Regular dosing of a prescribed statin is important to its effective use, and missed doses can interfere with ideal use. Pharmacokinetics of statins may be altered in the elderly, who are also at greater risk, on average, of medication errors due to cognitive impairment.1 Under-exposure to statins can render the medication ineffective. Excess exposure to statins can result in an increased risk of adverse effects.2,3
The elimination half-life of statins varies greatly by agent, from one to four hours for pravastatin, fluvastatin, simvastatin, and lovastatin, 12 hours for pitavastatin, 14 hours for atorvastatin, and 19 hours for rosuvastatin.4-10 The elimination half-life for extended-release formulations are longer. Manufacturers recommend taking a missed dose of statin as soon as possible unless it has been more than 12 hours. After 12 hours have passed, they recommend resuming normal dosing timing the next day. Doubling up on doses is not recommended.
References
- Piťha J, Topinková E, Bláha V, et al. Statin therapy in elderly patients. Vnitr Lek. 2018;64(11):1021-1027.
- Spence JD, Dresser GK. Overcoming challenges with statin therapy. J Am Heart Assoc. 2016;5(1). doi:10.1161/JAHA.115.002497
- Sirtori CR. The pharmacology of statins. Pharmacol Res. 2014;88:3-11. doi:10.1016/j.phrs.2014.03.002
- Atorvastatin. Micromedex Solutions [database online]. Truven Health Analytics. http://www.micromedexsolutions.com. Accessed 3/22/2020.
- Pravastatin. Micromedex Solutions [database online]. Truven Health Analytics. http://www.micromedexsolutions.com. Accessed 3/22/2020.
- Fluvastatin. Micromedex Solutions [database online]. Truven Health Analytics. http://www.micromedexsolutions.com. Accessed 3/22/2020.
- Lovastatin. Micromedex Solutions [database online]. Truven Health Analytics. http://www.micromedexsolutions.com. Accessed 3/22/2020.
- Pitavastatin. Micromedex Solutions [database online]. Truven Health Analytics. http://www.micromedexsolutions.com. Accessed 3/22/2020.
- Rosuvastatin. Micromedex Solutions [database online]. Truven Health Analytics. http://www.micromedexsolutions.com. Accessed 3/22/2020.
- Simvastatin. Micromedex Solutions [database online]. Truven Health Analytics. http://www.micromedexsolutions.com. Accessed 3/22/2020.