Q. My husband has been taking statins for years and didn’t do well with any of them until he took Crestor. After about 6 years on Crestor, however, he developed diabetes which I believe may have been caused by Crestor. At the same time, he was experiencing muscle weakness and soreness but the doctor didn’t believe that Crestor could have been the cause.
Because I am aware of the data that you at the People’s Pharmacy have been reporting for years, I insisted that my husband be taken off of Crestor and be put on something else that is not so harmful. The only thing his doctor could come up with was Livalo, which I was told does not work like a statin. I am confused, though. Is Livalo a statin or not?
My husband has also been taking fenofibrate all these years. I am concerned that this may not be an optimal combination.
The kicker is that even though my husband does have high cholesterol, he does not have heart disease. He went into surgery a few years ago, thinking they were going to find blocked arteries, and they found that his arteries are completely clear. The cardiologist released him from his care, but told him he should still take statins.
My husband has not had muscle soreness with the Livalo (which btw costs with insurance $125 every 3 months). Please advise if Livalo is a statin and about the combination of Livalo and fenofibrate. My husband has had some depression and very mild cognitive impairment and I wonder if it would improve if he adjusted the Livalo dose.

A. One need look no further than the generic name for Livalo to discover that it is indeed a statin. Livalo, aka pitavastatin, works the same way as atorvastatin, lovastatin, pravastatin, rosuvastatin, or simvastatin. In other words, Livalo, like Crestor, inhibits an enzyme called HMG-coA reductase. It is this enzyme that is essential for the production of cholesterol. We are surprised that your husband’s doctor switched him from Crestor to Livalo without explaining that he was switching from one statin to another statin.
It is sometimes true that a patient will do better on one statin than another (for awhile), but that is not always the case. Below you will see some examples of what may happen when people are switched.
As for your second concern about combining a fibrate-type cholesterol-lowering drug such as fenofibrate (Fenoglide, Lipofen, Lifibra, Tricor, Triglide) with a statin such as Livalo, there are a lot of unanswered questions. The Action to Control Cardiovascular Risk in Diabetes (ACCORD) study found that adding fenofibrate to simvastatin in patients with type 2 diabetes did not reduce the risk of a patient experiencing a heart attack or a stroke.
The FDA issued a communication about this study and concluded that Trilipix (fenofibric acid), which is similar to fenofibrate, may not be expected to add benefit either. There is even a concern that adding fenofibrate to simvastatin might have the paradoxical effect of increasing “major cardiovascular events” in women. Many health professionals may not know about a warning put out recently by the FDA that fibrates may sometimes lower good HDL cholesterol. This would not be a good thing for a heart patient. There may also be an increased risk for muscle breakdown (rhabdomyolysis) with the combination of a statin and a fibrate like gemfibrozil.
Here are some quick summaries of side effects to be aware with these drugs:
LIVALO (Pitavastatin) SIDE EFFECTS
• Muscle pain, back pain, leg pain, arm pain, myalgia, fatigue, muscle spasms
• Digestive distress, heartburn, nausea, constipation, diarrhea
• Skin rash
• Elevations in blood sugar, pre-diabetes, diabetes
• Liver enzyme elevations
• Muscle breakdown, rhabdomyolysis
• Kidney damage, liver damage
• Mental fuzziness, memory problems, forgetfulness, cognitive dysfunction, amnesia
• Insomnia, dizziness, depression
• Erectile dysfunction

CRESTOR (Rosuvastatin) SIDE EFFECTS:
• Headache

• Muscle aches, muscle cramps, muscle pain, fatigue, weakness

• Abdominal pain, nausea, diarrhea

• Blood sugar elevation, diabetes

• Back pain

• Sore throat, flu symptoms, sinusitis

• Dizziness

• Itching, rash

• Liver damage, liver failure, kidney damage

• Insomnia, sleeping difficulties, nightmares

• Forgetfulness, memory problems, amnesia, confusion

• Peripheral neuropathy, nerve tingling, nerve burning

• Pancreatitis

• Cataracts

FENOFIBRATE (Fenoglide, Lipofen, Lifibra, Tricor, Triglide) SIDE EFFECTS:
• Liver enzyme elevations, hepatitis, cirrhosis
• Breathing problems, nasal congestion
• Digestive distress, stomach pain, constipation, diarrhea, nausea, gas, heartburn
• Headache
• Gall stones, gall bladder disease
• Pancreatitis
• Muscle pain, weakness, rhabdomyolysis, back pain, arthritis, bursitis, leg cramps
• Skin rash
• Blood disorders
• diabetes

