ALIPZA

Statins(orHMG-CoA reductase inhibitors) are aclassof medications that lowercholesterol. They are typically prescribed to people who are at high risk ofcardiovascular disease. Low-density lipoprotein(LDL) carriers ofcholesterolplay a key role in the development ofatherosclerosisandcoronary heart diseasevia the mechanisms described by thelipid hypothesis. Aslipid-lowering medications, statins are effective in loweringapolipoprotein Band LDL cholesterol; they are widely used forprimary preventionin people at high risk of cardiovascular disease, as well as insecondary preventionfor those who have developed cardiovascular disease. Side effects of statins includemuscle pain, a modestly increased risk ofdiabetes, and abnormal blood levels of certainliver enzymes.Additionally, they have rare but severe adverse effects, particularly muscle damage, and very rarelyrhabdomyolysis. They act by inhibiting the enzymeHMG-CoA reductase, which plays a central role in cholesterol production. High cholesterol levels in the blood have been associated with cardiovascular disease. There arevarious formsof statins, some of which includeatorvastatin,fluvastatin,lovastatin,pitavastatin,pravastatin,rosuvastatin, andsimvastatin.Combination preparations of a statin and another agent, such asezetimibe/simvastatin, are also available. The class is on theWorld Health Organization's List of Essential Medicineswith simvastatin being the listed medicine. In 2024, US sales were estimated at $5–6B, down from $19B in 2005.The best-selling statin is atorvastatin, also known as Lipitor, which in 2003 became the best-selling pharmaceutical in historyat $12B in 2008. Patient compliance with statin usage is problematic despite robust evidence of their benefits.