Cholesterol Synthesis

Statins HMG-CoA reductase inhibitors

• 
  
  Facts:
  
  
  
  
  Lower cholesterol by inhibiting the enzyme HMG-CoA reductase (rate-limiting enzyme of the mevalonate pathway of cholesterol synthesis)
  
  Inhibition of this enzyme in the liver results in decreased cholesterol synthesis and increased synthesis of LDL receptors, resulting in an increased clearance of LDL
• 
  
  Side Effects:
  
  
  
  
  Myalgias, muscle cramps
  Rhabdomyolysis
• 
  
  Notes:
  
  
  
  
  Mevalonate is also used for the production of dolichol and CoQ10
  Reduced CoQ10 is implicated in the pathogenesis of statin-induced myopathy