Even though all statins are similar chemically, they have some minor differences that could impact how likely they are to cause muscle pain. Simvastatin is the most likely to cause muscle pain, and fluvastatin is the least likely.
While pravastatin and fluvastatin may be associated with the lowest incidence of myalgia, the LDL-lowering effect is low compared to other statins.
Exercise. There is some evidence that people who have exercised regularly before taking statins are less likely to experience muscle pain and cramping. Although gentle stretching may relieve muscle cramps, beginning a new vigorous exercise regimen while taking a statin may increase the risk of muscle pain.
Our study found that muscle pain is highly associated with statin use with a prevalence of 73.5%, which causes many patients to tend to stop taking their medication.
Is muscle pain a side effect of all statins? Even though all statins are similar chemically, they have some minor differences that could impact how likely they are to cause muscle pain. Simvastatin is the most likely to cause muscle pain, and fluvastatin is the least likely.
Rhabdomyolysis or milder forms of muscle inflammation from statins can be diagnosed with a blood test measuring levels of the enzyme creatinine kinase. If you notice moderate or severe muscle aches after starting to take a statin, contact your doctor.
One of the most common complaints of people taking statins is muscle pain. You may feel this pain as a soreness, tiredness or weakness in your muscles. The pain can be a mild discomfort, or it can be serious enough to make it hard to do your daily activities.
This is when you stop the drug for 3 to 4 weeks. Your muscle pain should go away by then if it's related to your statin. Another way to do this is to take the statin every other day. This may help continue to lower bad cholesterol without the achy muscles.
If you've made lifestyle changes through diet and exercise that have lowered your cholesterol levels, you may not need to continue taking a statin. These changes can help reduce your risk of heart attack, stroke, or blocked arteries while allowing you to take one less medication.
People who are unwilling or unable to take statins have limited options for other cholesterol-lowering medications. One possible choice is bempedoic acid, which was approved by the U.S. Food and Drug Administration (FDA) in 2020.
A low-dose statin like atorvastatin (Lipitor®) is safe for most patients, including those with mild liver enzyme abnormalities.
Atorvastatin or fluvastatin are usually recommended because there is no need to adjust the dose according to the glomerular filtration rate [28]. In patients without diagnosed atherosclerotic cardiovascular disease, it is indicated a moderate dose of statin, such as atorvastatin 20 mg daily [28].
We showed that fluvastatin 20 mg/ezetimibe 10 mg was the most efficacious treatment regarding both renal outcomes.
Ezetimibe. Ezetimibe is a tablet that lowers cholesterol. It may be prescribed if statins cannot be taken, or alongside a statin for extra cholesterol-lowering. It's a 'cholesterol absorption inhibitor' that limits the absorption of cholesterol in the small intestine.
Skeletal muscle side effects that are associated with statin use involve muscle cramping, soreness, fatigue, weakness, and, in rare cases, rapid muscle breakdown that can lead to death (ie, rhabdomyolysis).
Within a month of starting statin therapy, they may feel aches or weakness in the large muscles of their arms, shoulders, thighs or buttocks on both sides of the body. About 5 to 10% of people who try statins are affected. It's more common in the elderly, in women and in those taking the more potent statins.
The cholesterol-lowering action of alternate-day statins is as effective as daily dosing in many individuals. Alternate-day statin administration seems to decrease the incidence of its adverse effects, particularly myopathy.
If your risk is very low, you probably won't need a statin, unless your LDL is above 190 mg/dL (4.92 mmol/L). If your risk is very high — for example, you've had a heart attack in the past — a statin may be helpful even if you don't have high cholesterol.
The highest incidence of myopathy in our study was observed with simvastatin 40 mg (50%). This finding is consistent with the PRIMO study [9], in which the highest risk of muscular symptoms was observed with simvastatin therapy, though, again, at a lower rate (18%) than ours.
Unregulated calcium leaks may cause damage to muscle cells, potentially leading to muscle pain and weakness.
Statins can rarely cause muscle inflammation (swelling) and damage. Speak to your doctor if you have muscle pain, tenderness or weakness that cannot be explained – for example, pain that is not caused by physical work.
By Lauran Neergaard • Published March 6, 2023
shows the cholesterol-lowering drug Nexletol made by Esperion Therapeutics Inc. Drugs known as statins are the first-choice treatment for high cholesterol but millions of people who can't or won't take those pills because of side effects may have another option.