Any evidence to support statins and aspirin are better taken at night?

Posted by Joe M. @joem, May 7, 2016

Is there evidence or studies that support this article from the UK that statins and aspirin are better taken at night? http://www.dailymail.co.uk/health/article-2809844/Popular-medicines-statins-aspirin-effective-taken-NIGHT.html

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Hi @joem. Welcome to Connect. Thanks for joining our community. This is a great question and it's always good to stay up-to-date on research like this. I did a quick Google search on this and it looks like the overall consensus is that it depends on the statin. According to this article from Medscape (http://www.medscape.com/viewarticle/552756) multiple research studies show simvastatin is best taken at night. There is a trend favoring evening statin administration with lovastatin, pravastatin, and rosuvastatin but it's not statistically significant. In regards to the aspirin, articles on WebMD, the New York Times and U.S. News all say it should be taken at night. I hope this helps!

I'm tagging @caroleann, @prairiesmoke and @sjpphil who have posted about the use of aspirin or statins in the past and may have some insight.

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This from Harvard....a reliable source...Getting the most from your statin

You can do several things to make sure your particular statin is working the best it can.

Take Mevacor with food. This almost doubles the amount of medication that gets into your bloodstream.
Take some statins at night. It’s best to take Mevacor, Pravachol, Zocor, and Lescol with your evening meal. That’s because these statins block a key cholesterol-making enzyme in the liver that is most active at night. Lipitor and Crestor last long enough in the body that it doesn’t matter when you take them.
Beware of drug interactions. Mention all other medications you are taking when talking with your doctor about a statin, to avoid potentially harmful interactions. If you are on other medications, you may want to try Pravachol, which is less likely than the other statins to interact with other medications. http://www.health.harvard.edu/heart-health/the_healthy_heart_preventing_detecting_and_treating_coronary_artery_disease

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also regarding aspirin@ night..https://my.americanheart.org/idc/groups/ahamah-public/@wcm/@sop/@scon/documents/downloadable/ucm_458297.pdf

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@lynnkay1956

This from Harvard....a reliable source...Getting the most from your statin

You can do several things to make sure your particular statin is working the best it can.

Take Mevacor with food. This almost doubles the amount of medication that gets into your bloodstream.
Take some statins at night. It’s best to take Mevacor, Pravachol, Zocor, and Lescol with your evening meal. That’s because these statins block a key cholesterol-making enzyme in the liver that is most active at night. Lipitor and Crestor last long enough in the body that it doesn’t matter when you take them.
Beware of drug interactions. Mention all other medications you are taking when talking with your doctor about a statin, to avoid potentially harmful interactions. If you are on other medications, you may want to try Pravachol, which is less likely than the other statins to interact with other medications. http://www.health.harvard.edu/heart-health/the_healthy_heart_preventing_detecting_and_treating_coronary_artery_disease

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As long as we are discussing statins, I have a question that I wonder if you might be able to point me in a certain direction or shed your personal knowledge on? After my HA, my cardiologist put me on 80 mg of atorvastin (in the evening). Over time I noticed that I was having problems with numbness developing in my legs & feet when I walk after a while or even when I stood still for a period of time. I have had testing done to look at different possibilities such as ultrasound for blood pressure in my lower extremities and also nerve testing in my feet and legs. None has turned up anything. This has been a continued source of frustration especially sense I love to walk. I have been discussing this with both my doctor & cardiologist and both seem to think that this is not a typical side effect from statins. I asked if I could consider either reducing the amount taken to see if there may be a difference and have had mixed responses. My regular Dr. suggested switching to 40 mg of simvastatin. My cardiologist is suggesting to stop taking the statin altogether for a few weeks to see if anything changes. Any thoughts?

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@lynnkay1956

This from Harvard....a reliable source...Getting the most from your statin

You can do several things to make sure your particular statin is working the best it can.

Take Mevacor with food. This almost doubles the amount of medication that gets into your bloodstream.
Take some statins at night. It’s best to take Mevacor, Pravachol, Zocor, and Lescol with your evening meal. That’s because these statins block a key cholesterol-making enzyme in the liver that is most active at night. Lipitor and Crestor last long enough in the body that it doesn’t matter when you take them.
Beware of drug interactions. Mention all other medications you are taking when talking with your doctor about a statin, to avoid potentially harmful interactions. If you are on other medications, you may want to try Pravachol, which is less likely than the other statins to interact with other medications. http://www.health.harvard.edu/heart-health/the_healthy_heart_preventing_detecting_and_treating_coronary_artery_disease

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@thankful Check out this thread https://connect.mayoclinic.org/discussion/is-there-any-connection-with-statin-use-and-neuropathy-i-have-had/

@sjpphil asked Connect members "Is there any connection with statin use and neuropathy?" Her doctor was suspected that Zocor might be an issue with night cramping and the neuropathy. And a Mayo Clinic pharmacist also added her thoughts.

