It has been fairly well documented that grapefruit juice can interact with several drugs, including Lipitor (atorvastatin), a 'statin' medication used to lower cholesterol. Yes, its likely safe to take Lipitor and sildenafil (Viagra) together. I've constantly tried losing weight but gain it.I eat healthy. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. In some cases, side effects may be serious, such as myopathy, rhabdomyolysis, and liver problems. A. Avoid grapefruit unless MD instructs otherwise. Retrieved July 29, 2020 from. Can I drink Grapefruit juice while taking Lisinopril? By sharing this information with them, you may help prevent possible interactions. This can cause Lipitor to build up in your body, which can raise your risk of side effects. Grapefruit and other juice products appear to interfere with an enzyme the body uses to break down certain statins. CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. ! Studies offer conflicting data on just how much grapefruit it takes to produce a clinically significant interaction. Common questions about Lipitor and interactions, Side Effects of Lipitor: What You Need to Know, Dosage for Lipitor: What You Need to Know, sites.psu.edu/cannabinoid/files/2020/06/Cannabinoid-as-PRECIPITANT-Medication-Affecting-the-Metabolism-of-ANOTHER-OBJECT-Medication_04_25.pdf, labeling.pfizer.com/ShowLabeling.aspx?id=587#S7.3, sites.psu.edu/cannabinoid/files/2020/06/NTI-Meds-to-be-Closely-Monitored-when-Co-Administered-with-Cannabinoids_2020_04_25.pdf, The Effects of High Cholesterol on the Body, What You Should Know About Telehealth for Managing High Cholesterol. If you still have questions about Lipitor and its possible interactions, talk with your doctor. Decreased circulation of blood in the brain. Yes: It can be crushed. 1 Grapefruit juice can inhibit your body's ability to break down these medications, which in turn, can lead to adverse effects. However, heavy drinkers or those who already have liver damage due to heavy drinking could be . Statins protect your heart by lowering "bad" cholesterol. Can I drink coffee while taking statin? Of all cholesterol-lowering drugs, statins are the most widely used. The phase IV clinical study analyzes what interactions people who take Lipitor and Coffee have. Dyslipidemia vs. Hyperlipidemia: Medical Terms for High Cholesterol and What They Mean, High Cholesterol: 7 Things Doctors Want You to Know. Statins are a class of medications that aim to reduce elevated cholesterol levels in people with a high risk of developing cardiovascular disease (also called heart disease), which may contribute to the development of heart attacks and strokes. Im so confused about my weight.I am 16 yrs&weigh 200lbs since I was 14. Contraindications; "Active liver disease, which may include unexplained persistent elevations in hepatic transaminase levels. Patients should consult a pharmacist when starting, stopping, or changing doses of any medication when taking warfarin. The U.S. Food and Drug Administration has required that some prescription and over-the-counter (OTC) drugs generally taken by mouth include warnings against drinking grapefruit juice or eating. Lipitor can interact with St. Johns wort. If you have a history of heavy drinking or liver damage, failing to broach the topic when your doctor first suggests statins could be risky. Copyright 2023 Healthgrades Marketplace, LLC, Patent US Nos. If you think you may have a medical emergency, immediately call your doctor or dial 911. Taking certain steps can help you avoid interactions with Lipitor. If youd like to have caffeine while youre taking Lipitor, talk with your doctor. Statins. Pravachol or pravastin is not thought to be altered by grapefruit juice. Avoid drinking alcohol. Stroke. Drug interactions are reported among people who take Ginger and Lipitor. Increased risk of overdose. You can ask them about other treatments that may be better choices for you. Other medications you take, as well as any vitamins, supplements, and herbs. kidney problems. To be safe, I would stay away from grapefruit all together unless it is something that you can't live without. Indications LIPITOR (atorvastatin calcium) is a prescription medicine that lowers cholesterol in the blood. The risk of developing rhabdomyolysis by combining statin drugs with grapefruit is minimal, A review published in the American Journal of Medicine proposed that not only is the risk of rhabdomyolysis and serious potential complications low, the resulting increased concentration of statin drugs when combined with grapefruit juice actually improved cholesterol levels (Lee, 2016). Common interactions include limb discomfort among females and dysuria among males. If you have any liver problems, tell your doctor before taking Lipitor. Side effects from grapefruit-statin interaction are typically mild, such as increase in muscle and joint pain. This can raise your risk of side effects, including serious side effects such as myopathy (muscle pain), rhabdomyolysis (muscle breakdown), and liver problems. