Statins are generally considered as safe drugs with a very favorable 
cost-efficacy-ratio. Calculation of health expenses limits the prescription of 
statins in primary prevention to persons on high risk (i.e. 20% risk of a 
coronary infarction within the next 10 years). Prescription of statins in 
secondary prevention of atherosclerosis is mandatory. Advanced age, impairment 
of renal function or polypharmacotherapy increase the incidence of severe 
side-effects, especially myopathy and rhabdomyolysis. These patients should be 
given statins with lesser risk of these side-effects. Combination of statins 
with fibrates has attracted public concern, but may be indicated in persons with 
otherwise not treatable hyperlipidemia. These patients need intensive 
monitoring, just as patients on other drugs that are metabolized via the enzyme 
CYP3A4. Patients on statins should get dietary counseling, as an appropriate 
diet increases the effect of statins.