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Statins are a medication used to lower high cholesterol. We offer a prescription service for all common types of statins – as long as you have been previously prescribed statins and have been taking them for at least 3 months.
ZAVA’s online statins service is a convenient and safe way to get a repeat 3 or 6 month supply, without having to see your GP. Get started today by filling in our brief questionnaire, so our doctors can assess whether the medication is suitable for you.
You can find more information on this page about what statins are, how they work, side effects, who should take them, and any alternative treatment options.
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About Statins
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Statins are a type of medication used to treat and lower high cholesterol in the blood.
There are a few different types of statins but they all work in essentially the same way by blocking an enzyme in the liver that creates what is known as ‘bad cholesterol’ or LDL (low-density lipoprotein). Bad cholesterol causes a plaque which clogs and narrows the arteries, a common cause of heart attacks and strokes.
What is high cholesterol?
Cholesterol is a natural fatty substance made in the liver and found in the blood that our bodies need to function. There are 2 types of cholesterol: HDL (high density lipoprotein) and LDL (low density lipoprotein). It is high levels of LDL that is considered ‘high cholesterol’ and the medical term is hypercholesterolemia.
How common is it?
High cholesterol is a very common condition that affects millions of people around the world. In 2021, the Health Survey for England found that the total number of cases of raised cholesterol was higher than in recent years at 56% among men and 61% among women.
How it affects your body
If left untreated, high cholesterol can be dangerous for your health. It affects the circulatory system and can cause arteries that carry blood around the body to get smaller or become blocked. This restricts blood flow and increases the risk of conditions like:
- heart disease
- heart attacks
- strokes
Causes
Too much ‘bad’ cholesterol in the blood can be caused by unhealthy diet and lifestyle, for example:
- not getting enough exercise
- eating an unhealthy diet with too much saturated fat
- smoking
High cholesterol is also more likely as we age and in general, men are more likely to develop the condition. There is also research to suggest that certain ethnic backgrounds, for example South Asian, may be more likely to develop high cholesterol.
High cholesterol can also be caused by genetics (inherited high cholesterol).
Symptoms
High cholesterol can cause symptoms but in most cases there is typically no symptoms of it, therefore many people do not realise they have high cholesterol until they have a blood test. In some cases where high cholesterol is genetic some people may experience visible symptoms like:
- swollen tendons on the hands, knees or Achilles tendon
- light coloured ring around the cornea in the eye
Due to the fact that symptoms for high cholesterol can often be caused by genetics, and that it often doesn’t cause any symptoms at all, it is a condition that needs to be monitored and treated with medication and lifestyle changes.
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Statins are a class of medications that manage cholesterol levels and prevent heart disease by reducing the amount of ‘bad cholesterol’ or LDL in the blood. They work by blocking the enzyme that the liver uses to make cholesterol.
Having high levels of LDL is a risk factor for cardiovascular disease (angina, heart disease, heart attack, or stroke) so when levels of LDL are reduced by statins your risk of cardiovascular disease is lowered.
There are different types of statins available but most come as tablets to be taken daily, usually at the same time of day. Your dose may vary depending on your cholesterol levels and any other medicines you are prescribed.
How effective are statins?
Statins are a very effective treatment for the management of high cholesterol levels. They are widely researched and are often the first choice for the treatment of high cholesterol along with diet and lifestyle changes.
The effectiveness of statins can differ based on dose and intensity but low and medium intensity statins can reduce LDL cholesterol by 20% to 40%, with high intensity statins able to reduce levels of LDL by greater than 40%.
How long does it take for statins to work?
Statins start to reduce cholesterol levels after 4 weeks, usually within 6 to 8, depending on the dose and how high your LDL levels are. Statins work best when they are taken consistently long-term, alongside a healthy diet and an active lifestyle.
Can high cholesterol levels come back after treatment?
If you stop taking statins or if lifestyle factors that cause high cholesterol (poor diet, lack of exercise, and being overweight) get worse while you are on statins, cholesterol levels can increase during or after treatment.
Treatment for high cholesterol, once diagnosed, is usually long-term. You will need a repeat supply of prescribed statins and taking the medication as advised is important to maintain lower cholesterol levels and prevent cardiovascular disease.
