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Narrative Review: Statin-Related Myopathy
Annals of Internal Medicine, 06/16/09

Joy TR et al. - Statin-related myopathy comprises myalgias, myositis, and rhabdomyolysis. Myalgias can affect up to 10% of persons prescribed statins, whereas rhabdomyolysis is rare. The mechanisms responsible for statin-related myopathy are unclear but may include decreased levels of coenzyme Q10, decreased bioavailability of isoprenoids, or mitochondrial dysfunction. Risk factors for myopathy include history of myopathy while receiving another lipid-lowering agent, family history of statin-related myopathy, high-dose statin therapy, increased age, female sex, and use of medications metabolized through cytochrome P450 3A4. Assessment of statin-related myopathy includes a search for other causes of creatine kinase elevation and myopathy. Management of statin-related myopathy can include switching agents or use of fluvastatin, low-dose rosuvastatin, nondaily dosing, and ezetimibe or bile acid–binding resins.

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