“High cholesterol” does not hurt, but it can lead to the development of atherosclerosis. Atherosclerosis affects the cardiovascular system, leading to the formation of atherosclerotic plaques and blood supply disorders. This often ends in heart attacks and strokes.
Today there are many drugs from the statin group. They have been shown to be effective in reducing mortality from cardiovascular disease, but debate continues about their safety. To achieve and maintain the desired levels of lipid metabolism, long-term use of drugs is required, but many patients do not follow the recommendations, causing the effectiveness of treatment to sharply decrease. What to say about patients when doctors have different opinions on this matter.
What are statins and how do they work?
These are the most effective medications to combat high blood fat. They are based on an active substance that is an inhibitor (a substance that reduces the activity) of HMG-CoA reductase. This is a liver enzyme involved in the formation of cholesterol from fat molecules.
About 70-75% of cholesterol is produced by the liver and about 25% comes from food.
Only 20-25% of cholesterol enters the body with food, the rest is produced in the liver. If you influence this process, you can significantly reduce the amount of lipids in the blood, which is what statins do.
An additional effect of medications is an increase in the sensitivity of receptors on liver cells to triglycerides. These are small fragments of dietary fats, in this form they are absorbed into the blood and transferred to the liver. Liver cells begin to intensively capture triglycerides and process them, reducing the overall concentration of fat in the blood.
The dual mechanism of action makes the latest generation of statins highly effective and makes them the most popular drugs in the fight against atherosclerosis.
However, statins remain drugs and have a number of contraindications:
- pregnancy, breastfeeding;
- thyroid diseases;
- acute liver and kidney diseases;
- severe allergies;
- cataract.
Medicines are indicated for the following problems:
- high cholesterol;
- post-infarction period;
- rehabilitation period after angioplasty, bypass surgery;
- borderline conditions (high probability of developing a heart attack or stroke);
- IHD;
- progressive atherosclerosis;
- hypertension;
- metabolic pathologies.
New generation drugs are characterized by a high degree of safety for the body. They are prescribed even to elderly people.
Contraindications
Despite the fact that the new generation of high cholesterol medications have a minimal number of side effects, they have a number of contraindications:
- Allergic reactions to drug components;
- Acute pathologies of the thyroid gland;
- Diseases leading to kidney or liver failure;
- Cataract;
- Pregnancy and lactation;
- Age up to 18 years.
When taking any medication, the risk should always be lower than the possible benefit of taking it. Therefore, before you start taking the latest generation of statin drugs, you need to carefully study the contraindications and do not forget to tell your doctor about them.
Names of the best drugs of the latest generation
The group of latest generation statins with the least side effects includes medications based on the active substance rosuvastatin. Let us take a closer look at their properties and distinctive features of the composition of the drugs.
"Rosuvastatin"
Domestic drug of the statin group. Canonpharma is also produced. It is based on the active substance rosuvastatin. The medicine is produced exclusively in tablets, dosage options: 10, 20 and 40 mg. Always start taking the medication with a minimum dosage to avoid side effects. For slightly elevated cholesterol levels, the doctor prescribes a medicine in a dose of 5 mg. To do this, you need to divide the tablet in half. In other cases, crushing and chewing Rosuvastatin is not recommended.
The tablet is covered with a special coating; it allows the substance to be released in the appropriate sections of the digestion, where it is maximally preserved and completely absorbed. The medication is taken between meals. The maximum concentration in the blood is reached 3-5 hours after consumption. By the end of the second week, cholesterol decreases significantly.
The price in Russian pharmacies is from 306 rubles.
"Akorta"
Another domestic rosuvastatin. Available in dosages: 5, 10, 20 and 30 mg. The main advantage of this company is the production of tablets in a dose of 5 mg. Patients at the initial stage of atherosclerosis will not have to divide the tablet and violate the integrity of the film membrane. This promotes better absorption of the drug.
The price of the medicine is slightly higher compared to Rosuvastatin - from 440 rubles. The dosage regimen and administration are similar.
A distinctive feature is its effect on people of the Mongoloid race. In their blood, the concentration of the drug taken in the same dose is comparatively higher than in Caucasians. This fact should be taken into account when dosing the drug.
"Crestor"
The drug "Crestor" is produced in three countries: Russia, England and Germany. It is an analogue of the drugs rosuvastatin. The highest efficiency in clinical studies and good tolerability were noted. The active ingredient in Crestor is highly purified and goes through several stages of processing.
A wide range of dosages helps the patient choose the right one without compromising the integrity of the tablet. Dose options: 5, 10, 20, 40 mg. At a dose of 40 mg, the medicine is prescribed extremely rarely, since there is a risk of developing hypocholesterolemia due to its high effectiveness.
