Statins

Order a prescription for your pharmacy of choice for high cholesterol treatment.

€21.50 per consultation

€21.50 per consultation

Simply fill in a brief questionnaire. One of our doctors will review your order and prescribe a suitable treatment. How to Order

Statins are a group of medications used to reduce high cholesterol levels in the blood.

If you are looking to order your repeat statin prescription online, our convenient online service at ZAVA provides a safe and fast option.

We will ask you to fill in a brief questionnaire when you place your prescription order. One of our doctors will check if the medication is suitable for you and issue your prescription to a local pharmacy in Ireland. Alternatively, you can choose to have your medication delivered directly to your door.

We prescribe all common types of statin. Please note, that this service is only suitable for patients who have been taking a statin for at least three months.

A consultation for statin prescription costs €21.50.


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What is high cholesterol?

Statins are used to control high blood cholesterol. Every cell in your body uses cholesterol to build the membrane in its outer wall. Cholesterol is made in the liver but can also be found in some foods. Cholesterol is transported around the body by proteins. When cholesterol and proteins combine, they are known as lipoproteins.

There are two types of lipoprotein:

  • High-density Lipoprotein (HDL) or good cholesterol: HDL returns cholesterol away from the cells back to the liver. In the liver, it is either broken down or passed out of the body as a waste product. For this reason, HDL is described as good cholesterol.
  • Low-density Lipoprotein (LDL) or bad cholesterol: High rates of bad cholesterol (LDL) can be dangerous because it can lead to a hardening or narrowing of the arteries. LDL is taken to cells that need it, but if there is an excess of cholesterol, it builds up in the artery walls, causing disease of the arteries. This can slow or block the flow of blood to the brain or heart or the rest of your body. Reduced blood flow increases the risk of serious conditions like coronary heart disease, heart attacks and strokes. It also increases the risk of developing a blood clot elsewhere in your body.

High blood cholesterol means high levels of LDL or bad cholesterol in the blood.

How can I tell whether my cholesterol is too high?

Cholesterol can be measured with a blood test – either blood is taken with a syringe or by pricking your finger. There are several types of cholesterol measurements used, but the HSE recommends a healthy total cholesterol (TC) blood level should be less than 5mmol/L.

What are the risk factors for high cholesterol?

The following factors increase your chances of having a heart attack or stroke as a result of high cholesterol:

  • family history of heart disease or stroke
  • family history of a genetic condition called familial hypercholesterolaemia
  • being of Pakistani, Bangladeshi or Sri Lankan descent – people from these ethnic groups have a higher likelihood of getting high cholesterol
  • having diabetes, high blood pressure, kidney disease, liver disease, or an under-active thyroid
  • age – as you get older your arteries are more likely to narrow due to fatty plaque build-up (known as atherosclerosis)
  • lack of physical activity or exercise
  • obesity
  • drinking lots of alcohol
  • eating an unhealthy diet
  • smoking – cigarettes contain a chemical called acrolein which stops High-Density Lipoprotein (good cholesterol) from transporting Low-Density Lipoprotein (bad cholesterol) to the liver. This means that the bad cholesterol continues to build up in your arteries, narrowing them.

What should I do first to lower my cholesterol?

The first thing you should do to lower high cholesterol is increase the amount of exercise you do and eat more healthily. If this does not work, then your doctor will suggest trying medications like statins.

How should I adjust my lifestyle to lower my cholesterol levels?

To change your diet, you should eat less saturated fat. Men should eat less than 30g of saturated fat and women should eat less than 20 g of saturated fat a day.

Check the labels of the food you are eating to work out how much saturated fat is in your food but try to avoid fatty meats or meat products (sausages and pies for example), butter, ghee, lard, cream, soured cream, crème fraiche and ice cream, hard cheese, cake and biscuits, chocolate, coconut oil, coconut cream and palm oil.

You can also start to eat more foods high in omega-3 fatty acids. Experts believe that eating fish like tuna, mackerel and salmon can lower cholesterol levels.

What treatment options are there?

To lower your high cholesterol, increase your daily amount of exercise and eat more healthily. If this does not work, your doctor may suggest trying statins.

What are statins?

Statins block a chemical that helps to make cholesterol in your liver. Taking statins means that less cholesterol is produced by the liver. This results in lower cholesterol levels in the blood. There are different types of statins. Most commonly, GPs ask people to start with simvastatin (brand name Zocor). Depending how you get on with this medication and whether you experience any side effects, there are other types of statins that you can try. These include atorvastatin (Lipitor) and rosuvastatin (Crestor). Reducing cholesterol is an important step in maintaining your health and preventing dangerous complications.

How do I take statins?

Most statins come as tablets. It is important to take them regularly as outlined on the prescription. Often statins should be taken at night because this is when the liver produces most cholesterol. If you are not sure, read the patient information leaflet or check with your doctor or pharmacist.

Which statins are best?

All statins do the same thing. They all block a step in the liver’s production of cholesterol and reduce the levels of cholesterol in the blood – especially the levels of bad cholesterol. Often, people do not need a very strong statin to lower their cholesterol levels. If you experience side effects or an intolerance to one type of statin, you might find that a different one works much better. Speak to your doctor about the right statin for you.

Statins and grapefruit - do they interact?

Drinking a glass of grapefruit juice or eating a grapefruit while taking certain types of statins can be very dangerous. Grapefruit contains the compound Bergamottin. Bergamottin interacts with several enzymes that break down statins and other medications. This means your body will not be able to break down the medication. As a result, you may end up with a high concentration of the drug in your body. This is dangerous and can cause liver, kidney or severe muscle damage. Always read the patient information leaflet for more information or speak to your doctor if you are worried.

Can I take statins and drink alcohol at the same time?

Taking alcohol and statins can damage your liver. You should not drink excessively while taking statins and discuss any regular alcohol consumption with a doctor, to make sure you are not causing any damage to your liver.

How do different statins compare?

A recent research paper found that with an identical dose, the statins atorvastatin and rosuvastatin may lower bad cholesterol the most. A single dose of atorvastatin and rosuvastatin lasts longer than a single dose of other types of statins. This also means that they can be taken at any time of day, whereas normally statins need to be taken at night because this is when the liver produces most cholesterol.

Clinical evidence is strongest for simvastatin, pravastatin and atorvastatin because they have been tested on the most patients and have very clear benefits. The longer-term benefits of fluvastatin and rosuvastatin are less clear.

Is there a price difference?

Simvastatin and pravastatin are made by generic manufacturers, so are significantly cheaper than other brands of statins.

Are there alternatives to statins?

There are different types of medication available to lower your cholesterol levels. These include statins, aspirin, niacin, and ezetimibe.

What is Niacin?

Niacin is a B vitamin found in foods and vitamin supplements. In high doses, Niacin can reduce levels of bad cholesterol. Niacin can cause side effects, particularly flushing on the face. It can also damage your liver if you take it for a long time. For this reason, it is not used very often.

What's Ezetimibe?

Ezetimibe is a medication that stops your body absorbing cholesterol and bile juices from the intestines into your blood. It is generally not as effective as statins, but it rarely has side effects, making it an alternative option for people who are unable to take statins due to possible drug interactions.

You can also combine ezetimibe with your statins if your cholesterol does not drop low enough with statins on its own. Using the two drugs in combination usually results in the same side effects as those caused by statins alone – primarily muscle pain and stomach problems. Speak to your doctor if you want to try both medications.

Types of statins

There are different types of statins, including:

  • simvastatin (Zocor)
  • atorvastatin (Lipitor)
  • rosuvastatin (Crestor)
  • pravastatin (Lipostat)
  • fluvastatin (Lescol)

All statins work in a similar way, by blocking a step in the liver’s production of cholesterol. They all reduce the levels of cholesterol in the blood – especially the levels of bad cholesterol.

Simvastatin and pravastatin are made by generic manufacturers and are cheaper than other brands of statins.

Which type of statin is right for me?

Often people do not need a very strong statin to lower their cholesterol levels. If you experience side effects or an intolerance to one type of statin, you might find that a different one works much better. Speak to your doctor about the right statin for you.

Side effects of statins

Statins are not the right choice for everyone and some people should never take them. Before taking statins, read the patient leaflet supplied with your medication for a full list of all known statins side effects and cautions.

