeAnswersCardiologystatinDo I need to change the dose of statins?

What is your opinion regarding my medication?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. K. Shobana

Published At November 7, 2016
Reviewed AtJune 2, 2023

Patient's Query

Hi doctor,

Three years ago, I had a stent in my LAD, which had been 96% occluded. At that time, my cardiologist put me on Plavix for a year and ongoing 81 mg Aspirin therapy. I am also taking 50 mg Atenolol. It was 25 mg until this month and was increased due to palpitations probably stress related. I was also put on 5 mg of Crestor a day. My doctor and I agreed to this, since five men in my family took statins and all had an adverse reaction. Also, two of them were hospitalized due to it. The therapy had been working and my total cholesterol dropped from pre-stent therapy total 219, HDL 140 mg/dL, HDL 44 mg/dL, triglycerides 209 mg/dL to post-stent with medicine total 138, LDL 71 mg/dL, HDL 39 mg/dL and triglycerides 141 mg/dL. Over the past one year, I have been doing intermittent fasting. In the past year, have further lowered my numbers to 91 mg/dL total cholesterol, 48 mg/dL LDL, 40 mg/dL HDL, and 61 mg/dL triglycerides. This latest result has been repeated twice at six months intervals. Now, my GP is skeptical about the low dose statin and wanted to put me back on a blood thinner as well. I cannot get in to see a cardiologist for a month. I am reluctant to be put back on Plavix and I am equally reluctant to change statins and increase the dose. The new GP has kept me where I am with medicines for now. What are my options? It appears with diet and the current medical regimen that I am getting excellent results. Am I mistaken? Are high dose statins required despite the good blood results? Are all statins created equal and are they interchangeable for every individual?

Hi,

Welcome to icliniq.com.

Good to know that you are in good control of your lipids. First of all, statins must be used when one has had any heart attack or stroke. The dose of statin is set by the level of LDL (low-density lipoprotein). LDL must be lowered to one half. In your case, Crestor (Rosuvastatin 5 mg) is doing the best. Yes, there are side effects of statins. The most common are muscle pain and weakness. In my opinion, Rosuvastatin 5 mg is the best for you because it is of low dose. If you change to another statin (Atorvastatin), you will have to take at least 40 mg per day and that may cause side effects as these are common in your family. So, I recommend to continue Crestor 5 mg. You may be thinking that should I quit statin as my lipid levels are quite under control. Remember, the good effects of statins in case of heart attack or stroke is not only through decreasing lipid levels, but there are also many other ways statins benefit patients. So, keep up with your current treatment regimen. Keep your blood pressure under control and do regular exercise of moderate intensity for about 30 minutes a day for at least five days a week.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Muhammad Zohaib Siddiq
Dr. Muhammad Zohaib Siddiq

Cardiology

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