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There are 5 different statins available on prescription in the UK. Most come as tablets to be taken once a day. Most statins work in the same way by reducing the amount of LDL cholesterol produced in the liver to lower your cholesterol levels and reduce the risk of cardiovascular diseases.
Not all statins are suitable for everyone, so you will be prescribed the best statin for you based on what other medications you take, your cholesterol levels, your general health and medical history.
Atorvastatin (Lipitor)
What is Atorvastatin and what doses are available?
Atorvastatin is an oral tablet to be taken once a day alongside a healthy diet. Generic atorvastatin is available in 4 different strengths: 10mg, 20mg, 40mg, and 80mg while Lipitor is available in 10mg, 20mg, and 40mg tablets. Both are available from ZAVA.
Effectiveness
Atorvastatin is a common and effective statin, on it cholesterol levels should lower within 4 weeks. Research shows it can lower elevated cholesterol levels by 30 to 46% and LDL levels by 41 to 46%.
Rosuvastatin (Crestor)
What is Rosuvastatin and what doses are available?
Rosuvastatin is an oral tablet taken once a day alongside a healthy diet. ZAVA can prescribe rosuvastatin and Crestor (branded rosuvastatin) in 5mg, 10mg, 20mg, and 40mg strength tablets.
Effectiveness
Rosuvastatin works in as little as 1 week, with the maximum effect reached within 4 weeks of taking it. Research shows that those taking a daily 40mg dose after 12 weeks have an average reduction in LDL levels of 53%.
Rosuvastatin may be prescribed to those with other health conditions as well as high cholesterol such as:
- heart disease
- diabetes
- kidney disease
- rheumatoid arthritis
Simvastatin
What is Simvastatin and what doses are available?
Simvastatin is an oral tablet to be taken once a day, preferably in the evening. It’s available from ZAVA as a generic treatment in 10mg, 20mg, and 40mg tablets. Your doctor may increase your dose after 4 weeks if your cholesterol levels need further management.
Effectiveness
Simvastatin takes around 4 weeks to reach its maximum effect. Studies show that it can reduce LDL levels on average by 30 to 47%.
It’s often prescribed to those with a family history of heart disease and other health conditions such as diabetes or rheumatoid arthritis. Like all statins, it should be taken alongside a healthy diet.
Pravastatin (Lipostat)
What is Pravastatin and what doses are available?
Pravastatin is also an oral tablet that is taken once a day, preferably in the evening. The recommended doses are 10mg, 20mg, or 40mg and your doctor will increase your dose if you need it. It is usually prescribed to those with a family history of heart disease and other health conditions such as diabetes or rheumatoid arthritis. It should be taken alongside a healthy diet.
Effectiveness
Your cholesterol levels should lower within 4 weeks on pravastatin or Lipostat (branded pravastatin). As well as lowering cholesterol, research shows that those taking pravastatin long-term (4.8 years or more) can lower their risk of cardiovascular disease and heart attack by 31%.
Fluvastatin (Lescol)
What is Fluvastatin and what doses are available?
Fluvastatin is an oral tablet to be taken once a day alongside a healthy diet. In some cases, it may be prescribed as 40mg twice a day. Fluvastatin can lower high cholesterol and triglycerides (fats) in the blood. It’s available from ZAVA and the recommended doses are 20mg, 40mg, or 80mg. Your doctor will always start you on the lowest dose and increase as needed
Effectiveness
Fluvastatin works quickly and the best effect can be seen after taking it for 4 weeks. After 24 weeks, fluvastatin can lower your LDL levels on average by: 22% (20mg), 25% (40mg), 36% (40mg twice daily), and 35% (80mg).
What’s the best treatment for high cholesterol?
The ‘best’ treatment for your high cholesterol depends on your personal needs and health. When prescribing a statin, doctors should have a discussion with you and take into consideration factors like:
- cholesterol levels – are they slightly high or very high?
- your age – cholesterol and the risk of heart disease increases with age
- overall health – how active is your lifestyle and do you follow a healthy diet?