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@lynnkay1956

also regarding aspirin@ night..https://my.americanheart.org/idc/groups/ahamah-public/@wcm/@sop/@scon/documents/downloadable/ucm_458297.pdf

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Thanks for adding these studies @lynnkay1956. I haven't connected with you in a while. Welcome back.

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@joem we took your question to a pharmacist here at Mayo Clinic. She offers this information:

"Great question Joe. @lynnkay1956’s response about the body making more cholesterol at night is correct. With regard to aspirin: Taking aspirin at night is still being studied. A 2013 Dutch study found that the platelet activity in the morning was decreased more when aspirin was taken at bedtime rather than in the morning. However, the study also stated that further research is needed to determine if this actually decreases the amount of morning cardiovascular events. In other words, it may affect the platelet activity, but it has yet to be seen if it actually decreases the number of heart attacks and strokes. Key points to keep in mind with aspirin therapy: 1. Discuss with your doctor before starting it. 2. Take it at the same time every day."

Hope this helps.

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@colleenyoung

@joem we took your question to a pharmacist here at Mayo Clinic. She offers this information:

"Great question Joe. @lynnkay1956’s response about the body making more cholesterol at night is correct. With regard to aspirin: Taking aspirin at night is still being studied. A 2013 Dutch study found that the platelet activity in the morning was decreased more when aspirin was taken at bedtime rather than in the morning. However, the study also stated that further research is needed to determine if this actually decreases the amount of morning cardiovascular events. In other words, it may affect the platelet activity, but it has yet to be seen if it actually decreases the number of heart attacks and strokes. Key points to keep in mind with aspirin therapy: 1. Discuss with your doctor before starting it. 2. Take it at the same time every day."

Hope this helps.

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Any update on taking aspirin at night since this reply a bit over a year ago? I'll search PubMed, too.

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@colleenyoung

@joem we took your question to a pharmacist here at Mayo Clinic. She offers this information:

"Great question Joe. @lynnkay1956’s response about the body making more cholesterol at night is correct. With regard to aspirin: Taking aspirin at night is still being studied. A 2013 Dutch study found that the platelet activity in the morning was decreased more when aspirin was taken at bedtime rather than in the morning. However, the study also stated that further research is needed to determine if this actually decreases the amount of morning cardiovascular events. In other words, it may affect the platelet activity, but it has yet to be seen if it actually decreases the number of heart attacks and strokes. Key points to keep in mind with aspirin therapy: 1. Discuss with your doctor before starting it. 2. Take it at the same time every day."

Hope this helps.

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No change, so far as I can tell, @soloact. I have been taking aspirin for several years, always at the end of the day, because of advice that heart problems tend to group at night. As for statins, I'm back on atorvastatin now, and given the variations in statins, I follow the advice of middle-of-the-road counselors: I take it with my evening meal. Martin

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@colleenyoung

@joem we took your question to a pharmacist here at Mayo Clinic. She offers this information:

"Great question Joe. @lynnkay1956’s response about the body making more cholesterol at night is correct. With regard to aspirin: Taking aspirin at night is still being studied. A 2013 Dutch study found that the platelet activity in the morning was decreased more when aspirin was taken at bedtime rather than in the morning. However, the study also stated that further research is needed to determine if this actually decreases the amount of morning cardiovascular events. In other words, it may affect the platelet activity, but it has yet to be seen if it actually decreases the number of heart attacks and strokes. Key points to keep in mind with aspirin therapy: 1. Discuss with your doctor before starting it. 2. Take it at the same time every day."

Hope this helps.

Jump to this post

No change, so far as I can tell, @soloact. I have been taking aspirin for several years, always at the end of the day, because of advice that heart problems tend to group at night. As for statins, I’m back on atorvastatin now, and given the variations in statins, I follow the advice of middle-of-the-road counselors: I take it with my evening meal. Martin

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