LDL-C and TC lowering was significantly greater in the evening dose than in the morning dose in case of short-acting statins .
Besides slight but significant effect on LDL-C , the efficacy of long-acting statins was equivalent for both regimens .
BACKGROUND Evidence about the optimal time of day at which to administer statins is lacking .
OBJECTIVE The objective of this study is to synthesize evidence about effects of morning vs evening statin administration on lipid profile .
CHRONOKINETICS OF PRAVASTATIN ADMINISTERED IN THE PM COMPARED WITH AM DOSING
Pravastatin , an HMG CoA reductase inhibitor used in the treatment of hypercholesterolemia , is recommended for bedtime ( PM ) dosing . Bedtime dosing with pravastatin is slightly more efficacious but not significantly different than morning ( AM ) dosing in lowering LDL-C and total cholesterol . The pharmacokinetics of pravastatin and its major metabolite SQ 31,906 were determined in 20 healthy men administered a single 20-mg dose either in the morning or at bedtime in an open , r and omized , crossover study . Concentrations of pravastatin and SQ 31,906  were measured in serum and urine by gas chromatograph/mass spectrometry methodology . The area under the serum concentration time curve ( AUC ) of pravastatin  was significantly less ( 40 % ) following PM dosing compared with AM dosing . Urinary excretion of pravastatin  following PM dosing was also significantly decreased . Bioavailability of SQ 31,906 was somewhat higher in the PM group ( 20 % greater following PM administration ) , and urinary excretion of SQ 31,906 was significantly increased by 60 % following PM dosing . The lower AUC of pravastatin  following PM dosing does not diminish its efficacy , possibly because PM dosing immediately precedes the diurnal peak period of hepatic cholesterol synthesis . Lower blood levels of pravastatin  following PM dosing may contribute to its favorable safety profile
LDL-C and TC lowering was significantly greater in the evening dose than in the morning dose in case of short-acting statins .
Besides slight but significant effect on LDL-C , the efficacy of long-acting statins was equivalent for both regimens .
BACKGROUND Evidence about the optimal time of day at which to administer statins is lacking .
OBJECTIVE The objective of this study is to synthesize evidence about effects of morning vs evening statin administration on lipid profile .