- other health conditions like diabetes, kidney disease, rheumatoid arthritis can increase the risk of high cholesterol and cardiovascular disease
- whether or not you smoke – smoking can increase LDL/bad cholesterol
From these factors, doctors can determine your level of risk for cardiovascular disease and determine the appropriate statin strength and dose for you. If you need it, you may be given the maximum dose of your statin.
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Like all medications, statins can cause side effects. Many people who take statins will experience little to no side effects, and most side effects are mild in nature.
The most commonly reported side effects are muscle aches and pains. Side effects will also vary from statin to statin so make sure to read the patient information leaflet (found in the box with your medication or online).
Common side effects
Common side effects of statins include:
- muscle aches and pains
- headaches
- dizziness
- feeling tired or weak
- low blood platelet count
- feeling sick (nausea)
- trouble sleeping
- digestive problems or discomfort, including indigestion, bloating and wind, diarrhoea, or constipation
Uncommon side effects
Uncommon side effects of statins include:
- being sick (vomiting)
- forgetfulness/memory problems
- increased risk of type 2 diabetes
- pins and needles (paresthesia)
- hepatitis (inflammation of the liver)
- pancreatitis (inflammation of the pancreas)
- sexual problems such as a reduced libido (sex drive) or erectile dysfunction in men
- skin problems such as rashes or acne
Rare side effects
The rare side effects of statins include:
- muscle pain and weakness (myopathy)
- muscle damage affecting the kidneys (rhabdomyolysis)
- tingling or loss of sensation in the nerve endings in the hands and feet (peripheral neuropathy)
- problems with tendons (the tissue connecting muscles to bones)
- serious allergic reaction to the medication, symptoms include breathing difficulties, wheezing, and swelling of the mouth, nose, tongue, or throat
Speak to a doctor straight away if you notice symptoms of any of the rare side effects of statins. Call 999 in an emergency, such as if you have a serious allergic reaction, signs of this include:
- skin rashes
- itching
- hives
- swelling of the face, lips, tongue or throat
- difficulty breathing
- blue or grey tongue, skin or lips
- dizziness, confusion and fainting
"While muscle pain is a common side effect of statins, if you experience any severe, unusual muscle pain you should contact your doctor or a healthcare professional immediately as it could be a sign of a serious condition called rhabdomyolysis that can be dangerous if not treated quickly." — Dr Brenda Ikeji, Medical Editor
How long do statin side effects last?
Any common and mild side effects you experience from statins will wear off or improve after your body gets used to taking the medication, usually within a few weeks. You may also find that you get used to and are able to cope with side effects like muscle aches and pains. Depending on your cholesterol levels, your statin dose may be increased after 4 weeks or more, which could cause or increase side effects.
If you do experience side effects that do not improve over time and are unmanageable or severe then you should consult your doctor or prescriber. They may be able to help you switch to a different statin that is a better fit for you or lower your dose.
Stopping your statin prescription altogether is not usually recommended because the benefits of the medication for those with high cholesterol at risk of cardiovascular disease often outweigh the discomfort of side effects.
What to do if you get side effects
Experiencing side effects on statins is normal especially if you have just started taking them, however, if you are experiencing side effects from statins and this is causing concern you should:
1: Manage them at home if you can
Side effects like muscle aches and pains, headaches, and nausea are common, mild symptoms that should improve and even go away with time. You can manage these by taking over-the-counter painkillers, using heat pads for muscle aches, and eating food with your statin.
2: Do not stop taking your statin
Stopping taking your statin can increase your risk of cardiovascular disease. If high cholesterol is not controlled your heart health is at risk. You should always talk to your doctor first if you are considering stopping your statin because of side effects.
3: Talk to your doctor or healthcare provider
Tell your doctor about any side effects you are taking, they will be able to help determine if the side effects you are experiencing are due to the statin or if they are caused by something else. They may also recommend how to manage the side effects, lower your dose or even change which statin you are prescribed.
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Statins may not be right for everyone. There are certain conditions and certain medications that can interact with statins that may make them less effective, or potentially unsafe. There are also conditions and medications that may worsen or increase the risk of side effects.
Who can’t take statins?
Certain conditions mean that you cannot take statins, they include:
Liver disease, including reduced liver or kidney function
You should not take statins if you have liver disease or if blood tests show that your liver is not working properly. Statins affect processes in the liver so if your liver is already damaged, you may experience more severe side effects.
