Alternate-day Dosing with Statins

The duration of the cholesterol-lowering effect of statins is considerably longer than the duration of the pharmacokinetic half-life of these drugs. The long duration of pharmacologic effects provides the rational for the efficacy of intermittent dosing that provides nearly the equivalent low-density lipoprotein cholesterol reduction compared with daily dosing. Review of studies comparing alternate-day dosing with daily dosing of statins indicates that the magnitude of low-density lipoprotein cholesterol reduction with alternate-day dosing is nearly the same, with obvious cost savings. It is possible that the adverse effects of statins, such as myalgia or diabetes, may be related to the cumulative amount of drug ingested over time, and if so, the adverse effects may be decreased by alternate-day dosing.