From the Guidelines
Most statins can be taken with or without food, as their bioavailability is relatively consistent whether administered with or without food 1. When considering the administration of statins, it's essential to note that the bioavailability of these medications is generally low, but it remains relatively consistent with or without food. According to a scientific statement from the American Heart Association published in Circulation in 2016 1, pitavastatin has the highest bioavailability among statins, ranging from 43% to 51%, while simvastatin and lovastatin have very low bioavailability of less than 5%.
However, specific recommendations may vary depending on the type of statin. For instance:
- Atorvastatin, fluvastatin, pitavastatin, and rosuvastatin can be taken at any time of day, with or without food.
- Lovastatin should be taken with food to enhance absorption, as its bioavailability is decreased by approximately 50% when given without food 1.
- Simvastatin is best taken in the evening due to its shorter half-life and the peak of cholesterol production overnight.
- Pravastatin should be taken on an empty stomach.
It's crucial to maintain consistency in taking statins, ideally at the same time each day, to ensure steady blood levels. The differences in food recommendations are attributed to the varying solubility of statins (fat-soluble vs. water-soluble) and how food affects their absorption. Ultimately, patients should follow their doctor's specific instructions, as individual health needs may necessitate a particular schedule.
From the FDA Drug Label
Take orally once daily with or without food ( 2.1) Although food decreases the rate and extent of drug absorption by approximately 25% and 9%, respectively, as assessed by C maxand AUC, LDL-C reduction is similar whether atorvastatin is given with or without food
Statins can be taken with or without food. The LDL-C reduction is similar whether the statin is given with or without food 2. It is recommended to take the statin orally once daily, and the presence of food does not affect the efficacy of the medication in reducing LDL-C levels 2.
- Key points:
From the Research
Statin Administration Timing
The timing of statin administration, with or without food, is not directly addressed in the provided studies. However, the studies do discuss the optimal time of day for statin administration.
- The studies suggest that the optimal time of day for statin administration depends on the type of statin and its half-life 3, 4, 5.
- Short-acting statins are more effective when taken in the evening, as they can better inhibit cholesterol biosynthesis during the night when HMG-CoA reductase activity is high 4, 5.
- Long-acting statins, on the other hand, can be taken at any time of day, as their effects are less dependent on the timing of administration 3, 6.
- One study found that the pharmacodynamics and pharmacokinetics of extended-release fluvastatin were not affected by the time of intake, suggesting that this particular statin can be taken at any time of day 6.
Food Interaction
There is no direct evidence in the provided studies regarding the interaction between statin administration and food intake.
- However, it is generally recommended to take statins with food to enhance absorption and reduce gastrointestinal side effects, although this may not be necessary for all types of statins 7.
- The studies primarily focus on the timing of statin administration in relation to the circadian rhythm of cholesterol biosynthesis, rather than the interaction with food.
Key Findings
- The optimal time of day for statin administration depends on the type of statin and its half-life.
- Short-acting statins are more effective when taken in the evening.
- Long-acting statins can be taken at any time of day.
- There is limited evidence regarding the interaction between statin administration and food intake.