Lipitor / statins.

UrbanFox

Out of curiosity, is there any particular reason why a person prescribed a statin takes it at night ?

What goes on overnight in the body as distinct from the day that requires a statin to be taken at night ?

2Scoops

I'm not aware that Lipitor is prescribed specifically for night time use. More than likely, a doctor would mention it as a mental anchor to remind patients to take their meds.

deepimpact

Most of the body's cholesterol is manufactured at night, so ideally the statin should be taken at that time ie before bed, so it can exert it's mechanism of action (HMG-CoA reductase inhibition) to a greater effect.

Taking a statin in the morning has some effects, but they are not as good as taking it at night.

2Scoops

scanlant wrote: »

Most of the body's cholesterol is manufactured at night, so ideally the statin should be taken at that time ie before bed, so it can exert it's mechanism of action (HMG-CoA reductase inhibition) to a greater effect.

Taking a statin in the morning has some effects, but they are not as good as taking it at night.

The half-life of Lipitor, in particular, is such that this is not relevant, but maybe it's easier to prescribe it that way as a general statin rule.

deepimpact

Lipitor, not as much, but it's generally accepted that directions are one at night, irregardless of the statin, so it has maximum effects on reducing cholesterol levels.

I've come across a few practice guidelines that recommend this and they say all statins aswell.

DrIndy

atorvastatin or lipitor to the best of my knowledge is the only statin you don't need to take at night due to the long half-life. The reason for doing so is as above.

The other interesting thing about statins is they have an immune-modulatory function and decreases macrophage activity. This can actually cause plaque stabilisation and even regression. There is ongoing research to see if a derivative can be used to treat MS.

deepimpact

There are also some papers on the use of statins in other neurodegenerative disorders such as Alzheimers through the reduction of Amyloid-beta production via inhibition of protein isoprenylation.

Are those initial research papers on the use of statin derivatives on Pubmed DrIndy? I don't seem to be able to locate them.

<edit> found them, some interesting findings. I must read into it more.

charlieroot

scanlant wrote: »

Most of the body's cholesterol is manufactured at night...

From my (very) limited knowledge of biochemistry, I was under the impression that the endogenous pathway for cholesterol production was quite an expensive one in terms of ATP used and that it generally only happened in the fed state when there is high insulin levels? I thought that at night your insulin levels would be at the basal level or just below this and you wouldn't have much cholesterol production. Please correct me on this if I'm wrong and any pointers on info also greatly appreciated.....

deepimpact

A quick cursory search of PubMed came up with the following paper (it's free-view)

In it, it makes direct references to the diurnal rhythm of lipid plasma levels, and references papers on humans (the paper is on rats and mice, but mentions the human states). It mentions insulin's role too.