What are the downsides of going on a statin?

October 7, 2025 •

3 min read

While statins are among the most commonly prescribed medications for lowering cholesterol, with evidence suggesting significant mortality and morbidity benefits, some individuals experience adverse effects. Understanding what are the downsides of going on a statin is crucial for managing treatment and making informed healthcare decisions.

Quick Summary

Statins are effective cholesterol-lowering drugs, but potential downsides include muscle pain, digestive issues, and a small risk of developing Type 2 diabetes. Rare complications like liver damage and severe muscle breakdown also exist.

Key Points

Common Side Effects: Muscle aches (myalgia), fatigue, and gastrointestinal issues like nausea are the most frequent downsides of taking a statin.
Rare but Serious Risks: Though very uncommon, serious risks include liver damage (indicated by elevated liver enzymes), rhabdomyolysis (severe muscle breakdown), and a slightly increased risk of developing Type 2 diabetes.
Diabetes Risk is Manageable: The increased risk of Type 2 diabetes from statins is small and mainly affects those already at higher risk; for high-risk cardiovascular patients, the heart benefits usually exceed this risk.
Managing Side Effects: Adjusting the dosage, switching to a different type of statin, or exploring non-statin cholesterol-lowering options can effectively manage or eliminate side effects.
Risk Factors: Higher doses, certain drug interactions, older age, female gender, and pre-existing conditions like liver or kidney disease can increase the risk of statin side effects.
Weighing Benefits and Risks: For many at-risk individuals, the significant cardiovascular protection offered by statins in preventing heart attack and stroke is considered to outweigh the potential downsides.

Statins are a class of drugs that work by blocking an enzyme in the liver responsible for producing cholesterol. While proven to be highly effective at reducing the risk of heart attacks and strokes, they can come with a range of side effects for some individuals. The severity of these side effects can range from mild discomfort to rare but serious health issues. Awareness of these potential problems is key to a productive conversation with your healthcare provider about managing your treatment.

Common Side Effects

Common statin side effects are generally mild and manageable. The most frequently reported issues include muscle pain (myalgia), affecting up to 10% of patients and often impacting larger muscles like those in the thighs and calves. Gastrointestinal issues such as nausea, bloating, gas, constipation, or diarrhea may also occur. Other less severe, common effects can include headaches, dizziness, and sleep problems, particularly when first starting the medication. These symptoms are often temporary or reversible upon stopping the medication.

Rare but Serious Complications

While infrequent, some statin side effects are more serious and require prompt medical attention. It's important to note that the risk of these complications is very low for most people.

Increased Risk of Type 2 Diabetes

Statins may slightly increase blood sugar levels, raising the risk of developing type 2 diabetes, especially in individuals with existing risk factors such as prediabetes or obesity. However, for many patients at high cardiovascular risk, the heart-protective advantages of statins typically outweigh this small increase in diabetes risk.

Liver Damage

Statins can lead to increased liver enzyme levels, which might indicate inflammation. Severe liver damage is rare, but possible. Regular blood tests may be used to monitor liver function. Symptoms of serious liver problems include unusual fatigue, loss of appetite, and dark urine.

Rhabdomyolysis

This is a very rare but life-threatening condition involving severe muscle damage. It can lead to kidney failure or death due to the release of damaged muscle tissue components into the bloodstream. The risk of rhabdomyolysis is higher with very high statin doses or when taken with certain interacting medications. Symptoms include extreme muscle pain, dark-colored urine, and weakness.

Neurological Effects

Memory loss and confusion have been reported by some patients taking statins, leading the FDA to include this on warning labels. These symptoms usually resolve after discontinuing the medication. Research continues, with some evidence suggesting statins might even benefit brain function in specific conditions.

Factors that Increase the Risk of Side Effects

Certain factors can increase the likelihood of experiencing statin side effects. These include high statin dosage, interactions with other medications (like certain antibiotics or antifungals), being over 80, being female, having a smaller body frame, or having pre-existing conditions like kidney or liver disease, hypothyroidism, or neuromuscular disorders. Excessive alcohol consumption and consuming grapefruit juice can also increase the risk of certain side effects by affecting how the body processes the medication.

Comparison of Common Statin Side Effects

Different statins have varying potencies and side effect profiles. The table below provides a general overview:


Feature	Atorvastatin (Lipitor)	Rosuvastatin (Crestor)	Pravastatin (Pravachol)	Simvastatin (Zocor)
Potency	High	High	Moderate	Moderate-High
Likelihood of Muscle Pain	Moderate	Lower	Lower	Higher
Drug Interaction Risk	Moderate	Lower	Lowest	Highest
Interaction with Grapefruit	Yes	No	No	Yes
Diabetogenic Risk	Higher (High dose)	Higher (High dose)	Lower	Higher
Hydrophilic/Lipophilic	Lipophilic	Hydrophilic	Hydrophilic	Lipophilic

Managing Side Effects

If you suspect you are experiencing side effects, consult your healthcare professional instead of stopping your medication suddenly. Your doctor may suggest strategies such as adjusting the dose, switching to a different type of statin (like one that is more hydrophilic, such as pravastatin), considering intermittent dosing for certain statins, or exploring non-statin alternatives like PCSK9 inhibitors or ezetimibe. Your doctor can also help rule out other potential causes for your symptoms, considering the possibility of a 'nocebo effect' in some cases of reported muscle pain.

Conclusion

While concerns about side effects are understandable, the significant benefits of statins in preventing heart attacks and strokes generally outweigh the potential risks for most individuals with high cholesterol. Open communication with your doctor is essential to discuss your personal risk factors and potential side effects to determine the most appropriate treatment plan. If side effects occur, they can often be managed through dose adjustments or alternative treatments, allowing you to effectively protect your cardiovascular health. For more information on statin side effects and management, you can refer to resources like the Mayo Clinic website: Statin side effects: Weigh the benefits and risks.

Frequently Asked Questions

No, you will not definitely get muscle pain. While myalgia is a common side effect, many individuals do not experience it. Some studies even suggest a 'nocebo effect,' where the expectation of muscle pain increases its reported occurrence. If you do experience it, it is often mild.

Some people have reported temporary memory loss or confusion, and the FDA has added a warning to statin labels. These effects are not common and typically reverse once the medication is stopped. Several large studies have found no evidence linking statins to long-term cognitive decline.

Statin use can sometimes cause elevated liver enzyme levels, but actual liver damage is very rare. Most cases of elevated enzymes are mild, and treatment can continue. Your doctor may monitor your liver function with blood tests, especially at the start of therapy.

If you experience side effects, discuss them with your doctor. Management strategies include adjusting your dose, switching to a different statin, or using a non-statin medication.

Yes, statins are associated with a small increase in the risk of developing Type 2 diabetes, particularly in people who already have risk factors like prediabetes or obesity. For patients with high cardiovascular risk, however, the heart-protective benefits are considered more significant than the increased diabetes risk.

You should not stop taking your statin medication on your own. Always consult your healthcare provider first. They can help determine if the statin is the cause and recommend a treatment plan, which may include a different dose or medication.

Yes, grapefruit juice contains a chemical that can interfere with how certain statins, like atorvastatin and simvastatin, are metabolized. This can increase the level of the drug in your body and raise the risk of side effects. It's best to discuss this with your doctor and pharmacist.