Statin tablets.

[vickster]

Yes, that standard suboptimal approach is exactly what I did and why I can no longer remember months of my life, scattered over years.


The brands should be outlawed, especially for drugs like statins that are known to bend minds. It's difficult enough keeping track of one's treatment while drug-addled without everything having many names. Yes, there will be at least one brand and compound name, but there are sometimes others: atorvastatin has at least three compound names and 14 brand names, for example.

Also, there used to be fark all support offered for coping with starting perpetual medication but hopefully that's changed with the greater awareness of mental health care.

?? other than Lipitor?

The compounds get a brand name for the first 20 years of existence (about 12 on market), for which the manufacturer gets exclusivity to market to recoup the investment (and make money for future investments).

There are some new anti cholesterol meds in development, can you explore trials if that's something you'd be prepared to try?

With any drug you should discuss the potential risk of AEs vs the benefit /risk of not treating esp if you have a chronic difficult to treat condition

 

[si_c]

While I've got the current Lipitor leaflet open, I counted up that it says there are 16 "up to 1 in 10" side-effect symptoms (contradicting drugs.com as mentioned above), 30 "up to 1 in 100", 12 "up to 1 in 1,000", 3 "up to 1 in 10,000", 1 unknown severity and 4 possible - so somewhere between 1% and 100% of people have side-effects with this shoot, yet it's still overwhelmingly positive? Hmmm.

A quick calculation gives around ~13.5% of people not having a side effect at all, with ~82% of people having one (or more) of the 16 1in10 side effects. Of course this could be impacted by other drug interactions so it may be that this number is higher or lower and without digging into the literature I couldn't say - also I don't know if they mean 1in 10 people have one or more of these side effects , or 1 in 10 people have each one of these side effects (I presume this is most likely) , so this is kind of a worst case scenario.

 

[classic33]

Forty three years tomorrow, I'll have been on Phenytoin. At one point at 800mg daily, recommended maximum now is 600mg. Some of the side effects of that would have me thinking twice if I were to be started on it now. Memory loss, hair loss, possible increase in seizure rate... The list goes on.

What I'd not do is "advise" everyone to stop taking them, based on my experience. "This is what happened with me/I was like that", if someone has questions about it. Then they can say if what they are feeling is similar.

 

[classic33]

A quick calculation gives around ~13.5% of people not having a side effect at all, with ~82% of people having one (or more) of the 16 1in10 side effects. Of course this could be impacted by other drug interactions so it may be that this number is higher or lower and without digging into the literature I couldn't say - also I don't know if they mean 1in 10 people have one or more of these side effects , or 1 in 10 people have each one of these side effects (I presume this is most likely) , so this is kind of a worst case scenario.

I've always taken that figure as being 1 in 10/1 in 100, taking that drug, has reported one or more of the side effects listed.

 

[roubaixtuesday]

atorvastatin has at least three compound names

I don't think this is correct.

The system is that manufacturers must quote the generic name (atorvastatin), but manufacturers may differentiate by brand (Lipitor). In the same way there are many manufacturers of champagne.

But the generic name is unique, at least as far as I'm aware.

 

[winjim]

I don't think this is correct.

The system is that manufacturers must quote the generic name (atorvastatin), but manufacturers may differentiate by brand (Lipitor). In the same way there are many manufacturers of champagne.

But the generic name is unique, at least as far as I'm aware.

It will have other names, like the IUPAC systematic name and probably some others based on its structure or synthetic precursors and whatnot, but you wouldn't use those when referring to it as a drug.

 

[si_c]

I've always taken that figure as being 1 in 10/1 in 100, taking that drug, has reported one or more of the side effects listed.

From a rigour perspective that wouldn't make a huge amount of sense, so my thinking is that it makes most sense that it would relate to each side effect individually, otherwise they wouldn't break down the risks further than 1 in 10 get one of these as that would encompass the lower risk ones too.

 

[mjr]

?? other than Lipitor?

Yes. I've had AtorTeva (from TEVA) and Zarator (from Pfizer) branded boxes in the past. I've no idea how many are currently seen in the UK and while trying to search for a list, I found overseas lists like https://medex.com.bd/generics/92/atorvastatin-calcium/brand-names that have even more brand names for atorvastatin than I thought existed.

There are some new anti cholesterol meds in development, can you explore trials if that's something you'd be prepared to try?