Pregnancy, breastfeeding, or trying to get pregnant
If you are pregnant or breastfeeding you should not take statins and you should stop taking them if you plan to get pregnant. This is because there is not enough evidence to suggest that it is safe to take statins during pregnancy.
Who has an increased risk of experiencing side effects?
Certain people may have an increased risk of experiencing side effects on statins because of other factors or conditions, including:
- being over 70 years old
- regularly drinking large quantities of alcohol
- having a history of kidney or liver disease
- hyperthyroidism
- having a pre-existing muscle condition, such as fibromyalgia
If you have any of these risk factors, it’s important to discuss with your healthcare provider before starting a statin.
Other medications that interact with statins
Certain medications may make statins less effective or even dangerous to take, so you need to be aware of them. They include:
- certain medications for HIV
- amiodarone
- cyclosporine
- some antibiotics like itraconazole, clarithromycin, and erythromycin
- some antifungals like itraconazole, fluconazole and voriconazole
- warfarin or other ‘blood-thinners’
- calcium channel blockers
- fibrates
- colchicine
Before prescribing you a statin your doctor should check and assess what other medications you take. If you have any concerns about other medications interacting with statins then make sure to discuss this with your doctor before taking them. If you are on statins but you need to take one of these medicines, your doctor can change your statin, adjust your dose, or advise you about stopping your statin.
Food and alcohol
Consuming certain things while on statins can make them less effective or even dangerous.
Grapefruit juice
Drinking large amounts of grapefruit juice can affect some statins and increase your risk of side effects. It is advised to avoid it completely or only consume small quantities when taking statins.
Can you drink alcohol on statins?
Drinking large amounts of alcohol can put you more at risk of experiencing more serious side effects of statins, so if you regularly do this you should talk to your doctor. However, drinking some alcohol on statins is okay (under 14 units a week).
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Statins are for people diagnosed with high cholesterol, meaning that they have too much LDL (bad) cholesterol. Most people will not know that they need statins until they take a blood test or are told by their doctor that they have high cholesterol as there are often no symptoms.
In the UK, high cholesterol levels are considered as follows:
High: between 5 and 6.4millimoles per liter (mmol/l)
Very high: between 6.5 and 7.8mmol/l
Extremely high: above 7.8mmol/l
You may also be prescribed a statin if you're considered at a high risk of developing cardiovascular disease, for instance if you:
- have diabetes
- have a family medical history of cardiovascular disease
- smoke
- are obese
How do I know if I have high cholesterol?
You will need a test to determine whether or not you have high cholesterol. You can request a blood test from your doctor or take an at-home test. You are more likely to have high cholesterol if you are overweight or obese, have a lot of saturated fat in your diet, and if you smoke and drink alcohol.
How to test cholesterol levels at home
It’s possible to check your cholesterol levels at home and you can do this with ZAVA’s easy-to-use cholesterol test kit:
- Order the test kit online and we’ll deliver it to your home.
- Provide a small blood sample using the lancet provided and following the instructions detailed in the kit.
- Use the prepaid envelope to post your blood sample to our partner lab.
- Your results will be ready 2 to 3 days after your sample reaches the lab, and we’ll then let you know they can be viewed in your account.
- A doctor will send you a message through your private patient account, letting you know what your results mean and whether you need further investigation.
Alternatively, you can also request a blood test from your doctor. In this case, it will be a full blood test, where a sample will be taken from a vein in your arm.
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There are some other ways to lower high cholesterol without taking statins. There may be alternative medical options that are suitable for you but the most important options are always lifestyle changes.
