Alternative to atorvastatin? Joint pain

[SnoozingFox]

Gp started me on 20 mg of atorvastatin a few weeks ago - my cholesterol is stubbornly high because of underlying under active thyroid issues. I am having quite bad pain in my knees which I was told could be a side effect? Have to go back for a blood test and review - what have others done in this situation - lower dose or different type of statin?

Interesting to read this as my mum had a stroke in January and this is one of the new tablets she is now taking.
She is in so much pain, she says she feels as if her whole body aches from head to toe. She recovered so well from the stroke and seemed to be doing really well until she started on this medication. She is on a couple of other new tablets too so could be down to that also.

I have had every statin available and each one has given me appalling side effects from chronic constipation to excruciating shoulder pain and severe itching.
I am now on Bempedoic Acid, I’ve managed a low dose for some months.

This is the issue I’m having - disentangling whether the pain is from the tablets or just because I’m old and menopausal. It was 50/50 whether I should take a statin at all so it may be I just stop taking it completely and leave it another couple of years - I did bring cholesterol down massively by overhauling my diet but it was unsustainable as so restricting on what I could eat.

Talk to your GP. Don't just stop taking it because it massively increases your stroke risk. Atorvastatin gave DH loads of cramps, so his GP changed his prescription.

I think Atorvastatin is the default first option because it is the cheapest.

See this is the thing - I don’t really have a high stroke risk. My blood pressure is fine, my sugars are fine, no familial history. It’s just the bloody cholesterol. Will make another appointment to discuss, would be happy to try another brand.

I'm on Atorvastatin but I'm fine with it. The GP and Pharmacist said to come back if there were any problems, the most likely problem being joint pain, so do that. I even got a phone call from the Pharmacy after a couple of weeks to check everything was going well.

There are lots of different types so it’s worth getting your prescription changed

I have just been prescribed Rosuvostatin, daren't take it, I have arthritis and fibro already.

So, why not talk to the GP first and try to find something else to reduce your risk of stroke or heart attack?

I don't understand people who are prescribed potentially life saving prescriptions who then just refuse to take them without discussing it with a health professional.

Check in with your pharmacist, they know medicines.
Alternatively talk to your GP (or practice pharmacist, different to the pharmacist the local pharmacy). You know the joint pain isn't right, it is a common side effect but atorvastatin is the first line treatment. There's other options out there!

Statins stabilise the plaque in your blood vessels so it's not just a case of lowering cholesterol. This reduces your chances of stroke and heart attack for a start. There are several variations of statins so it's worth trying a different one to see if it suits.

Tried all different statins with painful muscle side effects. Referred to the lipid clinic ( familial hypercholesterolaemia) and now on Nustendi. What a revelation.No side effects. Cholesterol levels dropped.You might need a referral if your GP can’t prescribe it initially.

Go back to your doctor. I can’t take any of the statins that the name ends in statin, I’ve tried them all. Doctor said my cholesterol is because of my age, 67. My father also died of a heart attack at 51. I had severe muscle pain and large, boil like acne appear over my face and back.
Put me on Nilemdo. I have no muscle pain and no acne. There are alternatives to statins.

I was prescribed that ,I explained to the GP that I wasn't prepared to try it as I battle with cramps and joint pain due to an accident years ago but he wouldn't even consider it. Wanker 🙄

From what I understand there are two types and mostly GPs start you on Atorvastatin as it's cheap but to avoid cramps/pain you need to ask for a water based one like Rovastatin . I haven't had any issues at all once the pharmacist who was really understanding did my review and changed it.

No it’s not a cost saving thing . Atorvastatin is the first choice because it’s a highly affective modern statin that causes fewer side effects than older statins like simvastatin.
Many people attribute aches and pains and other symptoms to statins but they are so important for anyone with cardiovascular disease as they stabilise arterial linings and a study showed that only one in 11 people who thought their muscular pain was statin related was correct.

If you think statins are causing muscular pain you can get a blood test to check.

But first
take the statin at night
increase dose slowly
consider rosuvastatin as an alternative high intensity statin with low side effect profile

Pravastatin is the other one to try if you don’t get on with atorvastaatin..

I am exactly the same.

I had two strokes in January and was doing much better until they put me on the atorvastatin. 80mg is apparently the protocol after Stroke no matter what. As is lowering your cholesterol much lower than the generally accepted level. Mine wasn't even high before the stroke.

i'm on other tablets too (I wasn't on any before the Stroke) but I know other people feeling awful on atorvastatin and others who feel mostly okay on a low dose, but if they go from say 20 to 30 or 30 to 40 they feel dreadful, so I'm not really surprised that we feel so awful on 80!!

I've done my three months on 80 and I have an appointment with my GP in the middle of April where I will be really really pushing to get the dose lowered.

Interesting, how do you determine what dose is necessary??

Good post - I have myositis so was expecting to get the muscle pain when I first started this drug and I did but it slowly subsided. Think it’s important to show that many of us do get on with this drug which as far as I’m concerned is an absolute must for my health.

I don't know the answer to that apart from I assume the higher the risk, the higher the dose. I'm on 40mg Atorvastatin as I have CHD and had a completely blocked left artery (2 stents now in). I didn't have raised cholesterol, though it's lower now and in the right areas. The stabilising of the plaque seems pretty important though as bits breaking off aren't good news.
DH is on 20mg as he had a small stroke (not TIA) a few years ago. Neither of us has had side effects luckily.

Thanks for your reply.

I assumed you were speaking from a medical point of view rather than a personal one earlier as you really seem to know what you were on about 😊

How was your husband getting on after his stroke?

Thank you for your explanation @olympicsrock
I stand corrected.

I had two strokes in January and was doing much better until they put me on the atorvastatin. 80mg is apparently the protocol after Stroke no matter what.

Yes, this is what DH was told. He is on 80mg daily.

Experiment with your GP's suggestions for statin variants. One thing I'll add: there are non-statin cholesterol reduction drugs too, for those intolerant - ezetemibe for example.

Please get it changed and get blood tests as it can do damage. This is speaking from someone who used to work in a pharmacy and also someone who was put on atorvastatin.

I was in so much pain the pharmacist at the time insisted I stop it immediately and phone the doctors. I was sent for same day bloods and changed to rosuvastatin.

Luckily no long term damage but it is very important for you and all the others experiencing pain on it to get bloods ASAP and change. I will add the risk of issues which cause muscle breakdown and liver issues are about 5% so low but it is still a risk you shouldn't take.

I put off taking statins for years (“ I will try to sort my cholesterol with lifestyle changes, really, I will. ” ) even though my gp rightly pointed out that this wasn’t working, and hadn’t worked for years! However, I went onto statins after having a few heart rhythm issues and having a pacemaker fitted. Cholesterol went down within weeks, I was put onto atorvastatin and luckily have had no problems with it.

I do wonder whether going on a statin earlier would have possible prevented my other heart problems -hindsight is very unhelpful - but I would say to anyone who has been prescribed something which could save you from a stroke or heart attack please do work with your gp to get the best out of your diagnosis by discussing things with them and being honest.