Case studies

A patient with heart disease having myalgia with statin therapy: a challenging case history

Leon A Simons



How should a patient with generalised myalgia secondary to high-dose statin therapy be managed?

Key Points

  • Statin drugs, in addition to other medications, form an essential part of therapy after a patient has had a myocardial infarction.
  • Statins occasionally induce myalgia of varying severity in the short or longer term. Changes in the concentration of the muscle enzyme creatine kinase may not be diagnostic.
  • Provided that other causes of myalgia have been excluded, patients may be tried on other statin drugs.
  • One approach in such cases is for patients to take a very small dose of rosuvastatin, initially 2.5 or 5 mg on two days per week, which may avoid the return of myalgia yet still offer potential benefit.
  • Unfortunately, some patients may experience a return of muscle symptoms with other statins and future lipid therapy may be very challenging.