I have been taking Simvastatin (= Lipitor) for 2 years and hear a lot of negative comments about the side effects, such as sore muscles, joints and so on. I now seem to be bothered by that too… What’s the point of that? Am I not better with more cholesterol but no side effects? Which is the least harmful? The doctors are very vague about it…
Answer
You have to start with the basics: everything revolves around probability and weigh the advantages against the disadvantages.
One must first know your cardiovascular risk profile. On that basis, one can decide whether it is indeed useful to take a cholesterol lowering agent. After all, this reduces the chance that you will have a cardiovascular incident in the future (heart attack, stroke, …). However, if your cardiovascular risk profile is already low, it is of course no use to take a cholesterol lowering agent. Because the chance reduction of an incident is negligible.
Then you have to consider whether the chance reduction you get by taking a cholesterol-lowering agent (quality gain) is acceptable against the disadvantages that you experience when using the cholesterol-lowering agent (quality loss).
Personally, I think your complaints are too heavy for the benefit you would have from the cholesterol lowering. But of course I don’t know the whole picture and I think it’s best to discuss this with your doctor.
Domus Medica, the Belgian general practitioners association, has a nice recommendation about this, and the Dutch GP Association has an extensive guideline on this. The federal knowledge center has also published a report on this.
PS1: Lipitor is atorvastatin, not simvastatin. Lipitor is also known to have more side effects than simvastatin. (The latter I did not research scientifically, but is a personal opinion and also what I hear from my colleagues.) It is also not a first choice product according to the recommendations/guidelines. Products of first choice are simvastatin and pravastatin.
PS2: Cholesterol lowering agents are a commercial industry. Every pharmaceutical company wants its product to be prescribed and has an aggressive advertising policy towards doctors to influence their prescribing behaviour. That is why I base myself on these guidelines/recommendations which are neutral.
Hoping that you are a little wiser in this tangle. Attached a few more ‘neutral’ links.
Kind regards,
Koen Lake Thome
General Practitioner – Researcher
Answered by
Koen Lake Thome
General Practice, Medical Informatics
Avenue de la Plein 2 1050 Ixelles
http://www.vub.ac.be/
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