advise please

[Jakey67]

first of all thanks for all the advise and support- like many I would be lost without it.

I have just, on Sunday, tapered down from 11mg to 10 gms so far OK but early days. Coincidentally my G P has just prescribed me 20mg of atorvastatin as my cholesterol is slightly elevated. Given the possible side effects I am wondering on the merits of delaying the statin because if my PMR apprears more uncomfortable I will not know if it is as a result of reducing the prednisolone or starting statins. What do you think, and if I should delay by how long?

I would have preferred a conversation with the GP about statins. I already take 6 different meds and have had some side effects…..not least because I am taking amlodipine which the NHS website suggests should not be combined with atorvastatin, but this has been done by text…..as an aside, because my cholesterol is only slightly elevated has anyone tried/had success with plant sterols?

thanks

[Charlie1boy]

Interesting! I have been on amlodopine for almost 20 years. When I saw the Cardiologist last autumn, he doubled the amlodopine to 10mg a day, and also prescribed 20mg daily of atorvastatin. No mention of any contraindications.

As it happened I took myself off the statin, with my GP’s agreement, as I developed cramp pains every night.

[PMRpro Ambassador]

Blowed if I can see why the NHS says not to combine them since there is actually a fixed ratio tablet manufactured by Pfizer:

labeling.pfizer.com/ShowLab...

But I would only change one thing at a time.

[DorsetLady PMRGCAuk volunteer]

Agree with PMRpro - with PMR/GCA never change more than one thing at a time … whatever it is !

[piglette]

I do feel that if a doctor is prescribing anything they should ask if you have any questions about the product. On the other hand I am rather sceptical about the knowledge a lot of doctors have about drugs. I must admit I do normally do some research on anything recommended by my doctor, on the other hand I did work with the drug industry for over thirty years so have become a bit jaundiced.

[Obscureclouds]

I have LVV rather than PMR but when statins were suggested for slightly elevated cholesterol the GP pharmacist rang me to discuss and although I had always been anti taking statins I did decide it was probably in my best interests to start them. She suggested I try 10mg of Atorvastatin rather than her normal starting dose of 20mg . My cholesterol level quickly came down below the borderline and was then just over 5 at my 3 month review with the pharmacist. She said with LVV ( and taking steroids ) she would prefer it was nearer to 4 but as I was then slowly tapering down from 13 to 10mg Pred she suggested that rather than rock the boat it was probably to stay on the same 10mg dose of statin. Perhaps you could suggest to your GP a lower dose of statin to see if that works better for you if your cholesterol level is no longer rising. Also going down from 12mg Pred to 10 I went in 0.5 mg stages which worked well so will continue that practice from now on. Can’t comment on plant alternatives I’m afraid. I’ve always had such a healthy diet with lots of variety of fresh fruit, vegetables, seeds, herbs etc and when tested in the past have always had a high level of “good” Cholesterol so was disappointed that it wasn’t enough for the Pred to raise my levels to an extent were statins were being recommended - good luck finding what works for you

[Bcol]

Hi, I also take Amlodipine and also had big problems with the first three statins we tried which included Atorvastatin. Been on Rosuvastatin now for many years with no problems at all. As already suggested though, I'd give it a while before you change to make sure your reduction is OK.

[Countrykitten]

I was given Atorvastatin a few months ago and also take Amlopidine Resulting flare took me back almost to beginning of PMR journey, not good!!

Dr told me to stop statins, as if I needed telling. I've been taking plant sterols ever since. Drs don't seem to know the combination of Atorvastatin and Amlopidine is not a good idea. I had to research that myself. Dr told me recently on phone that my cholesterol is 'coming down nicely with the statins'....I reminded her that I'm not taking them, so Plant Sterols must be helping. I don't have actual figures because Dr will insist on doing telephone appointments when they know my hearing is bad ( that's another long story.)

I've got to carry on as I am and have further blood tests in August. I'll keep you posted. Meanwhile, best of luck. We're all different, but my advice would be to exercise caution when it comes to statins.

[PMRpro Ambassador in reply to Countrykitten]

"Drs don't seem to know the combination of Atorvastatin and Amlopidine is not a good idea."

It is actually marketed as a single fixed ratio tablet so must have gone through clinical testing. It is much more likely it was the statin itself being added that caused the problem.

[Jakey67 in reply to PMRpro]

What is a single fixed ratio tablet please? I’m a bit unsure what to do as tricky via text messages with the GP rather than a conversation. I might try and speak to the pharmacist.

[PMRpro Ambassador in reply to Jakey67]

A tablet that contains fixed doses of two different medications often used together so the patient takes a single tablet instead of 2 - it improves patient compliance and reduces errors in dosing. Another example is cocodamol which has codeine and paracetamol in it although it comes in 3 different codeine strengths. The downside is that if someone needs a higher or lower dose of one of them it doesn't help. My point in mentioning it was that there really isn't any reason why the two drugs shouldn't be used together.

[proactive]

I was put on atorvastatin a few years ago (before I had PMR) and after taking it for two weeks, experienced muscle pain, so I used the next few weeks to taper off the remainder of the prescription. I have had PMR for 2 years, diagnosed after 6 months. I am pre-diabetic and the endocrinologist at the Diabetes Clinic wanted to put me on statins. I resisted, but the finally convinced me to try a low dose of Rosuvastatin (5 mg) as it is more well tolerated. I have been taking it for three months now with no side effects and my cholesterol levels have come down.

I believe it is comon to start with atorvastatin as it is less expensive.....