Contraindications and method of application are similar. The price is about 1300 rubles.
"Tevastor"
Israeli rosuvastatin. Available in doses of 5, 10 and 20 mg. It is taken as a medicinal substance that lowers blood cholesterol levels. In Russian pharmacies it can be purchased at a price of 280 rubles. This is the cheapest statin among those described.
When taking this medication, special attention is paid to its combination with other medications. Concomitant use with oral contraceptives without prior permission from a physician is prohibited. “Tevastor” affects the hormonal balance in the body; when combined with taking hormones, the drug produces serious side effects. The same applies to combinations with antiviral agents of different groups.
"Roxera"
This is a drug called rosuvastatin, produced in Slovenia. Available in the form of tablets in dosages of 5, 10, 15, 20, 30 and 40 mg. Largest dose range. In view of this, it is actively prescribed by doctors. The active substance in the drug is a compound of rosuvastatin and calcium. The effect of the medication is absolutely unchanged, but in this form the component is more easily absorbed by the body.
A dose of 30 mg is available specifically for patients with liver dysfunction of unknown origin. It is inconvenient for them to prescribe other rosuvastatin drugs, since there are no 30 mg tablets. “Roxera” is an ideal option in this regard. Slovenian medicines of the new generation are distinguished by a high degree of purification of the active substance, which reduces the occurrence of side effects and increases the effectiveness of the medicine.
The drug is not expensive - from 340 rubles.
"Rozulip"
Hungarian drug rosuvastatin. The active substance in tablets is part of a complex of rosuvastatin and zinc. The drug is available in dosages: 5, 10, 20 and 40 mg, 28 tablets per package. The maximum dose of the substance in the blood after administration accumulates within 3-5 hours. It is advisable to use the drug in the evening, between meals.
The dosage regimen can be changed 4 weeks after the start of use. A biochemical blood test is usually performed to evaluate the effectiveness of the statin after a month of use.
"Rozulip" can be bought in Russian pharmacies at a price of 190 rubles (increases in proportion to the dosage of the active substance).
general characteristics
All statins belong to a general pharmacological group of drugs that affect fat metabolism in the body.
Medicines from the statin group can be divided into synthetic and natural. Natural ones are isolated from mushrooms on a nutrient medium. These include the entire first generation of statins (simvastatin, lovastatin). They have the lowest effect and have a large number of adverse reactions. The very first statin was compactin, obtained from a penicillin culture. Then monacolin was isolated from the culture of monascus purpureus, which was then renamed to the more famous “Lovastatin”
The second (fluvastatin), third (atorvastatin) and fourth (pitavastatin, rosuvastatin) are the results of synthesis. 4th generation statins are the safest and most effective compared to all others.
Statin drugs are classified not only by generation, but also by dose. Highlight:
- Low-dose (pitavastatin);
- Medium dose (rosuvastatin);
- High-dose (atorvastatin).
All latest generation statins act on the enzyme mevalonate and disrupt the chain of cholesterol synthesis, reducing its amount in the blood.
4th generation drugs based on another active ingredient
The newest statin based on the active ingredient pitavastatin is Livazo. Available in tablet form, dosage 1.2 and 4 mg. The active substance, similar to rosuvastatin, is an inhibitor of HMG-CoA reductase, prevents the formation of cholesterol in the liver and captures fat molecules in the liver cells for processing.
Pitavastatin is more effective, is used in lower dosages, but maintains a high safety profile and is indicated for use even in old age.
The maximum effectiveness of the medicine appears within a few weeks from the start of use. Usually the doctor prescribes a control blood test after a month and evaluates the cholesterol level. In Russian pharmacies, the medicine can be purchased at a price of 700 rubles (for the smallest dosage).
When are they appointed?
Statins are prescribed for elevated cholesterol levels in the blood (examined using a biochemical blood test), as well as for high levels of C-reactive protein, which indicates the presence of an inflammatory process associated with the development of atherosclerosis.
The use of statins is indicated to prevent heart attack, heart attack, stroke and other consequences of high cholesterol, which most often occurs in combination with the following types of diseases:
- Cardiovascular - coronary heart disease, angina pectoris, atherosclerosis, hypertension, tendency to thrombosis. Treatment with statins is indicated after a heart attack and stroke to improve blood circulation in order to prevent recurrent attacks.
- Endocrine – type 2 diabetes, insulin resistance, obesity, since these diseases increase the likelihood of developing atherosclerosis and subsequent pathologies of the cardiovascular system.
