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Are you sure statins at night?

Dear readers,
Statins @ HMG-CoA reductase known as lipid lowering drug. Commonly the pharmacist will counsel the patient to consume at night. This been a tradition for years, but are you sure all the statin should be consumed at night? Although some cholesterol comes from dietary intake, a significant amount is produced endogenously.  It was previously hypothesized that human cholesterol production may be cyclical in nature mimicking the confirmed pattern of cholesterol synthesis in animals.  Human trials then confirmed the fluctuation in cholesterol synthesis, noting the greatest cholesterol production from the liver during fasting states. 
        The apparent circadian rhythm of cholesterol production sparked the recommendation that statins be dosed at bedtime to provide the greatest medication concentration when endogenous cholesterol production is the highest.
        There are long acting statins and short acting statins. The older generation statins are short acting so the old references suggest to consume at night. Now its different. 
















Full journal can be download here : Download journal

          This literature review investigated the chronobiologic effects of morning vs evening administration of statins on low-density lipoprotein cholesterol (LDL-C). Based on clinical trials reviewed, short acting statins demonstrated a significant low-density lipoprotein cholesterol (LDL-C) percentage reduction when administered in the evening, compared with morning administration. Meanwhile long acting statins appears to decrease LDL-C regardless of the time administered.


References
1) https://www.ncbi.nlm.nih.gov/pubmed/28826569
2) https://www.ebmconsult.com/articles/statin-administration-evening-night-bedtime
3) https://www.medscape.com/viewarticle/552756

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