title: Non-traditional dosing of statins in statin-intolerant patients-is it worth a try?
abstract: In this manuscript, three manifestations of statin intolerance will be covered. The first, myopathy, is mostly subjective with variable complaints of myalgias often worsened by exercise, muscle cramping or weakness, and at times associated with a biomarker, elevations in creatine kinase (CK). A rare but serious manifestation can be rhabdomyolysis. The second, liver toxicity, is associated with reversible biochemical increases in transaminases and rarely other liver function tests. Finally, statin-related central nervous system (CNS) toxicity typically defined as cognitive impairment is quite rare and appears to be idiosyncratic. Statin dose alternatives will then be discussed and highlighted in the setting of the new cholesterol-lowering guidelines. Non-statin lipid-altering therapies as well as other alternative therapies will also be reviewed.
authors.affiliation: Division of Endocrinology, Metabolism and Diabetes, University of Colorado School of Medicine, Mail Stop C26, 12348 E Montview Blvd, Aurora, CO, 80045, USA, marc.cornier@ucdenver.edu.
authors.forename: Marc-Andre
authors.initials: MA
authors.lastname: Cornier
authors.forename: Robert H
authors.initials: RH
authors.lastname: Eckel
mesh_terms: D000924:Anticholesteremic Agents / Q000627:therapeutic use; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis / Q000209:etiology; D003072:Cognition Disorders / Q000139:chemically induced / Q000175:diagnosis; D004305:Dose-Response Relationship, Drug; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D009135:Muscular Diseases / Q000139:chemically induced / Q000175:diagnosis; D017410:Practice Guidelines as Topic
chemical_list: D000924:Anticholesteremic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors