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Clinical resource

Statins and Alcohol

Alcohol is notorious for never mixing well with medication, except for a few exceptions. While most interactions between alcohol and drugs are mild and ignorable, some may react more severely than others. For those…

Written by THE BALANCE

Medically reviewed byDr. Sarah Boss, MD
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Quick Summary

  • Heavy alcohol use while taking statins may increase the risk of liver damage, muscle problems, and other medication-related side effects.
  • Possible warning signs include intense muscle pain, weakness, abdominal pain, nausea, appetite loss, fever, breathing difficulties, or persistent trembling.
  • People who drink regularly should discuss their alcohol use with a doctor before starting statins and seek prompt advice about unusual symptoms.

Alcohol is notorious for never mixing well with medication, except for a few exceptions. While most interactions between alcohol and drugs are mild and ignorable, some may react more severely than others. For those battling alcohol addiction, understanding which medicines are the most dangerous to mix with alcohol is essential for long-term health and recovery.

Statins, a common category of medications used for lowering blood cholesterol levels, pose a moderate risk to those fighting alcohol abuse, mainly because of the way both interact with each other. These medicines are commonly prescribed for cardiovascular disease management and may have pretty severe side effects, especially in people who continue to combine them with alcohol without any checks.

This article will discuss statins and alcohol, whether they are safe to mix, what side effects are likely to occur, and the warning signs to watch out for in case of possible body damage.

Due to the cumulative effects of alcohol and statins on the liver, mixing them is not advisable. While low-level or infrequent consumption of alcohol may not have any lasting repercussions, the combination does increase the risk of strokes and heart attacks. Moreover, statins and alcohol also have a pharmacodynamic reaction, which puts liver health at stake.

Additional side effects of the alcohol-statins combination include:

  • Sleep disruption
  • Bloating
  • Nausea
  • Diarrhea or constipation
  • Headaches
  • Dizziness
  • drowsiness

The side effects mentioned above are relatively mild and may not cause any significant disruption in life quality for most people. However, continuing to combine alcohol and statins despite these symptoms may lead to more severe side effects. These side effects include:

Myositis or Myalgia

Muscle inflammation (myositis) and muscle weakness (myalgia) are the two most common side effects of statins. As a result of these side effects, users are more likely to acquire injuries, mainly when using statins with certain medications like fibrates. A more extreme version of this side effect is rhabdomyolysis, a type of extreme muscle damage and inflammation that triggers extensive aches and a feeling of weakness. This widespread breakdown of muscle fiber in the body forces the kidneys to work harder and may lead to kidney failure in untreated cases.

Increased Blood Sugar Levels

Consuming statin medication carries a mild risk of experiencing increased blood sugar levels. While these increases are mild or temporary in most cases, some people may keep experiencing them in the long term. This is how some people using statins for years end up acquiring type 2 diabetes. That said, remember that in most cases, the benefits of taking statins generally outweigh the risk of experiencing blood sugar alterations.

Memory Loss

There is a risk of memory loss and confusion in a minimal number of people who combine statins and alcohol. The precise cause of this side effect is unknown, and the evidence confirming this relationship is still insufficient. Nevertheless, some drinkers taking statins have reported experiencing these side effects.

It is not uncommon to get abnormal liver function tests while consuming statins. However, it is crucial to understand the origin of these abnormalities. There are several ways to understand how statins affect the liver, and some of the most important ones include:

Liver Enzymes and Statins

Current guidelines suggest that everyone must undergo liver function tests before commencing statin therapy. These tests only require a repeat if a clinical reason means it. Research indicates that some individuals who use atorvastatin have increased alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Roughly 3 percent of people using this medication experience an increase in these enzymes, but most experts believe these elevations are temporary and mostly not dangerous. 

Since moderate to high consumption of alcohol also increases liver function tests, combining them with statins increases the chances of this abnormality.

Liver Injury and Statins

Clinical injury, i.e., an injury severe enough to induce physical symptoms, is uncommon with statins. However, it is definitely possible in some users, sometimes leading to death or an urgent need for liver transplantation. Remember that while talking about the effects of alcohol on the liver in association with statins, severe injury is usually because of an autoimmune condition prompted by statins. As a part of this autoimmune condition, the user’s body starts making antibodies that attack their own liver cells.

Potential Benefits of Statins for Liver

It might be slightly reassuring to hear that despite all the recommendations for monitoring liver tests and the risk of acquiring severe liver injury, statins may potentially benefit people with liver disease. Some studies suggest that these medications reduce the risk of death from alcoholic cirrhosis in people with severe alcoholic liver disease by up to 50 percent.

Another study reveals that people with cirrhosis may benefit from using statins as these medicines reduce the risk of liver failure and the complications that may arise from it. Currently, experts are also evaluating the potential of statins to reduce the worsening of liver disease in individuals diagnosed with non-alcoholic fatty liver disease.

Additionally, those with an active liver disease secondary to chronic hepatitis C infections may respond better to their prescribed medications when combined with statins.

If you notice any unusual side effects after taking statins, it is essential to get in touch with a doctor immediately. Any signs like constant headaches, vomiting, nausea, weakness, or a rash may indicate that you are developing liver problems. This is especially true if you are consuming alcohol simultaneously. In that case, keep a look out for the following symptoms:

  • Intense muscle pain
  • Shortness of breath
  • Abdominal pain
  • Fever
  • Cramps
  • Nausea
  • Loss of appetite
  • Muscle weakness
  • Constant muscle trembling

Statins are medications, while alcohol is not. Despite this difference, there is a critical proviso they share: you must use each of them responsibly. While the two may not interact directly, heavy alcohol use increases the risk of multiple side effects associated with statins, muscle issues, and liver damage.

