Which is the best statin for preventing further plaque growth?

I think it’s more likely to depend on which you tolerate best because some statins are more likely to cause side effects than others and the individual response may vary. Some people have no side effects at all. In the experience helping my dad, rosouvastatin and atorvastatin (Lipitor) are considered the most “potent.” It’s not usually a situation where “stronger is better” though; the focus is on finding something someone can take consistently with minimal side effects because any statin, even at a lower dose would lower risk of a cardiac event. They look at it as how to lower the risk calculation.

Can you talk to your doctor about options and what they suggest to consider first, and why they recommend it?

He happened to start on atorvastatin (don’t know why; I assume his doctor just chose it to try first because it’s one of the most widely prescribed), but it was moot because he had very bad side effects. He then changed to Crestor, which caused him acute liver damage (labs are done regularly with Crestor because it’s a known adverse effect). So neither of this worked for him; he’s most likely statin-intolerant, but technically you have to try three statins to be considered statin-intolerant.

There are many, so in his case, he could have still tried a lower dose or another statin, or even a non-statin cholesterol-lowering medication like Zetia, which many people tolerate well, but it’s not as strong as a statin. But he has extreme sensitivities to medication, so we decided to forgo a statin because at the moment he’s also struggling with PMR, an autoimmune inflammatory arthritis that occurs in older individuals, so being on a medication merry-go-round while also trying to manage the complexity of the PMR seemed a bad idea.

@lazarian
Statin drugs have been around a long time now. Brand types have now gone to generic. I take Atorvastatin. This was prescribed to me by both cardiologist and heart failure specialist at Mayo Clinic.

I take 40 mg of it each night. If you are being prescribed 20 mg then your plaque probably is not very bad and/or not expected to get much worse. I think 40 mg is highest recommended dose (but not sure). I was actually prescribed 35 mg. but it comes in 40 mg tablet so they raised it to 40 for convience.

Have you been told to take Co-Q-10 with the statin? The research and finding have discovered that taking a statin can reduce Co-Q-10 in body and cause muscle soreness. Thus I take Co-Q-10 recommended again by my heart failure and cardiolgist at Mayo of 200 mg.

You will read in MCC a lot of discussion on Co-Q-10 and taking Ubiquinol instead. This is because Ubiquinol is much more highly absorbed by body than regular Co-Q-10.

The max daily dose for atorvastatin is 80.

I take 10mg rosuvastatin - generic Crestor. My brother took it without issues and they say what works for one first degree relative genetic tends to work for another. But it causes constipation and so I have to balance that with a med that does the opposite like magnesium.

I agree with all that has been offered. It's always a trial with every initial prescription. Some find it like a placebo in terms of its apparent impact, while others have all sorts of problems and have to be prescribed another formulation. Muscle and joint pain and weight gain are quite common complaints.

Good call on the CoQ10, although I just saw a meta-analysis this morning saying there is no significant improvement in CoQ10 circulating in the blood between those taking it, when on statins, and those not taking the supplement. Yikes!! Maybe the problem is when each is taken. Statins best in the evening, so maybe swallow your CoQ10 about four hours prior to ingesting the statin? Remember, it's what is bioavailable, not just how much you take. The statin quells the bioavailability when it is also active in the blood, which itself has a half-life of around 14 hours. Taking the CoQ10 about four hours prior to the statin puts the half-life of the statin down at about 35%.

shelby29
The information on Statin comes from my Mayo Cardiologist. He was referring to the dosage and the 40 mg pill as maximum dose size pill. I was on a lessor dosage at first which required me to break the pill and raised it to 40 mg for convience.

Prescribed medications the amount can be higher of course based on need and degree of plaque that your doctor wants for you. I don't know what is on manufactures web site as there are many manufactures of Statins and probably by FDA have to set maxium levels.

My posts was to say I did not have any side affects with the statin but I was already taking Co-Q-10. The taking of the Co-Q-10 came from my heart failure doctor who is the Director of Heart Failure and Transplant at Mayo.

My wife though was put on a very low statin dosage and experienced muscle pain. I told her about the Co-Q-10 and she took it (after discussing with her doctor) and got improvement. I think it is a personal think in what works for one or good for one person my not be good or work for another. Every drug, every supplement, have a side affect. It is a good ones that we want and not any negative ones.

I was not aware the research on statins substantiated preference for taking them at night?
https://connect.mayoclinic.org/comment/1076112/

My cardio has suggested Repatha which is a self-injection taken every 2 weeks. I am in the process of maybe switching. Repatha is known to decrease numbers better than most oral statins. The side-effects are troublesome but I am unsure of how common they are.

https://www.healthline.com/health/high-cholesterol/why-should-you-take-statins-at-night#:~:text=Most%20statins%20should%20be%20taken%20once%20every%2024,the%20cholesterol-making%20enzyme%20is%20more%20active%20at%20night.
https://www.medicalnewstoday.com/articles/325047#best-times-to-take
The short-term statins are best taken at night, while the longer acting ones can be taken at any time.

gloaming,

Thanks for the citation - absolutely correct.

I had not read much re short term statins.