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Statin Side Effects: From Muscle Soreness to Rhabdomyolysis

Statins are drugs used to lower cholesterol. They are effective agents for treating high cholesterol, enabling your liver to remove cholesterol from your blood, which lowers your total cholesterol. Lowering LDL (low-density lipoprotein, or “bad”) cholesterol results in substantial reductions in cardiac events. Statins also help prevent other cardiovascular diseases, such as chest pain, heart attacks, strokes, and certain blood vessel problems (Pharmacy Times “Statins Provide Heart Benefits Besides Cholesterol Lowering” June 1 2017).


Statins approved for use in the United States include the following agents: atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor), simvastatin (Zocor), and pitavastatin (Livalo).

One of the most common unwanted symptoms from taking statins is muscle pain, muscle soreness, muscle fatigue, and muscle weakness. People who take statins shouldn’t drink large quantities of grapefruit juice, as this is associated with the muscle pain side effects. Statins may affect specific enzymes present in muscle cells that are responsible for muscle growth. The muscle pain is located in skeletal muscle, and the side effects range from slight myalgia to severe rhabdomyolysis.


Rhabdomyolysis: Rapid Breakdown of Skeletal Muscle

Rhabdomyolysis is a serious condition in which the destruction of striated muscle tissue, or skeletal muscle, releases muscle enzymes such as myoglobin and electrolytes from inside the muscle cells. If you have too much myoglobin in your bloodstream it can cause kidney damage. If treated early, rhabdomyolysis may be stopped.   This condition is treated with fluids given in an IV drip. Some people may require dialysis or hemofiltration (therapy filtering bad waste and products from blood) to address the more severe cases.

Early symptoms of rhabdomyolysis may be vague as they are not specific and may mimic other conditions. The symptoms of rhabdomyolysis include:


  • Muscle weakness
  • Fatigue
  • Low urine output
  • Bruising/soreness
  • Dark or tea-colored urine
  • Infrequent urination
  • Fever
  • Malaise (discomfort)
  • Nausea/vomiting
  • Confusion
  • Agitation

Although only a minimal number of people get rhabdomyolysis, many people take these medications and it is important to be aware of the risks.


Importance of Determining Muscle and Kidney Health

There are several tests to check muscle and kidney health. Creatine kinase levels should be tested, as it is an enzyme found in the skeletal muscles, the brain, and the heart. Myoglobin levels in the blood and urine should also be tested, as myoglobin is a protein that is a byproduct of muscle breakdown. Potassium is an important mineral that may leak from injured muscles and should be tested as well. Lastly, creatine in blood and urine should be tested, as creatine is a breakdown product created by muscle that is normally removed from the body by the kidneys.

Rhabdomyolysis can be successfully treated without long-term damage to the kidneys if it is treated early. Fluid recovery is essential and is the first and most important treatment.


Statin Muscle Side Effects and Pharmacogenetics

Although few patients experience muscle pain and the associated serious side effects, it has been suggested that the basis for this reaction is genetic. Once the human genome was sequenced and completed, the field of pharmacogenetics could advance its knowledge base. Pharmacogenetics is an important medical field that studies the genes that are responsible for drug metabolism and related events. Advances in the wider field of pharmacogenomics showed that in a genome wide study, muscle myopathy was associated with single nucleotide polymorphisms (SNPs) in the gene SLCO1B1. Those authors identified common genetic variants in SLCO1B1 that are strongly associated with statin-induced myopathy.


Know Your Risks with the Rxight® Pharmacogenetic Test

Genotyping using the Rxight® pharmacogenetics test from MD Labs may help patients receive the benefits of statin therapy without the muscle-associated side effects. Pharmacogenetics testing with the Rxight® platform from MD Labs is an advanced, state-of-the-art method to test many gene variations in your individual genome that may be responsible for adverse effects with statins and over 200 other drugs on the market. This precision medicine approach to personalized care is now available by prescription.

Ask your physician to prescribe the Rxight® pharmacogenetics test from MD Labs. You and your physician may use these results over the lifetime of your care, as many genes are tested for variations that are responsible for adverse side effects not only in statins, but also in the majority of drugs on the market.

These results inform your physician about what drugs you may safely take, and what drugs are not recommended for you, in addition to giving dosing schedules that might be different from label instructions. Participating in this precision medicine advance may lead to lessened side effects over the course of your lifetime pharmaceutical treatments.



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