Here are some other stories of a similar nature:
“I was taking Lipitor, but when the pain became too much, was switched to Crestor. There was a noticeable decline in my short term memory, to the point I didn’t trust myself driving. My doctor dismissed my complaints even though I registered them strongly over a course of a year. Finally it became all too much and I removed myself from the statins. My memory improved remarkably within several days and continued to rebound back to what I would call ‘normal’ within several weeks.
“Also, the racking body pains also subsided as well during the same time frame. Statins effect different people different ways. Not everybody can take them and that is something physicians should be more attuned to.”

J.M.C.
++++++++++++++++++++++++++
“I just turned 50 and was placed on the new statin drug called Livalo 2mg. In just one week I have no sex drive or an erection. I have been prescribed crestor, zocor, and lipitor in the past with the same results. I am hoping another cholesterol med will come out w/o the side effects.”
A.E.P.
++++++++++++++++++++++++++
“I recently turned 50. I have been taking Livalo for high Cholesterol. I have been experiencing all kinds of symptoms like no sexual desire, can’t sleep through the night, feel totally exhausted and have missed several days of work. Now my doctor prescribed Androgel for low testosterone levels. My question could taking Livalo be causing all my problems and has anyone taken AndroGel for low T problems?”
Thanks, Guy
++++++++++++++++++++++++++
“I am a 44 year old woman who has the familial genetic cholesterol issue despite being on a fat-free vegetarian cholesterol-free diet my entire life. I am also athletic, lean/thin and run 20-30 miles a week, etc. I resorted to taking 10mg of Crestor for just 4 weeks and landed in the ER 3 weeks ago with pain that warranted morphine. The statin caused severe nerve inflammation/pain and neuropathy in my hands, nose and ears, chest, legs, etc.
“My body felt like I was on fire- burning alive and my skin turned beet red. The lining of my nose became so inflamed that I developed nose bleeds, plus I had chest burning with a red rash. My face -which is usually pale Irish white turned sunburn red and the palms of my hands became red as lobsters with burning pain and numbness in the fingers, etc.I also had scary kidney test results until I quit the statin.
“Since I practice natural medicine, I put myself immediately on an anti-inflammatory diet with anti-inflammatory herbs to purge my body of the fire that the statins have caused. I am also on supplements for nerve health and regeneration. Everything seems to be working, as my pain is diminishing and every day I am getting better!”

P.O.
+++++++++++++++++++
“About 5 years ago I took Crestor for about 9 months and started to get pain in my hips so got off have tried other statins but the same result.

“My doctor told me about a new statin that may work for me and I was on it for 28 days, it’s call Livalo. One morning upon rising I was fine but then about noon the pain came on all of a sudden. The pain was so bad I almost cried with it. It was in the ankle, the right hand my whole back my hips, legs, and knees.
“I have been off for 5 days and every day is better, I also had watery eyes and wasn’t passing urine the way I should.
“I think the FDA is using us as an experiment. No more of that stuff for me.”

Jackie
+++++++++++++++++++
Some people have found that a fibrate is a reasonable cholesterol-lowering alternative for a statin drug. Nancy reported: “When I started taking statins in the 80’s I began having episodes of violent itching on my arms right above the elbow at night. No medication helped. I could only get relief using cold wet cloths, often sleeping that way.
“After years of trying many different statins I was switched to Tricor in the 90’s. It doesn’t get the numbers as low as statins but my HDL is great and triglycerides are within normal range. I supplement with exercise and a high fiber diet. I now have a 20 year history with no side effects from a fibrate.”