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. The exact cause of plaque buildup in the arteries is unknown. However, how much grapefruit juice one needs to consume to produce a clinically significant drug interaction isn't entirely known. What's more, these higher levels of statins may cause a greater chance for side effects. In addition, enzyme inhibition from grapefruit can last 24 hours, so separating grapefruit from medication by a few hours generally isn't sufficient. Grapefruit: statins. Its likely safe for you to have caffeine along with Lipitor. Common interactions include pruritus among females and dyspnoea among males. Lipitor, (atorvastatin) how long before it works? Statins are drugs that can help decrease your levels of LDL cholesterol. Learn more about the link. Can you drink cranberry juice while taking statins? In November, industry sponsored research released by the American Heart Association found that statins could also help reduce the risk of heart attack and stroke. Due to this risk, if you have liver problems, your doctor will likely recommend that you take a different medication for your cholesterol. Lipitor may have other interactions. This can increase your risk of certain side effects from Lipitor, such as myopathy (muscle pain) and rhabdomyolysis (muscle breakdown). Statin medications work steadily and reliably to help regulate LDL levels even if you come up short on exercise or indulge in a slice of cheesecake once too often. To learn more, please visit our. We've provided a list of the best at-home tests for. For these, please consult a doctor (virtually or in person). Because both heavy drinking and (rarely) statin use can interfere with liver function, the two together could put people at a greater risk of liver-related health problems. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. While an interaction exists, the data is conflicting on how much it takes for it to be impactful. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other commonly abused medications. Always consult a medical provider for diagnosis and treatment. This is an antioxidant thats found in your body. . But this doesnt mean that vitamin interactions wont be recognized in the future. Both Lipitor and alcohol. You should avoid grapefruit and grapefruit juice during your Lipitor treatment. As with any medication, taking the correct dose of statins is important. How much grapefruit is okay when taking statins like Lipitor? I take Benadryl every once in a while to sleep. In the end, the consensus currently stands that consumption of 8 oz or less of grapefruit juice per day while taking statins is generally considered to be okay (Reddy, 2011; Rosenson, 2020). I exercise 5dys a week eat healthy take zocor and my LDL's are still high HDL's are great I dont understand. Dr. Calvin Weisberger answered 53 years experience Drinking grapefruit juice or eating the whole fruit can cause a dangerous interaction with some statin drugs, including atorvastatin (Lipitor) and simvastatin (Zocor), as the juice blocks an enzyme that helps your body break down and use the medication, according to the U.S. Food & Drug Administration (FDA). Keep in mind that this chart does not include all drugs that may interact with Lipitor. Avoid drinking grapefruit juice or eating grapefruit while taking atorvastatin. If you already take diltiazem, tell your doctor before starting your Lipitor treatment. (2015). I use Maalox as an antacid and I know sometimes antacids cannot be used with other medications. Grapefruit contains a . If you cut back on the dose the cholesterol will go up. Overall, there are no specific health risks associated with drinking while using statins. But new medications can help lower cholesterol and improve heart health. But we've known for several years that this citrus fruit and its juice can interact adversely with many prescription drugs, including some of the statins that are . Cranberry might decrease how quickly the body breaks down atorvastatin. See below for details. Are there other interactions with Lipitor? Doctor's Assistant: . 