Do I Have to Take my Statin Cholesterol-Lowering Medication at Night?

A class of medications commonly called “statins” work by decreasing the amount of cholesterol we make in our liver and by increasing the amount of cholesterol our liver removes from the blood. Statin medications have historically been said to work best with evening or bedtime dosing, because our bodies make the majority of cholesterol at night.

While there are 7 different types of statin medications, they all generally work the same way. They differ in terms of how potent they are, how they are broken down in our bodies, and how long they last in the body. There are a few statin medications that last a shorter amount of time our bodies, and because of that are found to work best at night. These statin medications include simvastatin, lovastatin, and fluvastatin. Other statin medications last longer in our bodies, which allow these medications to be taken at any time of day. These statins include rosuvastatin, atorvastatin, and pitavastatin. The exception to this rule is pravastatin, which does not last long in our bodies, but the manufacturer recommendations state that it can still be taken at any time of the day.

Should I Take My Statin Medication With Food?

Most statins can be taken without regard to meals. Lovastatin has increased absorption when taken with food, and is more effective if taken with an evening meal.

Grapefruit and grapefruit juice can interact with some statin medications by decreasing the breakdown of these statins and increasing the amount of drug in our bodies. When there is too much statin medication in the body, there is a greater risk of experiencing medication side effects and possible toxicities. Interacting statin medications include lovastatin, simvastatin, and atorvastatin. To avoid this interaction, it is recommended to either avoid grapefruit juice, consume less than 8 ounces of grapefruit juice, or less than one-half of a grapefruit per day if you are taking one of these medications.

 

Statin Medication Duration in Body Time of Administration Meal Administration Food Interaction
Simvastatin (Zocor) Short Evening No regard to meals Grapefruit
Lovastatin (Mevacor) Short Evening Take with food Grapefruit
Fluvastatin (Lescol) Short Evening No regard to meals None
Pravastatin (Pravachol) Short Anytime No regard to meals None
Rosuvastatin (Crestor) Long Anytime No regard to meals None
Pitavastatin (Livalo) Long Anytime No regard to meals None
Atorvastatin (Lipitor) Long Anytime No regard to meals Grapefruit

 

Additional Advice for Taking Statin Medications:

Statins work best when they are taken at the same time each day. If you see that the time of administration above as “anytime,” choose the time you are most likely to remember to take it. The most important thing is to be sure to take your medication daily as prescribed. If your doctor does specify nightly dosing for a statin that can be taken at any time, communicate with your doctor before switching to a different time of administration to make sure they don’t have a specific reason for indicating an evening dose.