Taking cholesterol medication with food could reduce risk of side effects

Statins are a class of drugs prescribed to over three million Canadians each year to help lower cholesterol. While effective in reducing the risk of heart disease, statins can often cause a number of side effects such as muscle ache, pain and weakness. 

Current Canadian guidelines do not indicate if statins should be taken with or without food, and most people take the medication on an empty stomach. With some drugs, eating food when taking a dose of the medication can reduce negative side effects.

Led by Dr. Richard Kim, Scientist at Lawson, a recent study showed that eating food when taking the medication rosuvastatin can reduce the risk of side effects. The study marks the first time the relationship between rosuvastatin and food intake has been assessed in a real-world setting.

The study focused on factors that can affect the way humans respond to drugs. The first part included 23 healthy volunteers randomized to either eat a low-fat meal, high-fat meal or fast immediately before taking their dose of medication. The research team found that taking the medication with food resulted in a near 40 per cent reduction in the amount of rosuvastatin present in the blood of healthy research participants. 

“High statin blood concentrations can increase the risk of muscle pain and injury,” says Dr. Kim, also a clinical pharmacologist at London Health Sciences Centre (LHSC). “Taking statin with food could be a simple way to reduce the risk of statin side effects. This could have a major impact on increasing the number of people who can safely take statins while enhancing quality of life.” 

The next phase of the study, in collaboration with Dr. Robert Hegele, an internationally recognized leader in cardiovascular genetics and lipid disorders, included 156 patients from the Lipid Genetics Clinic at LHSC, who were already taking rosuvastatin. Participants were divided into groups based on self-reported time of medication intake and the likelihood of whether food was consumed at that time of day. 

Blood concentrations of low-density lipoprotein (LDL) cholesterol, as well as lathosterol (a cholesterol-like molecule), were measured in each group. The team found that the measured blood concentrations of LDL-cholesterol and lathosterol did not differ between the two groups and that the dose of rosuvastatin did not differ, meaning one group was not taking a higher dose than the other. This suggests that taking rosuvastatin with food did not compromise the cholesterol lowering benefit of the statin medication. 

“Our hope is to add new research insights that can lead to individualized medication dosing and treatment options,” says Kim, professor of medicine at Western University’s Schulich School of Medicine & Dentistry. “In this study, we’ve shown that taking statins with food could be a simple way to reduce side effects. These results add to the research we’ve gathered in the field of personalized medicine.”

Personalized medicine uses pharmacogenomics - the study of genetic changes that alter the way a person responds to individual drugs. LHSC was the first in Canada to implement personalized medicine as a clinical strategy. The practice began in 2008 through Dr. Kim’s research on warfarin – a blood thinner prescribed to treat blood clots. Dr. Kim continues to lead groundbreaking and translational research initiatives in this area. 

The study, “Food effect on Rosuvastatin Disposition and Low-Density Lipoprotein Cholesterol,” is published in Clinical Pharmacology & Therapeutics.