How well tolerated are lipid-lowering drugs?

B. Tomlinson, P. Chan, W. Lan

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

It has been clearly established that lipid-lowering treatments [such as 3-hydroxyl-3-methylglutamyl coenzyme A reductase inhibitors ('statins') or fibrates] can reduce cardiovascular events, and with one of the statins even total mortality, in high-risk populations. Intervention studies have not included the very old, but it is generally assumed that this patient group would benefit from these treatments to an extent similar to younger patients. Worries about the associations seen in observational studies between low cholesterol levels and cancer, cerebral haemorrhage or mood and behaviour change have been largely overcome by findings from the latest large drug intervention trials, which do not show any increase in these conditions with statin or fibrate treatments. The common adverse effects associated with these drugs are relatively mild and often transient in nature. Potentially more serious adverse effects, which are more clearly related to drug treatment and are probably dose-dependent, include elevations in hepatic transaminase levels and myopathy; however, these effects are uncommon and generally resolve rapidly when treatment is stopped. The risk of myopathy with fibrate treatment is increased in patients with renal impairment, and the risk of myopathy with statin treatment increases with coadministration of drugs that inhibit statin metabolism or transport. Other adverse effects are related to specific drugs, for example, clofibrate is associated with an increased risk of gallstones. Studies in elderly patients have not shown an increased risk of adverse effects with lipid-lowering drugs compared with younger patients, but in clinical practice there may be some increased risk, particularly with regards to drug interactions. Therefore, lipid-lowering drugs should be administered with extra caution to elderly patients.

Original languageEnglish
Pages (from-to)665-683
Number of pages19
JournalDrugs and Aging
Volume18
Issue number9
Publication statusPublished - 2001

Fingerprint

Hydroxymethylglutaryl-CoA Reductase Inhibitors
Lipids
Fibric Acids
Pharmaceutical Preparations
Muscular Diseases
Therapeutics
Clofibrate
Cerebral Hemorrhage
Gallstones
Coenzyme A
Transaminases
Drug Interactions
Hydroxyl Radical
Observational Studies
Oxidoreductases
Cholesterol
Kidney
Mortality
Liver
Population

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Pharmacology

Cite this

Tomlinson, B., Chan, P., & Lan, W. (2001). How well tolerated are lipid-lowering drugs? Drugs and Aging, 18(9), 665-683.

How well tolerated are lipid-lowering drugs? / Tomlinson, B.; Chan, P.; Lan, W.

In: Drugs and Aging, Vol. 18, No. 9, 2001, p. 665-683.

Research output: Contribution to journalArticle

Tomlinson, B, Chan, P & Lan, W 2001, 'How well tolerated are lipid-lowering drugs?', Drugs and Aging, vol. 18, no. 9, pp. 665-683.
Tomlinson, B. ; Chan, P. ; Lan, W. / How well tolerated are lipid-lowering drugs?. In: Drugs and Aging. 2001 ; Vol. 18, No. 9. pp. 665-683.
@article{32d17a2d73b241478b892522a8bf6531,
title = "How well tolerated are lipid-lowering drugs?",
abstract = "It has been clearly established that lipid-lowering treatments [such as 3-hydroxyl-3-methylglutamyl coenzyme A reductase inhibitors ('statins') or fibrates] can reduce cardiovascular events, and with one of the statins even total mortality, in high-risk populations. Intervention studies have not included the very old, but it is generally assumed that this patient group would benefit from these treatments to an extent similar to younger patients. Worries about the associations seen in observational studies between low cholesterol levels and cancer, cerebral haemorrhage or mood and behaviour change have been largely overcome by findings from the latest large drug intervention trials, which do not show any increase in these conditions with statin or fibrate treatments. The common adverse effects associated with these drugs are relatively mild and often transient in nature. Potentially more serious adverse effects, which are more clearly related to drug treatment and are probably dose-dependent, include elevations in hepatic transaminase levels and myopathy; however, these effects are uncommon and generally resolve rapidly when treatment is stopped. The risk of myopathy with fibrate treatment is increased in patients with renal impairment, and the risk of myopathy with statin treatment increases with coadministration of drugs that inhibit statin metabolism or transport. Other adverse effects are related to specific drugs, for example, clofibrate is associated with an increased risk of gallstones. Studies in elderly patients have not shown an increased risk of adverse effects with lipid-lowering drugs compared with younger patients, but in clinical practice there may be some increased risk, particularly with regards to drug interactions. Therefore, lipid-lowering drugs should be administered with extra caution to elderly patients.",
author = "B. Tomlinson and P. Chan and W. Lan",
year = "2001",
language = "English",
volume = "18",
pages = "665--683",
journal = "Drugs and Aging",
issn = "1170-229X",
publisher = "Adis International Ltd",
number = "9",

