In humans, cholesterol biosynthesis varies diurnally, reaching its peak at night. Therefore, choosing the time of statin administration is critical because of their different half-lives. Dose timing becomes more important in patients with polypharmacy because it might affect their adherence to the statin therapy.
Herein, we narratively summarized the available clinical studies (n = 17) and meta-analyses (n = 2) that compared the morning with the evening dose of statins in terms of safety and efficacy, with special focus on their low-density lipoprotein-lowering effects. We also explained the difference in efficacy results in case of short-acting compared with the long-acting statins and highlighted how flexibility in choosing the time of statin administration is important for better adherence.
The current limited evidence suggests that short-acting statins should be given in the evening whereas long-acting statins could be given at any time of the day with allowing more patient-based choice (of timing) for better adherence. Lager RCTs with longer durations are recommended to extend and confirm the current evidence.
aFaculty of Medicine, Zagazig University, Egypt
bHead Department of Hypertension, WAM University Hospital in Lodz, Medical University of Lodz (MUL)
cPolish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz
dCardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
Correspondence to Kamal Awad, Faculty of Medicine, Zagazig University, Zagazig, El-Sharkia, Egypt. Tel: +20 1004092741; e-mail: email@example.com