“…After 2 to 3 months of chronic treatment of rats with simvastatin, the voltage threshold for contraction (mechanical threshold, MT), a calcium-sensitive index of excitation-contraction coupling, was shifted toward more negative potentials in fast-twitch muscle fibers (Pierno et al, 1999), an effect that is compatible with an increase of resting cytosolic calcium concentration ([Ca 2ϩ ] i ). Moreover, in vitro studies showed a statin-induced elevation of [Ca 2ϩ ] i and suggested a possible interference of the drug with intracellular Ca 2ϩ stores (Nakahara et al, 1994;Inoue et al, 2003;Sirvent et al, 2005), which in turn might be responsible of cell damages via activation of Ca 2ϩ -dependent proteolytic enzymes (Sacher et al, 2005). It is noteworthy that all statin-induced effects on skeletal muscle are strictly dependent on their lipophilicity, showing highly hydrophilic pravastatin, and no muscle toxicity, even at high doses (Nakahara et al, 1994;Pierno et al, 1995Pierno et al, , 1999.…”