Simvastatin (Zocor)

Simvastatin may not be suitable for you, if you:

  • are going to have surgery
  • are older than 65 years
  • are allergic/sensitive/have reacted badly to a statin or fibrate previously
  • are allergic to any of the ingredients in Simvastatin
  • are breast-feeding
  • are female
  • are pregnant (simvastatin must not be taken in pregnancy)
  • drink a lot of alcohol
  • are galactose intolerant or have problems with glucose-galactose malabsorption
  • have hypothyroidism
  • have kidney or liver problems
  • have Lapp lactase deficiency
  • have a family history of muscle disorders
  • have or have had high blood pressure/hypertension
  • have risk factors for rhabdomyolysis.

Simvastatin is unsuitable for children under 10 years old, or children who have not reached puberty, or girls who have not yet started having their period.

Simvastatin may interact with the following groups of medicines:

  • Anticoagulants
  • Calcium channel blockers
  • Cytochrome P450 enzyme inducers
  • Cytochrome P450 enzyme inhibitors
  • Fibrates
  • HIV protease inhibitors
  • Certain antibiotics (rifampicin, erythromycin)
  • Some antifungal drugs (itraconazole, posaconazole)

For a full list of drugs that interact with Simvastatin (Zocor), read the patient leaflet supplied with your medicine. If you are taking any of these drugs or any other medications, including vitamin supplements, inform your doctor immediately.

What are the side effects of Simvastatin?

Simvastatin side effects are rare, but they include:

  • abnormal laboratory test results
  • blood problems
  • constipation
  • diarrhoea
  • feeling dizzy
  • flatulence
  • hair loss
  • headaches
  • indigestion
  • itching
  • nausea
  • damage to the nerves in your hands or feet, which can cause numbness, pain or weakness (peripheral neuropathy)
  • pancreatitis
  • paraesthesia
  • rhabdomyolysis
  • skin rash or rashes
  • stomach pain
  • vomiting
  • weakness
  • liver problems
  • muscle problems

Consult your doctor as soon as possible if you experience any of these side effects.

Atorvastatin (Lipitor)

Atorvastatin may not be suitable for you, if you:

  • could get pregnant and are not using an effective method of birth control
  • are older than 70
  • are allergic/reacted badly to a statin or a fibrate previously
  • are allergic/reacted badly to any of the ingredients in the medicine previously
  • are breast-feeding
  • are pregnant
  • drink a lot of alcohol
  • are galactose intolerant
  • have problems with glucose-galactose malabsorption
  • have had a stroke
  • have had transient ischaemic attacks
  • have hypothyroidism
  • have Lapp lactase deficiency
  • have lung problems
  • have or have a family history of muscle problems
  • have or have had kidney or liver problems
  • have risk factors for developing rhabdomyolysis
  • are a child under 10 years old.

To check if Atorvastatin is the right medication for you, the doctor may also run some tests first.

Your body’s reaction to Atorvastatin can change with time. If this happens, speak to your doctor straight away.

Atorvastatin may interact with the following groups of medicines:

  • Coumarin anticoagulants
  • Cytochrome P450 enzyme inducers
  • Cytochrome P450 enzyme inhibitors
  • Fibrates
  • Magnesium/aluminium hydroxide antacids
  • Medicines that can cause muscle problems
  • Oral contraceptives
  • Protease inhibitors
  • Antifungals (itraconazole, ketoconazole)

If you are taking any other medication or vitamin supplements, tell the doctor when you ask for the prescription. For a full list of drugs that interact with Atorvastatin, read the patient leaflet supplied with your medicine.

What are the side effects of Atorvastatin?

The most common side effects of Atorvastatin were headache, stomach problems, and/or back ache.

See a doctor straight away if you have muscle cramps, pain, or weakness, as they could be fatal.

For a full list of Atorvastatin side effects, read the patient leaflet supplied with your medicine.

Rosuvastatin (Crestor)

Rosuvastatin may not be suitable for you, if you:

  • could get pregnant and are not using an effective method of birth control
  • are older than 70
  • are allergic/reacted badly to any of the ingredients in the medicine previously
  • are breast-feeding
  • are of Asian origin
  • are pregnant
  • are or have been at risk of developing diabetes
  • are galactose intolerant
  • have problems with glucose-galactose malabsorption
  • have had muscular toxicity caused by a fibrate or a HMG-CoA reductase inhibitor
  • have kidney problems or have conditions that may increase the risk of developing kidney problems
  • have Lapp lactase deficiency
  • have or have had high blood pressure
  • have or have had liver problems
  • have problems metabolising medicines
  • have risk factors for developing muscle problems such as if you drink alcohol heavily, have hypothyroidism, have muscle disorders or have a family history of muscle disorders

To check whether Rosuvastatin is the right medication for you, the doctor may also run some tests first.