}

TY - JOUR

T1 - How well tolerated are lipid-lowering drugs?

AU - Tomlinson, B.

AU - Chan, P.

AU - Lan, W.

PY - 2001

Y1 - 2001

N2 - It has been clearly established that lipid-lowering treatments [such as 3-hydroxyl-3-methylglutamyl coenzyme A reductase inhibitors ('statins') or fibrates] can reduce cardiovascular events, and with one of the statins even total mortality, in high-risk populations. Intervention studies have not included the very old, but it is generally assumed that this patient group would benefit from these treatments to an extent similar to younger patients. Worries about the associations seen in observational studies between low cholesterol levels and cancer, cerebral haemorrhage or mood and behaviour change have been largely overcome by findings from the latest large drug intervention trials, which do not show any increase in these conditions with statin or fibrate treatments. The common adverse effects associated with these drugs are relatively mild and often transient in nature. Potentially more serious adverse effects, which are more clearly related to drug treatment and are probably dose-dependent, include elevations in hepatic transaminase levels and myopathy; however, these effects are uncommon and generally resolve rapidly when treatment is stopped. The risk of myopathy with fibrate treatment is increased in patients with renal impairment, and the risk of myopathy with statin treatment increases with coadministration of drugs that inhibit statin metabolism or transport. Other adverse effects are related to specific drugs, for example, clofibrate is associated with an increased risk of gallstones. Studies in elderly patients have not shown an increased risk of adverse effects with lipid-lowering drugs compared with younger patients, but in clinical practice there may be some increased risk, particularly with regards to drug interactions. Therefore, lipid-lowering drugs should be administered with extra caution to elderly patients.

AB - It has been clearly established that lipid-lowering treatments [such as 3-hydroxyl-3-methylglutamyl coenzyme A reductase inhibitors ('statins') or fibrates] can reduce cardiovascular events, and with one of the statins even total mortality, in high-risk populations. Intervention studies have not included the very old, but it is generally assumed that this patient group would benefit from these treatments to an extent similar to younger patients. Worries about the associations seen in observational studies between low cholesterol levels and cancer, cerebral haemorrhage or mood and behaviour change have been largely overcome by findings from the latest large drug intervention trials, which do not show any increase in these conditions with statin or fibrate treatments. The common adverse effects associated with these drugs are relatively mild and often transient in nature. Potentially more serious adverse effects, which are more clearly related to drug treatment and are probably dose-dependent, include elevations in hepatic transaminase levels and myopathy; however, these effects are uncommon and generally resolve rapidly when treatment is stopped. The risk of myopathy with fibrate treatment is increased in patients with renal impairment, and the risk of myopathy with statin treatment increases with coadministration of drugs that inhibit statin metabolism or transport. Other adverse effects are related to specific drugs, for example, clofibrate is associated with an increased risk of gallstones. Studies in elderly patients have not shown an increased risk of adverse effects with lipid-lowering drugs compared with younger patients, but in clinical practice there may be some increased risk, particularly with regards to drug interactions. Therefore, lipid-lowering drugs should be administered with extra caution to elderly patients.

UR - http://www.scopus.com/inward/record.url?scp=0034792091&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034792091&partnerID=8YFLogxK

M3 - Article

VL - 18

SP - 665

EP - 683

JO - Drugs and Aging

JF - Drugs and Aging

SN - 1170-229X

IS - 9

ER -