Anyone who would like to learn more about other ways to reduce the risk of heart disease may find our book, Best Choices from The People’s Pharmacy a handy guide. It discusses non-drug approaches and foods that are especially beneficial. And speaking of food as medicine, you will find a detailed description of how to adopt a Mediterranean diet into your regular routine. We keep learning that this approach is heart healthy, but very few experts will tell you which vegetables are really helpful and which might be counterproductive. Quick and Handy Home Remedies From The People’s Pharmacy provides the specific information you have been looking for when it comes to grocery shopping and creating delicious meals. Here is a link to this helpful information.
And please share your story about experiences with drugs like Crestor, Livalo and fenofibrate below.

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  1. TM
    Reply

    It is very interesting that there’s a 44 y.o lady who practices homeopathic/naturopathic therapy that experienced the intense burning sensation of her skin while on Crestor. I experienced something very similar and I was also on crestor at that time. It was more of intense itching, burning and redness of the palms, racing heart and shortness of breath. I also had redness and welts in my torso. It took a few days for the symptoms to subside after stopping both Crestor and Niacin.
    However I was wondering whether she was also taking Niacin, which I was also taking ( the”no flush” type to be exact) I’ve switched to Livalo and stopped the Niacin, and still take fish oil supplements both as an anti-cholesterol and anti inflammatory aid.
    I hope she sees my post and responds to my question.
    Thank you!

  2. Debbie
    Reply

    I am a 54 yr old female. 2 yrs ago I suddenly developed high cholesterol and triglycerides. I have tried 7 different statins. Of course, the ones that corrected these were absolutely intolerable.
    I had severe back pain and hip pain. I began having pain in my knees and my thumbs, to the point of not being able to open bottles and jars, which is essential for my job. I began having stomach aches and and nausea almost continuously. I also have developed a particularly upsetting side effect since I have been on livalo. I have become incontinent.
    When I don’t take the livalo I have no problem with anything like that and all of my pain gets much better. My Dr is understanding but insists that I need something to lower the cholesterol and triglycerides. I can not tolerate the side effects! I have tried the herbs and everything I can think of!
    I’m very frustrated. I eat well and fairly healthy. I just need something that doesn’t me feel like hell all the time. I am otherwise healthy so I would appreciate any other suggestions.

  3. Jimbo
    Reply

    NO ONE who does not have heart disease should be on a statin. Cholesterol does NOT cause heart disease. Sugar does, however.

  4. kevin j.
    Reply

    I refused statins for elevated LDL-C, cognitive deficits muscle and liver damage, not worth it. Diet and EPA fish oil works fine, only good side effects, and I take rx Vascepa so don’t worry about toxins or fish taste.

  5. RPE
    Reply

    My doctor put me on fenofibric acid (Trilipix), and I almost immediately developed a really scary rash..looked like my blood was trying to come through my skin..turned into scaly patches and left a dark place on my skin.
    I am very allergic to many things…I stopped taking this and the patches are very slowly going away,,how long does it take to get this out of my system?

  6. mlr
    Reply

    I’ve been on Livalo 1 day and have already experienced extreme fatigue and pain in my calf! I have been on all the statins in the past 20 years with serious side effects. My cholesterol is 400 with low fat diet. This is caused by genetics. Although I had a cousin who died at age 92 with cholesterol over 500! My HDL is over 90. Maybe getting an annual CT scan and taking low dose asprin will help me determine my risk for heart attack. I have low inflammation and non-sticky blood.