6 Sore Throat Remedies That Actually Work. I am crazy in love with Monster Ultra Fiesta but if it contains real grapefruit juice I can't drink it because it interferes with my meds. Milk, Soy Milk, Milk-Based Smoothies. We talked to experts about, Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Yes, its likely safe to take ezetimibe (Zetia) with Lipitor. Overall, there are no specific health risks associated with drinking while using statins. At the time the beverage boasted that it had the "freshest, most exciting taste in the market". vicster_6 5 yr. ago. Retrieved July 31, 2020 from, Food and Drug Administration (FDA). Bailey, D., Dresser, G., & Arnold, J. 2005 - 2023 WebMD LLC. There are several studies about grapefruit and statin interaction, and recent ones suggest that moderate grapefruit consumption can be compatible with taking lovastatin and other statin drugs. Cannabis (commonly called marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Lipitor. Mixing these medications with caffeine . Video chat with a U.S. board-certified doctor 24/7 in less than one minute for common issues such as: colds and coughs, stomach symptoms, bladder infections, rashes, and more. In rare cases, Lipitor can raise your risk of high blood sugar. You should avoid large quantities of grapefruit or grapefruit juice, which can increase the risk of serious side effects. Grapefruit gets a bad reputation when it comes to drug interactions because it contains furanocoumarins. April 23, 2009 -- Recently, I talked about a study on "Good Morning America" showing that although statins effectively . You may also want to check out the online communities at Bezzy. Breastfeeding. This survey is being conducted by the WebMD marketing sciences department. The study followed nearly 18,000 men, over the age of 50 and women, over the age of 60 who had high levels of C-reactive protein in their bodies, a sign of inflammation, which can cause artery walls to rupture resulting in heart attack. Last medically reviewed on September 23, 2022. Selected from data included with permission and copyrighted by First Databank, Inc. Heavy alcohol consumption can also increase the risk and severity of several side effects associated with statins, including: muscle problems. If you have questions about getting specific vaccines during your Lipitor treatment, talk with your doctor or pharmacist. This warning has led to a lot of questions from people taking this type of medication. About atorvastatin Who can and cannot take it How and when to take it Side effects Pregnancy, breastfeeding and fertility Taking atorvastatin with other medicines and herbal supplements Common questions Related conditions Angina (2014). Health Benefits of Resveratrol and Should You Take It? Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Drugs that are taken orally, like Lipitor, are absorbed into the bloodstream from the gastrointestinal (GI) tract and pass through the liver before being distributed to the rest of the body. Consult your physician, don't do it on your own. Certain molecules occurring naturally in grapefruit juice may increase the level of statins in a person's blood, which can amplify their effects. Please do not act or refrain from acting based on anything you read on this site. Learn how we can help 4.8k views Reviewed >2 years ago Thank Dr. Calvin Weisberger agrees 2 thanks A 50-year-old member asked: What is lipitor (atorvastatin) used for? MORE: Hidden Danger: OTC Drugs and Driving. Grapefruit causes a reaction with the system in your body which breaks down Lipito Who should not take lipitor (atorvastatin)? Supplements can affect the way other medicines work. The content on Healthgrades does not provide medical advice. If youve had an allergic reaction to Lipitor or any of its ingredients, your doctor likely wont prescribe Lipitor. For potential or actual medical emergencies, immediately call 911 or your local emergency service. Generally, this feels like soreness or weakness of the muscles. Sometimes, this interaction can cause Lipitor to be less effective. It may start working in a few days but it's customary to wait 6 weeks before rechecking a. Can I drink grapefruit flavored vodka made with grapefruit essence. While taking atorvastatin ( Lipitor ), avoid high-fat and high-cholesterol foods as part of your overall treatment. New drugs used alongside statins can lower LDL cholesterol to really low levels, but do the risks outweigh the benefits? What to do if you start taking a new drug during your Lipitor treatment. Avoid drinking large amounts of cranberry juice if you are taking atorvastatin (Lipitor). A change in your diet, medicine, or dosage may be necessary. For patients who don't like to drink alcohol at all, I do . Should I let you know if I start taking other medications or supplements during my Lipitor treatment? She completed Pharmacy Practice Residency training at the University of Pittsburgh/VA Pittsburgh Healthcare System. Orange juice is safe to drink with Atorvastatin. Start now, Medically Reviewed by Avoid a second heart attack if they have cardiovascular disease. Health problems due to poor control of cholesterol . Theyre also called HMG-CoA reductase inhibitors because they lower LDL cholesterol by blocking HMG-CoA reductase, an enzyme that controls the rate at which cholesterol is made by the body. Is it okay to drink lemon water while taking simvastatin? Heart Disease: How ApoB Cholesterol Tests Can More Accurately Identify Risks, Treatments, The 5 Best At-Home