Statins: 10 items that 'react unpredictably' with statins to cause serious side effects - Express

Statins divide opinion. Although the evidence points to the clear benefits of taking them - they offer protection against a heart attack or stroke - they can cause unwanted effects. It is therefore important to carefully consider the pros and cons before taking them.

"Statins can react unpredictably with certain other substances (known as 'interacting'), potentially increasing the risk of serious side effects, such as muscle damage," warns the NHS.

Medicines that can interact with some types of statin include:

• Certain antibiotics and antifungals
• Certain HIV medications
• Warfarin – a medicine commonly used to prevent blood clots
• Ciclosporin – a medicine that suppresses the immune system and is used to treat a wide range of conditions, including psoriasis and rheumatoid arthritis
• Danazol – a synthetic (manmade) hormone medicine used to treat conditions such as endometriosis
• Verapamil and diltiazem – types of medicine called calcium channel blockers, which are used to treat various conditions affecting the heart and blood vessels
• Amiodarone – a medicine sometimes used to treat irregular heartbeats
• Fibrates – medicines that, like statins, help reduce cholesterol levels in the blood.

"Grapefruit juice can affect some statins and increase your risk of side effects," warns the NHS.

What's more, people who regularly drink large amounts of alcohol are at increased risk of getting more serious side effects, it notes.

READ MORE: Statins side effects: Two fruits that can be a 'dangerous mix' if you're taking statins

"For full details of cautions and interactions relating to your specific medicine, check the patient information leaflet that comes with it."

It is important to note that the risks of any side effects also have to be balanced against the benefits of preventing serious problems.

A review of scientific studies into the effectiveness of statins found around one in every 50 people who take the medicine for five years will avoid a serious event, such as a heart attack or stroke, as a result.

How to lower cholesterol naturally

You can also lower cholesterol levels by altering your lifestyle.

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Other ways to reduce cholesterol include losing weight; being physically active; and following a healthy diet, inspired by the traditional Mediterranean diet.

Why a Mediterranean diet?

"We have known for some time that people living in countries along the Mediterranean appear to have less heart disease than people living in the UK and northern Europe," explains cholesterol charity Heart UK.

"Health professionals now believe that this may be partly due to the foods that make up the traditional Mediterranean way of eating."

According to Heart UK, one of the best components of the diet are oily fish.

The Mediterranean diet is high in vegetables, fruits, legumes, nuts, beans, cereals, grains, fish and unsaturated fats such as olive oil.

It usually includes a low intake of meat and dairy foods.

This is now seen as a good way of eating – both for a healthy heart and for general well-being.

Exercise can also improve cholesterol.

The Mayo Clinic explains: "Moderate physical activity can help raise high-density lipoprotein (HDL) cholesterol, the "good" cholesterol."

HDL cholesterol has earned its reputation by flushing out LDL cholesterol - the harmful cholesterol.

"With your doctor's okay, work up to at least 30 minutes of exercise five times a week or vigorous aerobic activity for 20 minutes three times a week," advises the Mayo Clinic.

It adds: "Adding physical activity, even in short intervals several times a day, can help you begin to lose weight."

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