  7. James
    Reply

    I have type 2 hyperlipidemia, it is hereditary, it runs in my fathers side of the family. This was discovered when I was 27 years old, my total cholesterol was 350, with upside down ratios, triglycerides low.
    I went on strict diet for two years and increased cardio into my work out, the best I could do was with diet and exercise was 300 total cholesterol.
    So, I finally caved in, and agreed to try Lipitor 20 mg, then 40 mg for 10 years, this dosage brought my total cholesterol down to 220 (hdl 85).
    I noticed headaches and dizziness once in a while. At the 10 year mark, my insurance no longer covered Lipitor, so my doctor prescribed Vytorin 20/10 mg. Vytorin reduced my cholesterol to 170, but hdl also suffered hdl 50. I stayed on Vytorin for 10 more years, then insurance no longer covered and Lipitor was available in generic.
    When I switched back to generic lipitor the best numbers I could get was 230. I tried name brand Lipitor, and same thing 230.
    I complained to my doctor, he told me about Livalo, so I tried it at full 4 mg dosage. My total cholesterol when taking 4 mg of Livalo is 230, with hdl of 55. I have been on this medication for over a year, no side effects I can tell. I am happy to only take 4 mg of any drug to help keep my cholesterol under control.

  8. Nil
    Reply

    In November 2012, my husband and I were prescribed LIVALO 2mg, two weeks after starting the the medication I started to experience pretty bad aches in my arms and calves. I felt as if I was coming down with the flu but I recognized the pain because I had been given several different prescriptions of statins….Zocor, Tricor, Welchol and a few others and all of them after a very short time of taking caused the same symptoms.
    I stopped the LIVALO and called my doctor and told him what I was experiencing and he said I did the right thing and would make a notation on my medical records. At this time, I asked my husband to stop taking the medication because he had experienced the same I had with the other statins and I was afraid if he continued it would not be good for his health. Since he did not feel any symptoms, he continued taking the LIVALO 2mg, but this past March 2013 he started feeling very ill. He started with a runny nose and very achy.
    He went to the doctor but the doctor did not suspect that his problem could be caused by the LIVALO. My husband continued with the LIVALO for 2 more months and continued to worsen… he had back pain, hip pain that was unbearable that he couldn’t even lift his feet to put his pants on, his shoulders were causing pain in any movement he made, he couldn’t even lift his arms or hands to wave. I had to do everything for him.
    He finally listened to me and stopped taking the LIVALO and within two days he was able to lift his hands and arms. He has gone through a lot in the past few months and attribute all to him taking the LIVALO. My husband feels that his joints were probably wearing out from age but that LIVALO intensified the pain tremendously that he thought he had a broken hip and he could not figure out he had done it. We have sworn off any statins and the doctor feels there is nothing else he can prescribe to us.

  9. JJ
    Reply

    I took a generic statin and had pain in my legs so was switched to Livalo. I am 55 and started experiencing memory problems. I took it for over a year, but did not realize Livalo was the cause until I heard a news report. After just two weeks of not taking it, my memory is improved.
    People’s Pharmacy response: Livalo has been promoted as though it were safer than other statins, but we don’t know of any studies to support that.

  10. Mae H.
    Reply

    I am a 55 year old female. My doctor put me on Fenofibrate about 3 months ago. The cramping, tingling and burning in my left arm is almost unbearable. I’ve decided to stop my dosage and try a holistic approach to see what happens.

  11. fbl
    Reply

    mw, please read my post above. You are on the right track, but keep it up and don’t start taking more drugs.
    Nattokinase might be a better choice than aspirin if blood flow is a concern.
    If I were you I’d also double the Q10 and Omega 3.
    Lose the sugars and diet sodas to help your other blood test numbers.

  12. mw
    Reply

    Age 68 been on statins for over 20 yrs. have had joint & muscle pain. I’ve had cataracts both eyes in mid 50’s. no one in my family had this problem. complain many times were never told the statins could be the cause. I finally decided what ever life I had in front of me I didn’t want to be in a fog & pain! I went off tricor & simistatin April 2013. in about 2 1/2 weeks.
    I felt like a new person fog gone sleeping at night,the muscle aches & some of the joint pain gone or lessen. their’s artheritis I am 68 after all (lol) unfortunately the #’s not good in( may) chlo250 hdl33 ldl 182
    (july) chlo 283 hdl 36 ldl 214. I’ve been taken 1200mg fish oil 3x’s a day 200mg coq10 2 baby asprins lost 12 lbs. no beef increased fruits vegs. & fiber try to walk 3-4 x’s a wk. was considering taking livalo. but after reading the info might reconsider. any other ideas would love to here them.i know mine is genetic is there anything out there that can aid me in getting the #’s in a safer range?

