Should You Take Statins at Night?

Should You Take Statins at Night?

Statins are drugs like simvastatin and atorvastatin which inhibit cholesterol synthesis by inhibiting the enzyme HMG CoA reductase in the liver. Studies have shown that most cholesterol is synthesised when the dietary intake is at its lowest, typically at night. Thus it was proposed that drugs which inhibit cholesterol synthesis will have better effect when taken at night. This is more so with earlier drugs like lovastatin and simvastatin which were shorter acting than atorvastatin. Studies on simvastatin have documented better effect when taken in the evening than in the morning [1,2]. So it was often advised to take statins at night. As atorvastatin is a long acting drug, it will have its effect even if it is taken at other times of the day. This has also been documented experimentally [3].

References

1. Wallace A, Chinn D, Rubin G. Taking simvastatin in the morning compared with in the evening: randomised controlled trial. BMJ. 2003 Oct 4;327(7418):788. doi: 10.1136/bmj.327.7418.788. PMID: 14525878; PMCID: PMC214096.
2. Saito Y, Yoshida S, Nakaya N, Hata Y, Goto Y. Comparison between morning and evening doses of simvastatin in hyperlipidemic subjects. A double-blind comparative study. Arterioscler Thromb. 1991 Jul-Aug;11(4):816-26. doi: 10.1161/01.atv.11.4.816. PMID: 2065035.
3. Cilla DD Jr, Gibson DM, Whitfield LR, Sedman AJ. Pharmacodynamic effects and pharmacokinetics of atorvastatin after administration to normocholesterolemic subjects in the morning and evening. J Clin Pharmacol. 1996 Jul;36(7):604-9. doi: 10.1002/j.1552-4604.1996.tb04224.x. PMID: 8844442.