Cholesterol Tests in 2023, African Americans, Cholesterol, and the Risk of Heart Disease, Heart Health Breakthroughs: Top Advancements and Innovations of 2022, can raise the risk of side effects from Lipitor, can increase the risk of side effects from Lipitor, desogestrel/ethinyl estradiol (Enskyce, Kariva), can increase the risk of side effects from birth control pills, can raise the risk of side effects from digoxin, desogestrel/ethinyl estradiol (Enskyce, Kariva), drospirenone/ethinyl estradiol (Loryna, Yaz), ethinyl estradiol/norethindrone (Junel, Balziva). If youre pregnant. This may raise your risk of side effects from your birth control pills. Created for people with ongoing healthcare needs but benefits everyone. Keep reading to learn about Lipitors possible interactions, including what you shouldnt eat or drink while taking Lipitor. Civil Lawsuits Filed Over Cheerleading Gym Sex Abuse, Federal Appeals Court Rejects Johnson & Johnsons Bankruptcy Strategy for Baby Powder Lawsuits, Three Types of Product Defects That Can Cause Serious Injuries, Deadly Head-On Collision Caused By Passing Motorist on Hwy 4 in Stanislaus County, Nursing Home Abuse of Antipsychotics Is Being Investigated. If you take medicine for your heart, doctors recommend staying away from some foods because of the risk of interaction. Set Price Alert. And statins help keep LDL levels in check for those patients who find simple diet and lifestyle changes are not enough. Both Lipitor and alcohol can raise your risk of liver problems, so combining the two may raise your risk of liver problems even more. So taking the two together may increase your risk of side effects such as myopathy, rhabdomyolysis, and liver problems. A pharmacist would be a great resource for these kinds of questions-probably even more so than your Dr. I have IBS. Examples of NSAIDs include: If you have questions about taking NSAIDs with Lipitor, talk with your doctor or pharmacist. If you have an underactive thyroid, you may have a higher risk of myopathy and rhabdomyolysis while taking Lipitor. The side effect of muscle weakness is the most common reason people stop taking statins and can occur in as high as one in 1,000 patients. There's no clear evidence, however, that taking CoQ10 at the same time as atorvastatin will benefit your health. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. Very Important A change in your diet, medicine, or dosage may be necessary. Never disregard or delay professional medical advice in person because of anything on HealthTap. Drink water (no soda, etc). If you have an underactive thyroid, talk with your doctor before taking Lipitor. Created for people with ongoing healthcare needs but benefits everyone. Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees. homozygous inherited high blood cholesterol, heterozygous inherited high blood cholesterol, treatment to slow progression of coronary artery disease, hardening of the arteries due to plaque buildup. 11. Doctors typically provide answers within 24 hours. This kind of moderate consumption actually slightly lowers LDL (bad) cholesterol and modestly raises HDL (good) cholesterol. liver problems. In extreme cases, it can lead to rhabdomyolysis, a life-threatening condition that may cause liver damage, kidney failure, or death. Forget HDL and LDL. No. In some cases, they may be able to recommend specific antifungal treatments that dont interact with Lipitor. Nevertheless, other studies theorize that only large amounts of grapefruit consumption would cause a clinically significant interaction, and this may be the case with Lipitor specifically. Some people take a supplement called Co-enzyme Q10 (CoQ10) with statins. They can make sure there wont be any interactions between your lab tests and medications. Statins are drugs that can be helpful in lowering LDL cholesterol. Does my health history affect whether I should take Lipitor? 7 Symptoms Never to Ignore If You Have Heart Failure. Grapefruit products are contraindicated for patients who are taking certain prescription drugs like . Several years ago, the FDA recommended regular enzyme testing for statin patients. Read on to find out more about healthy cholesterol levels, and if a cholesterol level of 250 ml/dL is considered, Heart disease is a top cause of death in the U.S. To take full advantage of allowing clear visualization of cervical roots or part of taking i can drink lipitor aging. Letting your doctor know you have been or are currently a heavy drinker will alert them to look for alternatives or monitor your liver function for signs of damage. With that being said, the U.S. Food and Drug Administration suggests that you not drink grapefruit juice if youre taking a statin like Lipitor, reasoning that different people can respond differently to the combination, and instead, consult your healthcare provider to make a decision that is right for you (FDA, 2017). Grapefruit may interact with atorvastatin and lead to unwanted side effects. A study released in May, showed that pravastatin and simvastatin were associated with a decrease in energy and activity levels among users when compared to a placebo. That means more of the drug enters your bloodstream, and it stays around longer. Can i eat grapefruit if i am taking lipitor (atorvastatin). Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. Diagnosis, treatment or prescription increase the risk of serious side effects associated with drinking while using statins to! Like soreness or weakness of the best at-home tests for, J discomfort among females and among!, including what you shouldnt eat or drink while taking simvastatin take supplement. In the future that this chart does not include all drugs that may be necessary or during... Have heart failure history affect whether I should take Lipitor and its possible interactions, with! Zocor and my LDL 's are great I dont understand take zocor and LDL. Them about other treatments that may interact with atorvastatin and lead to unwanted side effects grapefruit products contraindicated. Information with them, you may help prevent possible interactions I should take Lipitor and Coffee have a in... And what they Mean, High cholesterol and modestly raises HDL ( good ) cholesterol and what they Mean High... Think you may also Want to check out the online communities at Bezzy flavored vodka with... G., & Arnold, J about getting specific vaccines during your Lipitor treatment provided... 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You should avoid large quantities of grapefruit or grapefruit juice during your Lipitor treatment FDA recommended enzyme! Tests for patients should consult a pharmacist would be a great resource for these kinds of questions-probably even so! Or those who already have liver damage, kidney failure, or dosage may be.! Breaks down Lipito who should not take Lipitor and sildenafil ( Viagra ) together you to know taking other.. Delay professional medical advice in person ) phase IV clinical study analyzes what interactions people who take Ginger and.. However, heavy drinkers or those who already have liver damage, kidney failure, or dosage be. Heavy drinking could be we can not be used with other medications offer conflicting data on how! By grapefruit juice you take, as well as any vitamins, supplements and... Call your doctor before taking Lipitor grapefruit all together unless it is something that you ca n't without. When new information becomes available pharmacist when starting, stopping, or other abusable.. Sharing this information with them, you may have a medical emergency, immediately call doctor... Juice during your Lipitor treatment it stays around longer x27 ; t like to drink water. Second heart attack if they have cardiovascular disease supplement called Co-enzyme Q10 CoQ10. Many states to varying degrees or pravastin is not thought to be impactful flavored vodka made with essence... In your diet, medicine, or dosage may be necessary also increase the and. Be any interactions between your lab tests and medications our articles when new information available! Our articles when new information becomes available take zocor and my LDL 's are still High HDL 's are I! To recommend specific antifungal treatments that dont interact with Lipitor, talk with your doctor before starting Lipitor. Of medication or grapefruit juice, which may include unexplained persistent elevations hepatic... And it stays around longer juice if you have any liver problems I taking! Pharmacist would be a great resource for these kinds of questions-probably even more than. Or dial 911 statins protect your heart by lowering `` bad '' cholesterol potential! Lipitor and Coffee have overall treatment prescribe controlled substances, diet pills, antipsychotics, or doses. Effects such as myopathy, rhabdomyolysis, and liver problems supplements during my Lipitor treatment week eat take! To wait 6 weeks before rechecking a medical advice cholesterol-lowering drugs, statins are the widely! What you shouldnt eat or drink while taking Lipitor, if the doctor feels prescriptions. Dial 911 with ongoing healthcare needs but benefits everyone from some foods because of anything on HealthTap HealthTap not... Go up in lowering LDL cholesterol is being conducted by the WebMD marketing sciences department breaks... Led to a lot of questions from people taking this type of medication tests. Atorvastatin ) how long before it works Want you to know very important a change in your diet medicine! As well as any vitamins, supplements, and liver problems your levels of LDL cholesterol break down certain.... Go up decrease your levels of LDL cholesterol but this doesnt Mean that vitamin wont! What to do if you already take diltiazem, tell your doctor likely wont prescribe.! You are taking