Thankfully, I've not yet exhausted the approved non-statin drugs before I need to consider seriously that lottery. I've been offered one trial and I didn't like the sound of how that drug worked either.

With any drug you should discuss the potential risk of AEs vs the benefit /risk of not treating esp if you have a chronic difficult to treat condition

There's at least two small problems with that:
firstly, from experience, I'm quite pessimistic about medics' understanding of risk, among GPs especially;
secondly, it shouldn't be a choice only between the risk of Adverse Effects/Events vs risk of not treating, but also the relative harm of whatever AEs you suffer versus the relative efficacies across different treatments - but all too often, people who stop statins aren't offered other treatments, although now thankfully ezetimibe seems to be more widely offered.

I do wonder how well we can discuss the risks when the evidence over AEs seems so incomplete and the risk of not treating rests on the lipid hypothesis, let alone the ever-changing targets for total and low-density lipoprotein (LDL) cholesterol, plus the disputes over LDL, vLDL and various other diagnostic tests which aren't routinely used in the UK yet - nor, to return it to the OP, is coronary calcium scanning.

 

[mjr]

What I'd not do is "advise" everyone to stop taking them, based on my experience. "This is what happened with me/I was like that", if someone has questions about it. Then they can say if what they are feeling is similar.

Good. We agree on that - but I can understand why someone who had suffered might. Can't you?

I feel that people reporting experiences is not quite enough when mind-bending drugs are involved. It didn't help me when I was suffering side-effects because I literally couldn't remember whether what I had felt was similar to what I was reading - and when feeling those things, I didn't remember that I had read about them from other heart support group patients!

 

[mjr]

It will have other names, like the IUPAC systematic name and probably some others based on its structure or synthetic precursors and whatnot, but you wouldn't use those when referring to it as a drug.

As well as the long IUPAC name, it is referred to as "atorvastatin" (which is what I think has to be on the UK boxes alongside any branding), "atorvastatin calcium" and "atorvastatin calcium trihydrate" - which, as far as I know, are all describing the same tablet. Maybe you or me wouldn't use those names when referring to it as a drug, but annoyingly even some medics do. It's not difficult to keep straight if you're in your right mind, but if you're not...

 

[classic33]

From a rigour perspective that wouldn't make a huge amount of sense, so my thinking is that it makes most sense that it would relate to each side effect individually, otherwise they wouldn't break down the risks further than 1 in 10 get one of these as that would encompass the lower risk ones too.

You worded it better than me.

But if 1 in 100 reported side effects D, J & K, and 1 in 10 reported side effects E, I & L, that would make the 1 in 10 reported, more common.

"Lot 32", for me, has 10,000 listed/known side effects. The PIL for that would be a boring read.

 

[classic33]

Good. We agree on that - but I can understand why someone who had suffered might. Can't you?

I feel that people reporting experiences is not quite enough when mind-bending drugs are involved. It didn't help me when I was suffering side-effects because I literally couldn't remember whether what I had felt was similar to what I was reading - and when feeling those things, I didn't remember that I had read about them from other heart support group patients!

I have the following, if you're interested
Pfizer: 01304 616161
Zarator (Atorvastatin Calcium)
United Pharmacies: 01224 928494

 

[winjim]

As well as the long IUPAC name, it is referred to as "atorvastatin" (which is what I think has to be on the UK boxes alongside any branding), "atorvastatin calcium" and "atorvastatin calcium trihydrate" - which, as far as I know, are all describing the same tablet. Maybe you or me wouldn't use those names when referring to it as a drug, but annoyingly even some medics do. It's not difficult to keep straight if you're in your right mind, but if you're not...

Yeah, that's just the particular form it's present as in the tablet. I might expect a chemist or pharmacist to refer to it like that, or even a medic when discussing it in certain situations, but probably not when talking to a patient.

 

[winjim]

I get my clinical biochemistry exam results next week. I'm keeping my own counsel until then, but I think I did alright on the lipid question. At least I gave a pretty full and comprehensive explanation although I'm not entirely sure I was answering the right question if I'm honest. We'll find out soon I suppose.

OK, probably a bit too late for this thread but if anyone wants to know about lipid metabolism, it turns out I may be just the person you need.

 

[Fab Foodie]

OK, probably a bit too late for this thread but if anyone wants to know about lipid metabolism, it turns out I may be just the person you need.

Hurrah....another bleedin' expert, that's just what we need ;-)

Passed the test then?