title: Statin-induced myopathy: a review and update.
abstract: BACKGROUND
  Statin-induced myopathy is an important cause of statin intolerance and the most common cause of statin discontinuation. Observational studies estimate that 10 - 15% of statin users develop statin-related muscle side effects ranging from mild myalgia to more severe muscle symptoms with significant CPK elevations.
  
  
  METHODS
  This article reviews the epidemiology, clinical features, risk factors and mechanisms of statin-induced myopathy and provides an evidence-based algorithm for managing patients with statin myopathy.
  
  
  CONCLUSIONS
  There are multiple risk factors for statin-induced myopathy that are both patient-related (age, genetics, co-morbidities) and drug-related (statin metabolism via the CYP system, drug-drug interactions and statin drug transport). Management options for statin-intolerant patients include statin switching, especially to low-dose, non-daily doses of long-acting statins, such as rosuvastatin and atorvastatin, and other non-statin lipid-lowering agents, such as ezetimibe and colesevelam, and possibly red yeast rice. In conclusion, statin-induced myopathy is a significant clinical problem that contributes considerably to statin therapy discontinuation. However, there exist multiple and effective management options for statin intolerant patients.
authors.affiliation: Emory University School of Medicine, Department of Medicine, J. Willis Hurst Internal Medicine Residency Program, 69 Jesse Hill Jr Drive SE, Atlanta, GA 30303, USA.
authors.forename: Thura T
authors.initials: TT
authors.lastname: Abd
authors.forename: Terry A
authors.initials: TA
authors.lastname: Jacobson
mesh_terms: D000818:Animals; D004347:Drug Interactions; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D009132:Muscles / Q000187:drug effects; D009135:Muscular Diseases / Q000139:chemically induced*; D012307:Risk Factors
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors