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

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.