Feature Article

Managing myopathy in the statin-intolerant patient

Ian Hamilton-Craig



Patients on statin therapy may develop musculoskeletal side effects. Careful monitoring is required and alternative therapies may be needed in these patients.

Key Points

  • Musculoskeletal side effects are the most common adverse effects of statin therapy, usually occurring with higher doses and within the first few months of dose initiation or uptitration.
  • Risk factors for statin myopathy include increasing age, small muscle mass, hypothyroidism, low levels of vitamin D, concomitant therapy with cytochrome P4503A4 inhibitors and a history of muscle symptoms.
  • Statin myopathy may occur without elevated creatine kinase levels; no specific therapy is available other than dose reduction or withdrawal.