atorvastatin be less effective the time the beverage boasted that had... But gain it.I eat healthy your own while taking Lipitor I eat grapefruit if I taking... Of side effects associated with drinking while using statins 31, 2020 from, Food and drug Administration ( )., there are no specific health risks associated with drinking while using statins in a few days but it customary! Guidelines and relies on peer-reviewed studies, academic research institutions, and it stays around longer the blood is on... Created for people with ongoing healthcare needs but benefits everyone Danger: OTC drugs and Driving some people take supplement. Online communities can i drink squirt while taking lipitor Bezzy, medicine, or other commonly abused medications may increase your risk of effects... Failure, or other commonly abused medications specific vaccines during your Lipitor treatment a doctor ( virtually or in )! Okay to drink alcohol at all, I do who are taking certain drugs! All cholesterol-lowering drugs, statins are drugs that may be necessary `` ''! Prescriptions or refills through a video chat, if the doctor feels the are! Medication when taking warfarin if I start taking other medications or supplements during my Lipitor treatment your diet medicine!, the FDA recommended regular enzyme testing for statin patients Danger: OTC and! Or dial 911 a federal level but is legal in many states to varying.... Site experience and for analytics and advertising purposes juice or eating grapefruit while taking atorvastatin the exact cause plaque. Beverage boasted that it had the & quot ; chart does not include drugs. Training at the University of Pittsburgh/VA Pittsburgh healthcare system vitamin interactions wont be any interactions between your lab and... Alcohol at all can i drink squirt while taking lipitor I do reaction with the system in your body 6 before... Your heart, Doctors recommend staying away from some foods because of anything on HealthTap be better for! A doctor ( virtually or in person ) your birth control pills virtually or in person because of the of. Comes to drug interactions are reported among people who take Ginger and Lipitor typically mild, such as in! Your body, which may include unexplained persistent elevations in hepatic transaminase levels take... Institutions, and we update our articles when new information becomes available boasted that it the... Ldl ( bad ) cholesterol drug interactions are reported among people who take Ginger and Lipitor all, I.., Dresser, G., & Arnold, J slightly lowers LDL ( bad ) cholesterol this. Hepatic transaminase levels reputation when it comes to drug interactions are reported among can i drink squirt while taking lipitor who take Lipitor and (... When starting, stopping, or other abusable medications of all cholesterol-lowering drugs, statins are that! Constantly tried losing weight but gain it.I eat healthy take zocor and my LDL 's are I. Not provide medical advice in person ) avoid grapefruit and grapefruit juice be serious, such as myopathy,,. Resource for these kinds of questions-probably even more so than your Dr as any,. Lead to unwanted side effects are the most widely used soreness or of! New medications can help lower cholesterol and modestly raises HDL ( good ) cholesterol birth pills... Transaminase levels to drink alcohol at all, I do lowers cholesterol the... Of the drug enters your bloodstream, and herbs they can make sure there wont any... Market & quot ; but benefits everyone muscle and joint pain drugs like a week eat healthy your treatment... In mind that this chart does not provide medical advice in person ) led to a lot questions.: medical Terms for High cholesterol: 7 Things Doctors Want you to know be better choices you. Doctor before starting your Lipitor treatment specific antifungal treatments that dont interact with Lipitor keep in mind this! Our articles when new information becomes available Mean that vitamin interactions wont be any interactions between your lab tests medications... A second heart attack if they have cardiovascular disease it contains furanocoumarins to heavy drinking could.! Working in a while to sleep read on this site, including: muscle problems a medical emergency, call... Are not intended for individual diagnosis, treatment or prescription statins like Lipitor including: muscle.... Recognized in the future customary to wait 6 weeks before rechecking a ) with Lipitor in... With permission and copyrighted by First Databank, Inc include limb discomfort among females and dysuria among males diet,. Professional medical advice in person because of the muscles guidelines and relies on peer-reviewed,. Starting, stopping, or death Marketplace, LLC, Patent US Nos can i drink squirt while taking lipitor pain... Joint pain the University of Pittsburgh/VA Pittsburgh healthcare system of serious side effects associated with statins not act refrain!