  13. blondie
    Reply

    I have been on and off livalo for 6months, every time I go back on it I get extremely depressed and tired is it the livalo?

  14. shirl
    Reply

    I have quit taking any calcium after having 3 stents (after heart attack) almost 2 yrs ago. (occasionally I take 1 or 2/wk of 600mg… but I’m not sure “why” I do) I am 76 & have taken a statin for many years & am now on Crestor. I was osteopenia therefore, I always took 1200mg Calcium w/D for many years & until 5 yrs ago I had been on foxamax & then actonel (which I quit).
    I am very active (& have been for many years)…. yoga 3x’s wk, circuit or other weight lifting regimens 2 or 3 x’s/wk & still play doubles tennis. I am now also wondering if Crestor is essential even tho it has reduced my cholesterol lower than any other statins have previously (160). However, even when lipitor only reduced my level to 198 or 200 my HDL was always in the high 90’s. Now w/Crestor that has come down to 80’s tho.
    All these meds are becoming soooo confusing. Wonder if my baby aspirin is all I really need?? LOL (I do take 2 meds for blood pressure control, even tho before my HA I never had high blood pressure… I was definitely not a candidate for HA… everyone that knew me was as shocked as my family.

  15. Toni J.
    Reply

    I recently had a calcium CT scan and my number was 739 (extensive build-up)and I was told to see a cardiologist. I immediately stopped taking my 1200 mg. calcium supplements, and the very next week NBC news had a story urging women to get off of them.
    Even though a stress test and sonogram showed that I have no blockage in my coronary arteries, both the cardiologist and my PC wanted me to start taking a statin drug, but I declined since my HDL was 90 and my CRP and Triglycerides were low (LDL was 123, but I’m Pattern A, which is the safer size).
    I’ve read too many terrible things about the side effects of statins, and am convinced that inflammation, not high cholesterol is the driving force in heart disease.
    My question is about lipoprotein(a). Is it a huge marker for heart disease? If so, why isn’t it part of normal blood work? My number was 16, which I think means I’m “borderline,” but there is such differing information online that I’m not sure that 16 is a fairly safe number. I’ve read that Lp(a) is genetically determined. Does that mean I can’t do anything to change this number, i.e., either through diet or more exercise? I’d be grateful for any light you can shed on this subject. Thanks so much

  16. STEVE W.
    Reply

    After my complaining a couple of years ago to my current doctor about statin side effects my doctor switched me to zetia. Does zetia create side effects similar or different than statins? Is zetia considered safer than statins? Some of my body aches went away after discontinuing statins.

  17. EWB
    Reply

    Has anyone had a problem with very, very itchy scalp while taking statins? I have tried all types of shampoos but nothing has helped with the itching. I stopped taking Lipitor (generic) for a while but my cholesterol skyrocketed so I am back on it now.

  18. Wb
    Reply

    How long does it take to get a statin drug out of ones system after stopping the drug?

  19. Penny H.
    Reply

    My internist retired and I was “given” to a new, young internist. Without any blood tests or even listening to my heart he had me start on Trilipix (fenofibric acid). It was a lot more expensive than what I had been taking for cholesterol.
    He also told me I had had a mild stroke (TMI) without even so much as touching me or running any tests. I had no symptoms of stroke except maybe age (72).
    I changed doctors again. After a month or so I broke out in a rash on my torso and went to my dermatologist. He looked at my list of medications and said to stop the Trilipix immediately.
    A rash is minor compared to what some of these patients endured but I now make it a practice to look up any new medication I receive, especially if the doctor tells me to take it from now on.

  20. TD
    Reply

    I took pravastatin for several year until about three years ago. My cholesterol numbers were good, but I was bothered by confusion.
    My doc immediately took me off the statin, saying he had the same problem.
    Here’s the kicker: my cholesterol has not gone back up! Perhaps statins are not an evermore treatment.

