Doctors often recommend that patients take statins at night because the medication can more effectively reduce Low Density Lipoprotein (LDL) cholesterol levels when taken in the evening. These drugs work by blocking the activity of an enzyme in the liver responsible for producing LDL, and its concentration tends to rise at night. Taking medications as the enzyme level increases can make them most effective. With some statins, the concentration of the drug in the body remains high enough over a 24 hour period that the time of the dose is not as critical.
In early clinical trials, researchers had participants take statins at night because of existing knowledge about cholesterol production in the body. They knew that cholesterol levels tend to increase while people are sleeping because this is when the liver enzyme involved is most active. Based on this information, they reasoned that statins would be most effective when taken in the evening, allowing the peak level of the drug to build up in tandem with the liver enzyme. The drug could block the enzyme, lowering LDL production and hopefully increasing High Density Lipoprotein (HDL) or “good cholesterol” at the same time.
Using information from clinical trials, manufacturers recommended that patients take these medications in the evening. This information was largely repeated by medical providers, who told patients to use statins at night. Researchers conducted several studies with various types of statins and found that, overall, LDL levels tended to be lower with patients using an evening dose in contrast with patients taking medication in the morning. These studies supported the recommendation.
Research on specific statins has shown that because their serum levels remain stable, meaning the medication remains at a consistent concentration in the body for an extended period, it may be safe to take them in the morning. A medical practitioner may consider these medications if there are worries about a patient’s medication schedule and the ability to adhere to treatment recommendations. Patients who find it hard to take statins at night could switch to these drugs to see if they will work for them.
As with many medications, statins should be taken on a consistent schedule. People who take their medication at around the same time every day will keep serum levels consistent, allowing the drug to work continuously. For those who take statins at night, it is important to pick a timing for the dose that will be easy to remember and adhere to.