Rosuvastatin may interact with the following groups of medicines:

  • Aluminium/magnesium antacids
  • Azole antifungal agents
  • Coumarin anticoagulants
  • Fibrates
  • Hormone replacement therapy
  • Lipid lowering medicines
  • Macrolides
  • Oral contraceptives
  • Protease inhibitors
  • Vitamin K antagonists

If you are taking any other medication or vitamin supplements tell the doctor when you ask for the prescription. For a full list of drugs that interact with Rosuvastatin, read the patient leaflet supplied with your medicine.

The most common side effects for Rosuvastatin are:

  • constipation
  • diabetes
  • muscle problems – See a doctor straight away if you get unexplained muscle pain, cramps, weakness or tenderness.
  • feeling dizzy
  • headaches
  • nausea
  • proteinuria
  • stomach pain
  • weakness

Pravastatin (Lipostat)

Pravastatin may not be suitable for you, if you:

  • are older than 70
  • are allergic or react badly to any of the ingredients in the medicine
  • are breast-feeding
  • are pregnant
  • drink a lot of alcohol
  • are galactose intolerant
  • have problems with glucose-galactose malabsorption
  • have had muscular toxicity caused by a statin or a fibrate
  • have hypothyroidism, kidney problems, or liver problems
  • have Lapp lactase deficiency
  • are at risk of developing diabetes
  • have risk factors for muscle problems

Generally, this medication is not prescribed for children under 8 years old.

To check whether Pravastatin is the right medication for you, the doctor may also run some tests first.

Pravastatin may interact with the following groups of medicines:

  • Ciclosporin
  • Clarithromycin
  • Colestipol
  • Cholestyramine
  • Erythromycin
  • Fenofibrate
  • Gemfibrozil
  • Nicotinic acid
  • Bile acid sequestrants
  • Fibrates
  • Liver enzyme inhibitors

If you are taking any other medication or vitamin supplements be sure to tell the doctor when you ask for the prescription.

What are the side-effects of Pravastatin?

The most common side effects of Pravastatin are abnormal laboratory test results, or muscle problems – these can also be fatal. See a doctor straight away if you get unexplained muscle pain, cramps, weakness or tenderness.

Less common side effects include:

  • constipation
  • diarrhoea
  • difficulty sleeping
  • eye or eyesight problems
  • dizziness
  • flatulence
  • headaches
  • heartburn
  • indigestion
  • itching
  • nausea and vomiting
  • scalp or hair loss problems
  • sexual dysfunction
  • skin rash or rashes
  • sleeping problems
  • stomach pain or ache
  • fatigue
  • urinary problems
  • urticaria

Fluvastatin (Lescol)

Fluvastatin (Lescol) may not be suitable for you, if you:

  • are an older person
  • are allergic or react badly to any of its ingredients
  • are breast-feeding
  • are pregnant
  • drink a lot of alcohol
  • have kidney problems, or liver problems
  • have risk factors for muscle problems

These medicines, among others, can interact with Lescol:

  • Colchicine
  • Cyclosporine
  • Phenytoin

If you are taking any other medication or vitamin supplements, tell the doctor when you ask for the prescription.

Common Fluvastatin side effects include:

  • memory problems or confusion
  • dizziness
  • headaches
  • indigestion
  • itching, skin rash or rashes
  • nausea and vomiting
  • fatigue
  • urinary problems
  • pain in your upper stomach,
  • loss of appetite
  • muscle problems – these can also be fatal. See a doctor straight away if you get unexplained muscle pain, cramps, weakness or tenderness

For a full list of drugs that interact with Fluvastatin and all known side effects, read the patient leaflet supplied with your medicine.

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Medically reviewed by:
Dr Kathryn Basford

Dr Kathryn Basford is an IMC and GMC registered GP who works with our Irish team here at ZAVA. She graduated from the University of Manchester and completed her GP training at Whipps Cross Hospital in London.

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Last reviewed: 08 Jan 2021





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