- Metabolism - dyslipidemia (hypercholesterolemia, hyperlipidemia, hyperglyceridemia) or lipid metabolism disorders caused by different development mechanisms and increased concentrations of certain forms of lipids. Treatment of such pathologies must be constant to maintain a balanced blood composition.
Do the new generation of statins really have the least side effects?
The drugs do have a higher safety profile. But they still have side effects:
- from the nervous system: migraine, paresthesia, neuralgia, depressive states, increased anxiety;
- from the digestive system: gastritis, dyspeptic disorders, abdominal pain;
- respiratory system: bronchitis, airway obstruction, laryngitis, pharyngitis;
- cardiovascular system: angina pectoris, blood pressure surges;
- musculoskeletal system: pain in muscles and joints, arthritis, asthenia;
- genitourinary system: edema, impaired renal function, changes in the composition of urine;
- diabetes mellitus, anemia, influenza-like syndrome.
When assessing the side effects of statins, keep in mind that they only appear in cases of individual intolerance to the drug and violation of the dosage regimen. This usually occurs when the medication is self-prescribed. In this case, it can really cause harm.
Study of the frequency of side effects from taking the latest generations of statins.
Comparing the side effects of drugs of the fourth and previous generations, we can conclude that rosuvastatin and pitavastatin have no negative effect on the organs of vision, the hematopoietic system, the risk of developing gastrointestinal bleeding is reduced, and there is no predisposition to contracting genital infections.
Only a doctor can choose the right drug for you. It will take into account the individual characteristics of your body and associated diseases. And this will not necessarily be a product from the latest generation.
To drink or not to drink?
According to statistics, people in a pre- and post-infarction state who take statins daily prolong their life by an average of 10 years. Statins are highly effective and, with the correct dosage regimen, are well tolerated and act quickly.
Characteristics and comparative analysis of the use of modern statins
What characteristics should be considered when choosing a statin drug?
- Efficiency;
- Safety;
- Price;
- Evidence base.
Among modern statins, pitavastatin has the fewest side effects. Next comes rosuvastatin and last is atorvastatin.
Direct studies of statins are practically absent or do not meet all the requirements due to the lack of solid clinical points. Therefore, only studies compared with placebo can be considered sufficiently reliable.
Benefits of taking the latest generation statins:
- Reducing the number of deaths from cardiac accidents by 40%;
- Reducing the number of heart attacks and strokes by 30-35%;
- Reducing cholesterol levels by 40-45%;
- If the prescribed dose is carefully followed, the drugs do not have a significant toxic effect on the body, and the number of adverse reactions is minimized.
According to all recent studies, the leading drugs are Pitavastatin and Rosuvastatin. You can make a choice based on four indicators: price, rate of decrease in low-density lipoproteins, effect on increasing high-density lipoproteins, safety of use. From a safety point of view, you should choose Pitavastatin; in terms of the effectiveness of lowering cholesterol and increasing the level of high-density lipoproteins, Rosuvastatin will take the lead. Pitavastatin is also twice as expensive as Rosuvastatin.
If the cost of the latest statins is too high for some patients, then first of all it is worth considering Atorvastatin, it is the most clinically studied and has a good clinical effect.
According to recent studies, generic drugs are absolutely identical to the original ones.
Prices
The cost of the medicine depends on the dose chosen, the country of origin and the quality of the raw materials. Below is a list of medicines and the price range of statins in Russian pharmacies.
| Drug name | Price |
| "Rosuvastatin" | 150-360 rub. |
| "Roxera" | 340-1600 rub. |
| "Crestor" | 730-5600 rub. |
| "Tevastor" | 360-1400 rub. |
| "Rozulip" | 200-1300 rub. |
| "Livazo" | 520-1000 rub. |
Where to buy the latest generation statins?
You can order medications without leaving your home through online pharmacies. The largest and most trusted pharmacy chains:
- https://wer.ru (“Rosuvastatin” - from 680 rubles, “Crestor” - from 1965 rubles, “Rozart” - from 419 rubles);
- https://apteka.ru (“Rosuvastatin” - from 700 rubles, “Crestor” - from 1300 rubles, “Rozart” - from 433 rubles).
In Moscow
You can purchase cholesterol medications in Moscow in the following pharmacy chains:
- "Rigla", metro station Kolomenskaya, st. Nagatinskaya, 3 8-800-777-03-03.
- "EAPteka", metro Planernaya, st. Planernaya, 12 k.1. 8-495-730-53-00.
In St. Petersburg
- "Rigla", metro station Moskovskaya, st. Tipanova, 27/29. 8-800-777-03-03.
- “Rigla”, Bolshoi Prospekt Petrogradskaya Side, 6. 8-800-777-03-03.
