Expert: Mary E Scott, RPh, CGP - 8/16/2006

Question
Hi,

I am asking for my wife (76) about cholesterol medication and side effects. First, let me recount  status:

In addition to the qustion of side effects form drugs used, she also is concerned about possible interference with her current use of Levothyroxinnatrium for her hypothyreose condition.  

She have tried various cholesterol 'fighting' drugs, but seem to experience some undesirable side effects.

Some of them I have experienced myself too,like headaches, and sometimes quite annoying, intense, vivid dreams, often of a somewhat unpleasant character. (I use Fluvastatin.)

Earlier she used Atorvastatin, but now she have tried Pravastatin. She stopped taking it when she experienced muscle problems, and in the documentation we find that muscle problems may lead to rhabdomyolysis.

Here is the question:

She want to continue taking something for reduction of the cholesterol levels, and is concerned about side effects, especially relating to use of Levothyroxinnatrium.

Is there anything general that you think may be said about this, like possible alternative drugs.

I understand that it may be difficult to give a conclusive answer, but any comment you might have would be appreciated.

In any case, she is of course depending on her physician for any prescription.

Sincerely, Rolf Aalberg  

Answer
Hi,Rolf!
Thanks for giving me the background on your wife's condition, and also which drugs were tried. Sometimes the muscle side-effects are tied to the high strengths of the statin drugs.  If the physician started her on a higher dose at first, that may be why she found the side-effects intolerable.  It may be that she needs to start with a lower dose,then increase gradually for a period of months.
Another medication she may want to try is extended-release niacin,  It is a prescription medication,not the supplemental niacin found over-the-counter.  The timed-release formulation has much less side-effects of the over-the-counter.  Hope this helps, Mary