Question: What are we to make of all the mounting criticism of statin drugs? My dear 71-year-old husband is four years away from bypass surgery, his latest blood readings are great and his doctor says, "take your medicines as prescribed." Yet he has muscle weakness and intermittent ED. He takes Vytorin, eats mostly right, and gets cardio and weights exercise. What do you think?

Dr. Hibberd's Answer:

The statin family of drugs is perhaps the most important discovery of the past twenty years enabling many cardiac and stroke patients to arrest or even reverse their vascular disease, and prolong and improve their quality of life. Criticisms focus on adverse effects that a few encounter, and we are striving to improve risk/benefit ratios.

Unfortunately, Vytorin has been under recent fire for reducing cholesterol numbers without a corresponding improvement in mortality /morbidity that has been seen with the Lipitor studies.

You should consult your doctor regarding your ED and muscle weakness. Ask whether you should stop the Vytorin for a short period, and possibly add CoQ-10. Check your CPK and blood chemistry and then consider resumption of an appropriate single lipid agent such as Lipitor with supplemental CoQ-10 after being off of Vytorin about two weeks. If desired, Vytorin may be reintroduced later or Zetia may be added to Lipitor if needed. Of course other choices can be made, but I believe you now have some food for thought.