Why are Statins recommended to be taken only in the evenings?
Statins is the common name for HMG-CoA, a kind of reductase inhibitor coenzymes are always recommended to patients as first-line agents in reducing LDL-C the lipoprotein cholesterol with low-density. Though cholesterol is quite useful for normal body functions, bad cholesterol can lead to a condition known as a thermogenesis. The formation of plaque in the arteries often result to disease conditions such as heart attack, coronary artery disease, and stroke. It is important to take Statins in a way that provides the greatest effects because a known level of mortality and morbidity benefits are associated with Statins therapy.
Most cholesterol in the body are formed endogenously, though some still come from dietary intake. There is an old hypothesis that there is a possibility of the production of human cholesterol being cyclical which resembles the mechanism of cholesterol formation in animals. Trials on humans confirmed the instability in the production of cholesterol, taking note of the greatest production of cholesterol by the liver during fasting periods.
The obvious circadian rhythm of the production of cholesterol brought up the suggestions that it is better to administer Statins during the night as a way of providing the highest concentration of the medication at a time when the production of endogenous cholesterol is highest. That's why take statins at night.
Here are the evidences from experiments:
Researches of pharmacokinetic properties of personal Statins refuted the need to dose all agents during bedtime. Though every Statin passes through the hepatic metabolite pathway, the elimination 1/2 lives have different lengths. Fluvastatin, Simvastatin, and lovastatin all have very short elimination 1/2 lives when compared to similar drugs in the same class. To maximize their effectiveness, agents with very significant elimination 1/2 lives require the use of bedtime dosing. As an alternative, the much longer 1/2 lives of rosuvastatin, pitavastatin, atorvastatin, and pravastatin permit these agents to uphold a therapeutic drug absorption over a period of 24 hours and permit alternative administration times.
Some patients do not comply with taking shorter 1/2 live Statins at bedtime, and this often reduces the efficacy. Agents that have longer 1/2 Lives permit greater flexibility in the time of administration, which improves compliance and results in far greater LDL-C lowering and makes it possible for the cholesterol goals to be achieved.