Managing Statin Myopathy

Integrated guidance on the care of familial hypercholesterolaemia from the International FH Foundation

“…Plasma CK should be assessed if musculoskeletal symptoms are reported. Statin myopathy should be managed according to adult guidelines [129][130][131]. Adolescent girls should be counselled to stop statins when contemplating or at risk of pregnancy [8,138,140].…”

“…Plasma hepatic aminotransferases should be measured prior to initiating a statin [127]. [130,131]. The combination of gemfibrozil with a statin should be particularly avoided [129][130][131], the risk of myopathy being significantly lower with fenofibrate [132,133].…”

“…The combination of gemfibrozil with a statin should be particularly avoided [129][130][131], the risk of myopathy being significantly lower with fenofibrate [132,133]. Statin myopathy should be managed according to expert recommendations [59,130,131,134]. Ezetimibe is well tolerated and has a statin dose-sparing effect [116,117].…”

Molecular mechanisms of toxicity of simvastatin, widely used cholesterol-lowering drug. A review

“…The incidence of myotoxic reactions in patients treated with statins ranges from 1% to 5%-7% [8,16,17]. Venero and Thompson [18] reported approximately 10% of patients treated with statins experienced some form of musclerelated side effects in clinical practice. The US Food and Drug Administration has registered 601 cases of statinassociated rhabdomyolysis in the 29-month time frame examined [19] and 3339 cases within the 12-years period [17].…”

Neuronal cholesterol esterification by ACAT1 in Alzheimer's disease

“…The uses of statins have reduced the incidence of atherosclerotic cardiovascular disease worldwide. When used at an appropriate dosage, statins are safe drugs; however, 10% of statin users experience myopathy (muscle weakness) (66). The cause is unknown, but it may be related to the fact that mevalonate is also an obligatory intermediate in the production of a variety of nonsterol metabolites.…”