The optimal time of day for statin administration: a review of current evidence

Abstract

Purpose of review 

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.

Recent findings 

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.

Summary 

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.