| • Drug addiction (3)
• Controlled drugs
• NHS
• EHC
• Statins
• Community pharmacy (3)
• The Society (3)
Letters to the Editor
|
Statins
Side effects can determine patient compliance
From Dr T. U. Qazi, MRPharmS
I admire efforts to enrich our knowledge about cholesterol treatment
with a combination of a statin and ezetimibe and the emphasis on the
importance of statin compliance to control cholesterol level.
I suffer with hypercholesterolaemia and, in the past 16 years, I have
tried most of the drugs available. I started using different statins
when I found that my compliance with
colestyramine (anion-exchange resins) was a failure after a few months’ use
because of its gastrointestinal side effects of constipation and diarrhoea.
It tasted as if I was swallowing a sandy drink.
After being treated with different statins, I concentrated on taking
rosuvastatin 20mg tablets, which brought my cholesterol level down to
5.8mmol/L. However there were numerous side effects such as dizziness,
myopathy and sometimes haematuria and these discouraged me from taking
it.
Then I started atorvastatin 10mg with ezetamibe 10mg and after six months
it lowered my cholesterol to 3.9mmol/L, but the side effects were dizziness
and haematuria.
My liver function was also affected and my serum alanine increased to
49iu/L. My serum albumin became 34g/L while the normal range should be
35–50g/L. My GP suggested that I should stick to taking atorvastatin
alone and stop using ezetamibe in order to ease the side effects. As
the dose for a statin is one tablet daily, compliance should not be a
problem.
Statins are predominantly taken by elderly patients. As a consequence
it is important that these patients regularly receive verbal reminders
from their pharmacist along with their typed dispensing instructions
because they are prone to visual and memory problems.
We should also
remind people with high cholesterol that fish, vegetable pulses, onion,
garlic and soya protein can lower cholesterol and that animal fat,
alcohol, refined foods, sugar and saturated fat, such as in biscuits
and cakes,
raise cholesterol.
Elderly patients are at risk of polypharmacy to treat their numerous
conditions including hypercholesterolaemia. It is the side effects
of the drugs that determine their compliance. T. U. Qazi
Halifax,
West Yorkshire
|
The
Pharmaceutical Journal