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Statin side effects: Weigh the benefits and risks

How to relieve statin side effects

To relieve statin side effects, your doctor may recommend several options. Discuss these steps with your doctor before trying them:

  • Take a brief break from statin therapy. Sometimes, it's hard to tell whether the muscle aches or other problems you're having are statin side effects or just part of the aging process. Taking a break of 10 to 14 days can give you some time to compare how you feel when you are and aren't taking a statin. This can help you determine whether your aches and pains are due to statins instead of something else.
  • Switch to another statin drug. It's possible, although unlikely, that one particular statin may cause side effects for you while another statin won't. It's thought that simvastatin (Zocor) may be more likely to cause muscle pain as a side effect than other statins when it's taken at high doses.
  • Change your dose. Lowering your dose may reduce some of your side effects, but it may also reduce some of the cholesterol-lowering benefits your medication has. It's also possible your doctor will suggest switching your medication to another statin that's equally effective, but can be taken in a lower dose.
  • Take it easy when exercising. It's possible exercise could make your muscle aches worse. Talk to your doctor about changing your exercise routine.
  • Consider other cholesterol-lowering medications. Ezetimibe (Zetia), a cholesterol absorption inhibitor medication, may be less likely to cause muscle pain than may statins, or may reduce muscle pain when taken with a statin. However, some researchers question the effectiveness of ezetimibe compared with statins in terms of its ability to lower your cholesterol.
  • Don't try over-the-counter (OTC) pain relievers. Muscle aches from statins can't be relieved with acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) the way other muscles aches can. Don't try an OTC pain reliever without asking your doctor first.
  • Try coenzyme Q10 supplements. Coenzyme Q10 supplements may help to prevent statin side effects in some people. If you'd like to try adding coenzyme Q10 to your treatment, talk to your doctor first to make sure the supplement won't interact with any of your other medications.

Watch for drug interactions

Statins can have several potentially dangerous interactions with other medications and some foods. These interactions can make it more likely you'll have statin side effects. These include:

  • All statins and grapefruit or grapefruit juice. Grapefruit juice contains a chemical that makes statins more potent. This can be dangerous because it's uncertain what the effect would be on your total cholesterol. You should still be able to have some grapefruit or grapefruit juice, but talk to your doctor about limiting how much grapefruit you can have.
  • Simvastatin (Zocor) and amiodarone (Cordarone). People taking the statin simvastatin, either alone (Zocor) or in combination with ezetimibe (Vytorin) and amiodarone (Cordarone), a medication for irregular heart rhythms, are at a greater risk of severe statin side effects, such as rhabdomyolysis and kidney failure.
  • All statins and gemfibrozil (Lopid). People who take both gemfibrozil (Lopid) and a statin may be at a greater risk of statin side effects.
  • All statins and some antibiotic and antifungal medications. If you have a fungal or bacterial infection, be sure to tell your doctor if you take a statin.
  • All statins and some antidepressant medications. It's possible that taking antidepressants, such as nefazodone (Serzone), and a statin could make you more likely to have muscle aches.
  • All statins and some immunosuppressant medications. If you take a medication to suppress your immune system, such as cyclosporine (Sandimmune), and a statin you may be more likely to have muscle aches.

Weigh the risks and benefits

Although statin side effects can be annoying, consider the benefits of taking a statin before you decide to stop taking your medication. Remember that statin medications can reduce your risk of a heart attack or stroke, and the risk of life-threatening side effects from statins is very low.

Even if your side effects are frustrating, don't stop taking your statin medication for any period of time without talking to your doctor first. Your doctor may be able to come up with an alternative treatment plan that can help you lower your cholesterol without uncomfortable side effects.

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References
  1. Rosenson RS. Muscle injury associated with lipid lowering drugs. http://www.uptodate.com/home/index.html. Accessed July 28, 2010.
  2. Sewright KA, et al. Statin myopathy: Incidence, risk factors and pathophysiology. Current Atherosclerosis Reports. 2007;9:389.
  3. Joy TR, et al. Narrative review: Statin-related myopathy. Annals of Internal Medicine. 2009;150:858.
  4. Backes JM, et al. Does simvastatin cause more myotoxicity compared with other statins? The Annals of Pharmacotherapy. 2009;43:2012.
  5. The SEARCH Collaborative Group. SLCO1B1 variants and statin-induced myopathy — A genomewide study. New England Journal of Medicine. 2008;359:789.
  6. Voora D, et al. The SLCO1B1*5 genetic variant is associated with statin-induced side effects. Journal of the American College of Cardiology. 2009;54:1609.
  7. Information on simvastatin and amiodarone. U.S. Food and Drug Administration. http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm118869.htm. Accessed July 28, 2010.
  8. Schaars CF, et al. Effects of ubiquinone (coenzyme Q10) on myopathy in statin users. Current Opinion Lipidology. 2008;19:553.
  9. Marcoff L, et al. The role of coenzyme Q10 in statin-associated myopathy: A systematic review. Journal of the American College of Cardiology. 2007;49:2231.
MY00205 Oct. 28, 2010

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