So if you are about to start statins but are a regular drinker, discuss your drinking habits with a doctor before commencing the medication to minimize the risk of complications. If possible, you may consider seeking therapy for cutting down or abstaining from alcohol to begin a sober life.

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Questions

Frequently Asked Questions

What are the names of some common statins? Are they all the same?
Statins are of two types: low-intensity statins, such as simvastatin and pravastatin, and high-intensity statins, like rosuvastatin. Most individuals use the former to keep their cholesterol levels under control. Examples of some commonly used statins include:
 
Atorvastatin
Pravastatin
Rosuvastatin
Fluvastatin
Lovastatin
Pitavastatin
Simvastatin
Are there any foods that I should avoid while taking statins?
You should avoid taking grapefruit and grapefruit juice while taking statins as they may increase the concentration of the drug in the bloodstream.
Can you mix statin and alcohol?
Both alcohol and statins are capable of impairing liver function. Mixing them may increase the burden on the liver, leading to severe multiple health complications, such as chronic liver disease. Drinking excessively while taking statins can also risk many other side effects, like kidney problems, muscle pain and soreness, and fatigue. Therefore, testing yourself before commencing treatment is essential to assess your current liver health. It is also imperative to schedule blood tests frequently every three months to keep tabs on how well your liver is functioning. Moreover, experts advise reducing alcohol as much as possible, avoiding smoking, and exercising to maintain good health.
What are some things to remember while taking statins and alcohol?
If you are drinking alcohol while using statins daily for cholesterol control, there are a few things to keep in mind. These include:
 
Both alcohol and statins directly affect the liver; hence, try not to mix them regularly, as they may increase the blood triglyceride levels
Chronic use of alcohol leads to high cholesterol levels
Seek urgent medical advice if you develop any symptoms of liver injury at any point while consuming statins
 
If you have been prescribed statins and are a chronic drinker, remember to be honest with your doctor about the amount of alcohol you consume daily. With this information, a doctor can guide you better about how to minimize risk while potentially referring you to addiction resources to begin the recovery process.
Who is at risk of mixing alcohol and atorvastatin?
Statins are deemed unsuitable for certain people, especially those with pre-existing kidney and liver damage. These medications are also unfitting for pregnant or breastfeeding women. Furthermore, those with a family history of rhabdomyolysis and myopathy, those over the age of 70, and those who are regular drinkers are at a higher risk of experiencing side effects.
 
Although not everyone who takes statins experience side effects, some people may be at a higher risk of developing them. These include:
 
Females
Those taking alcohol in excess
People over the age of 80 years
Those with a more petite body frame
Those who are taking some other type of cholesterol-lowering medicines
People with certain medical conditions, like neuromuscular disorder and hypothyroidism
Can I mix atorvastatin with other prescription medications or illicit drugs?
In addition to the risk of side effects with simultaneous atorvastatin and alcohol intake, the former may also react with other drugs such as:
 
Antifungal drugs
Certain antibiotics
Colchicine
HIV medications
Digoxin, a medicine for treating heart arrhythmias
Hepatitis C medications
Rifampicin, a medicine used for treating tuberculosis
Other cholesterol-lowering agents apart from atorvastatin
Oral birth control pills

Editorial evidence

Evidence & sources

Selected clinical guidelines, peer-reviewed research, and public-health sources used in this article.

01National Institute for Health and Care Excellence. (2023). Cardiovascular disease: Risk assessment and reduction, including lipid modification.View source
02StatPearls Publishing. (2024). HMG-CoA reductase inhibitors (statins). In StatPearls.View source
03American College of Cardiology, & American Heart Association. (2019). 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease.View source
View all 16 sourcesShow fewer sources
04National Institute on Alcohol Abuse and Alcoholism. (2023). Alcohol use disorder: A comparison between DSMu2013IV and DSMu20135.View source
05Cholesterol Treatment Trialistsu2019 (CTT) Collaboration. (2010). Efficacy and safety of more intensive lowering of LDL cholesterol: A meta-analysis of data from 170,000 participants in 26 randomised trials. The Lancet.View source
06Chalasani, N., Younossi, Z., Lavine, J. E., Diehl, A. M., Brunt, E. M., Cusi, K., Charlton, M., & Sanyal, A. J. (2012). The diagnosis and management of non-alcoholic fatty liver disease: Practice guideline. Hepatology.View source
09National Institute on Alcohol Abuse and Alcoholism. (2024). Alcoholu2019s effects on the body.View source
10Centers for Disease Control and Prevention. (2024). Alcohol use and your health.View source
11U.S. Food and Drug Administration. (2023). FDA drug safety communication: Important safety label changes to cholesterol-lowering statin drugs.View source
12StatPearls Publishing. (2024). Statin medications.View source
13National Institute of Diabetes and Digestive and Kidney Diseases. (2022). Atorvastatin.View source
14Ridker, P. M., Danielson, E., Fonseca, F. A. H., Genest, J., Gotto, A. M., Jr., Kastelein, J. J. P., Koenig, W., Libby, P., Lorenzatti, A. J., MacFadyen, J. G., Nordestgaard, B. G., Shepherd, J., Willerson, J. T., & Glynn, R. J. (2008). Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. New England Journal of Medicine.View source
15National Heart, Lung, and Blood Institute. (2022). Blood cholesterol.View source
16Stone, N. J., Robinson, J. G., Lichtenstein, A. H., Bairey Merz, C. N., Blum, C. B., Eckel, R. H., Goldberg, A. C., Gordon, D., Levy, D., Lloyd-Jones, D. M., McBride, P., Schwartz, J. S., Shero, S. T., Smith, S. C., Jr., Watson, K., & Wilson, P. W. F. (2014). 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults. Circulation.View source
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