Going off Zocor?

[KneadToKnow]

I'm on (generic) Zocor for high cholesterol and have been working with my diet to improve my numbers.

As of April 12, my blood test shows that I'm at all of my targets, several with wide margins:

total cholesterol: 124 (target: <200)
triglycerides: 73 (target <150)
hdl: 47 (target >45, preferably >60)
ldl: 62 (target >100)

What's the standard for taking someone off a statin? I'm at 20mg/day, if that matters.

Note: I'm not asking for medical advice. I'm asking what the standard of care is for patients who are on Zocor and improve their numbers to the point that they no longer need it, with my numbers as an example.

[Qadgop the Mercotan]

I prescribe a lot of statins.

Most folks who go off a statin see their cholesterol go back up to pre-statin numbers.Unless significant dietary and weight changes have taken place, and continue on ad infinitum.

The typical standard of care is to keep a person on a statin, if a statin was necessary to start with, after failure of lifestyle changes.

And many people cannot achieve their target cholesterol numbers without a statin, even with the best compliance with diet and exercise; some folks have livers that are really, really good at making cholesterol no matter what they weigh or what they eat.

Your numbers on the statin are quite good. I would have to know what they were before you went on the drug, and also what your particular risk factors were before I would even dream of commenting even peripherally about whether you need the drug forever or not.

Statins are well-documented to reduce mortality from cardiovascular disease. They're one of the few drugs I tend to do a moderately hard-sell to my patients on, if they fit the risk criteria.

[KneadToKnow]

I hear you, Q. I do have lots of family-history risk factors (father and paternal grandfather both died of coronaries before age 65). What I have going for me is that this is the first time I've really been aggressively making the lifestyle changes my doctor has been wanting since going on the drug.

Alas, I can't find my blood test results from immediately before going on the med ca. 1/2008. I have the first blood test after going on it, which (a) had numbers not as good as this and (b) my doctor described as "excellent."

[Qadgop the Mercotan]

Originally Posted by KneadToKnow

I have the first blood test after going on it, which (a) had numbers not as good as this and (b) my doctor described as "excellent."

What will you do if you go off the med, continue to make all the right lifestyle changes, and have lousy numbers on your cholesterol profile?

I'm not saying 'don't try it off the drug', but I am saying 'be prepared to do your best and still very possibly need the medication to achieve your goal'.

[KneadToKnow]

Originally Posted by Qadgop the Mercotan

What will you do if you go off the med, continue to make all the right lifestyle changes, and have lousy numbers on your cholesterol profile?

I'm not saying 'don't try it off the drug', but I am saying 'be prepared to do your best and still very possibly need the medication to achieve your goal'.

Oh, no worries about me doing anything until my doctor tells me to. I knew in the back of my mind that there was a good chance that going on Zocor would be a forever kind of thing. I was just hoping that maybe there was a "and if the patient no longer meets the diagnostic criteria for high cholesterol for 12 straight months, you can take them off the med and monitor every 6 weeks" kind of clause.

[VOW]

Originally Posted by KneadToKnow

Oh, no worries about me doing anything until my doctor tells me to. I knew in the back of my mind that there was a good chance that going on Zocor would be a forever kind of thing. I was just hoping that maybe there was a "and if the patient no longer meets the diagnostic criteria for high cholesterol for 12 straight months, you can take them off the med and monitor every 6 weeks" kind of clause.

My, aren't you the optimistic one?

Statins have been credited with so many positive influences, with relatively minor side effects (unless YOU have suffered side effects, and then they aren't so minor!), that some doctors are prescribing them to all patients over a select age even if cholesterol levels are not necessarily indicative of medical intervention.

They are almost in the "aspirin to prevent heart attack" category of prevention.

With a familial history such as yours, I'd simply accept statins as a way of life.

But DEFINITELY keep up the good work!


~VOW

[KneadToKnow]

Originally Posted by VOW

My, aren't you the optimistic one?

Yes, but in my defense, that's (roughly) how it worked with my blood pressure medication many years ago when I successfully got my b.p. down to the point that I no longer met the criteria for medication. Alas, a few years later, I again met the criteria and here I am.

Essentially, I'm on a lot more pills than I want to be, and I'm hoping there's light at the end of the tunnel for a few of them.

[VOW]

I do sympathize, because I am also on a lot of pills. I've managed to reduce them over the years, but now I am slowly adding to the pile.

In my case, my stubborn body takes a LONG time to equalize. Any response to my lifestyle changes can take YEARS before it registers on blood tests or BP readings. And then medication adjustments are often almost as slow to achieve the desired effects.

And I feel like SHIT when the BP is see-sawing up and down! Plus my kidneys doth protest, as well.

Good luck!


~VOW

[Qadgop the Mercotan]

Originally Posted by VOW

They are almost in the "aspirin to prevent heart attack" category of prevention.

We're getting more cautious about recommending aspirin for primary prevention these days.

For low risk patients, aspirin's benefit of reducing rates of heart attack and occlusive stroke may well be exceeded by the increased risk of bleeding. I'm recommending aspirin mainly for folks whose risk of first heart disease event in the next 10 years exceeds 10%.

For secondary prevention (that is, for folks who've already had a heart attack), aspirin is pretty much universally recommended save for clear and present contra-indications. It's just that beneficial in reducing risk of a second heart attack.

[Qadgop the Mercotan]

Originally Posted by KneadToKnow

Essentially, I'm on a lot more pills than I want to be, and I'm hoping there's light at the end of the tunnel for a few of them.

Eventually, everybody stops needing to take pills anymore.

Congrats to you for making positive changes and working to get healthier.

[KneadToKnow]

Post script: I saw my doctor on Monday for an unrelated issue when I brought up the fact that I've been achy all over for a couple of months. Turns out, the muscle pain and aches that you have to be alert to when you first start taking a statin can also develop after you've been taking one for a while, so I'm going off my Zocor for a couple of weeks anyway to test and see if the aches and pains go away with it. If so, he said, we can look at a different statin or ... "in light of your recent blood tests, and if you keep up the good work, we may just take you off it altogether."

Suw-eet!