  21. fbl
    Reply

    The drug companies have a lot to answer for, as do the medical professionals who believe their rubbish.
    High cholesterol is a non-disease, with few exceptions. Those exceptions are the genetic disease that drugs really don’t solve either but do extend the lives of those who lost the genetic game.
    Anyone who eats a natural diet and has a cholesterol between 200-300 are just fine. If the numbers are too high, as my hubby’s were, then clean up the diet and get rid of the artificial oils.
    We do NOT use vegetable oils, other than Extra Virgin Olive Oil. As we transitioned to all natural oil his numbers came down-100 points! His average now is between 225 and 235.
    What do we use? Organic coconut and palm oils, organic bacon and drippings, unadulterated lard (when I can find it) real butter, nut oils for making mayonnaise etc. By the way, making mayo is very simple an easy.
    No the numbers won’t change overnight; it is a slow but steady process.

  22. HB
    Reply

    No one tells you the risks of taking the statin drugs, therefore be diligent about your health issues with these medications. I took one of these “satin” drugs and will never take another one, however, that is for me to make that decision and I am not making that decision for everyone out there. We are so over medicated with pills and more pills. Doctors need to be more aware of their patients health issues — with the way our medical profession is going we have less doctors to treat more patients! Why is that???
    I believe all statin drugs have side effects and what is really crazy is the fact that what works for 5 or more may not work at all for that one patient. Which is me!
    We are being bombarded with “medicine” ads on TV, magazines and books: “ask your Dr. if this medication is right for you,” that is really so far out. Like asking which cigarette is better for you! What would the answer be??? Sorry, but I have negative reactions when it comes to Doctors ignoring their patients complaints about medications.
    We have become too dependent on those little “pills” that solve our problems but in fact they create more issues for our bodies. I am so negative about medications, guess I shouldn’t be, because I know a lot of people have to take certain medications —-as long as its for the right reason. And who knows I may someday be one of these people.

  23. Joleene U.
    Reply

    I suggest looking into the benefits of using Coconut oil. It lowers cholesterol and improves cognition. I found lots of references to using it on the web.

  24. DJ
    Reply

    Statins cause people to be deficient in CoQ10, too. And can lead to many more health problems. I avoid taking statins, because the risks are too great for side effects and adverse reactions.

  25. V.R.
    Reply

    Can taking Zocor be the cause of short term memory loss? Would switching to Lipitor be any better?

  26. Cathy
    Reply

    The article mentioned pancreatitis as a side effect of many of these medications.
    Pancreatitis is horrible. A dear friend of mine was diagnosed with pancreatitis after taking statin drugs for years because she once had a stroke from which she fully recovered. She was indeed very, very sick from pancreatitis for many weeks. She describes the condition as “worse than death.” There isn’t really a cure for it. The patient just has to suffer, without eating, until the inflammation subsides (or so she was told).
    Her cardiologist has never recognized it as a side effect of the drugs he was prescribing, but she overheard her internal medicine doctor very mildly suggesting the connection to his nurse. My friend has none of the typical risk factors for pancreatitis. She continued the statin regimen for several more years until she began feeling symptoms of another bout. Then she discontinued the statins and the symptoms eased.
    She now says she feels there was a connection. She did this against her doctor’s advice. I believe she still takes a drug that tends to thin blood or act as anticoagulant somehow (not warfarin). At age 81, she has decided she would rather die of a stroke than live through pancreatitis again.

  27. Rick
    Reply

    I was on Lipitor for over 10 years when I started to develop problems with my muscles. Had rotor cuff problems and I finally torn a muscle loose from the shoulder with no violent maneuvers, but just standing and turning my head around. MY doctor took me off of Lipitor and put me on Lipofen. Been on Lipofen for about a year.
    I wish there was more knowledge and information on what is the best method of reducing cholesterol without taking medications. I also wonder if Lipitor was really responsible for the problems I have experienced with the muscles in my arms. It is really hard for me to say. Could the muscle problems just be a function of aging? Maybe. The problems I find with medications is that there are no definitive test to know if a particular drug like Lipitor was really responsible. Then I started Lipofen and I wonder all the time if it is so good why don’t they put more patients on that instead of a statin.

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