A review of muscle-related adverse effects of statins

Abstract

3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase inhibitors or statins are lipid lowering agents and effective for reducing low density lipoprotein cholesterol (LDL-C) and thereby reducing cardiovascular events. Statin intolerance is associated with various side effects including statin-associated muscle symptoms (SAMS), diabetes mellitus (DM), hepatotoxicity, renal toxicity, neurological and neurocognitive effect. Statins can cause very serious muscle condition called rhabdomyolysis but this is rare. SAMS are most common adverse effects of statins and also the major reason for discontinuation of statin therapy. Pain and weakness in SAMS are generally affected on large muscle groups including thighs, buttocks, calves and back muscles. The diagnosis of SAMS is difficult because there are no validated clinical tests and diagnostic criteria. Management of SAMS requires possible diagnosis, discontinuation of statins or rechallenge, alternative lipid lowering therapy and alternative dosing strategies.