Lifestyle-based changes
1. Change your diet
Following a heart-healthy, low-saturated fat diet is key to achieving lower levels of ‘bad’ cholesterol. You can try:
- adopting a diet that contains more healthy fats and omega-3 fatty acids, such as from oily fish or plant sources like flax and chia seeds
- eating more fibre, such as whole grains and legumes, as this can help you absorb less cholesterol
- increase how much fruit and vegetables you eat as these can help you get a range of vitamins, fibre, and nutrients
- eat more plant stanols and sterols (cholesterol-like compounds naturally found in plant-based foods that can lower LDL levels), by switching to olive or avocado oil
- avoid foods that are high in saturated fats like fatty meat, butter, lard and ghee, cheeses, and foods containing coconut or palm oil
- get in the habit of checking packaging or buying ‘reduced fat’ products
2. Get more exercise
Aim to do 150 minutes per week of moderate aerobic activity such as a brisk walk, cycling or jogging. Regular exercise can help raise HDL and lower LDL.
3. Weight loss
Being overweight increases your risk of high cholesterol and cardiovascular disease. Start your weight loss journey to help you lower your cholesterol levels naturally.
4. Quit smoking and limit alcohol consumption
Smoking and drinking alcohol can both contribute to high cholesterol levels. Stopping or limiting these can naturally lower high cholesterol.
Lifestyle changes are integral to lowering high cholesterol. You should still try to change your diet and exercise habits even while taking statins or other medications.
Other prescription medications
1.Ezetimibe
Ezetimibe is an alternative treatment option to statins if someone is not able to take statins. It can also be used in combination with statins, for example simvastatin.
Ezetimibe works to reduce the amount of LDL (bad) cholesterol in the blood by decreasing how much cholesterol is absorbed from the food you eat in the small intestine. It starts to lower cholesterol within 2 weeks and can reduce LDL by up to 20 to 25%.
2.PCSK9 inhibitors
PCSK9 inhibitors work by blocking a protein called PCSK9 which helps the liver to remove more LDL or ‘bad’ cholesterol. They come as an injection taken every 2 to 4 weeks. These treatments are rare and expensive but can be prescribed for high-risk patients.
Research suggests that PCSK9 inhibitors can lower LDL cholesterol by up to 60%. However, they are only recommended in cases where a maximum dose of statins has not lowered cholesterol to the desired level or for people who have already experienced a heart attack or stroke.
3. Bempedoic acid
Bempedoic acid is a treatment used to lower high cholesterol that works by reducing cholesterol production in the liver. It’s often considered for statin-intolerant patients and can also be taken in combination with ezetimibe. It is thought to have less risk of side effects like muscle pain than statins.
4. Fibrates
Fibrates such as fenofibrate, are prescribed to lower high triglyceride levels, another type of fat in the blood. Fibrates can also help raise levels of HDL (good) cholesterol however, they are not as effective at lowering LDL levels as statins.
5. Bile acid sequestrants
Bile acid sequestrants work to lower LDL or bad cholesterol by stopping bile acid from the stomach (which contains cholesterol) from being absorbed into the blood. However, they may cause more gastrointestinal discomfort than statins.
6. Niacin
Niacin is a B vitamin found in certain foods or in supplements. It can be prescribed in high doses to lower high cholesterol. Although it can help, it’s not a popular statin alternative nor prescribed often due to side effects such as liver damage when used for a long time.
Home remedies or supplements
There is little to no scientific evidence to prove that most home remedies or supplements can help lower high cholesterol. Use these with caution and consult your doctor or a healthcare professional but they may include:
- berberine, a plant compound that is believed to lower cholesterol
- psyllium husk, a supplement and laxative that is a soluble fibre meaning it could help to lower the amount of cholesterol absorbed into the blood

Brenda studied medicine at St Georges University of London and has most recently worked in John Radcliffe Oxford University Hospitals, covering acute and general medicine.
Meet our doctorsLast reviewed: 30 Apr 2025
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Ethnic differences in blood lipids and dietary intake between UK children of black African, black Caribbean, South Asian, and white European origin: the Child Heart and Health Study in England (CHASE), National Library of Medicine [Accessed 2nd April 2025]
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Adults' health: Cholesterol - NHS England Digital, NHS [Accessed 3rd April 2025]
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Evidence review for statins: efficacy and adverse effects: Cardiovascular disease: risk assessment and reduction, including lipid modification, National Institute for Health and Care Excellence (NICE) [Accessed 4th April 2025]
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Fluvastatin for lowering lipids, National Library of Medicine [Accessed 4 April 2025]
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Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease, New England Journal of Medicine [Accessed 4 April 2025]