Statin myopathy

One of the most feared side effects of statins is muscle tissue damage. The pathophysiological mechanism of this damage is not entirely clear, and it is thought to be: Muscle damage can be classified into 3 groups: The risk of statin myopathy increases when statins are combined with drugs that increase the plasma concentration of statins. These are drugs that, like statins, are metabolized by cytochrome P450 complexes (simvastatin, atorvastatin, lovastatin, rosuvastatin - cytochrome cyp3A4; fluvastatin - cyp2C9, pravastatin is not metabolized by cytochromes).
 * sarcolemma instability resulting from a decrease in cholesterol (cholesterol is an important building block of sarcolemia);
 * mitochondrial damage;
 * direct myotoxicity.
 * 1) myalgia - muscle weakness, stiffness, pain, or cramping at rest or on exertion; creatine kinase (CK) elevation does not occur;
 * 2) myositis - CK elevation with/without muscle symptoms;
 * 3) rhabdomyolysis - muscle symptoms with CK elevation above 10 times the upper limit of normal.

When statin myopathy is suspected, the patient should be screened for thyroid function (hypothyroidism) and alcohol abstinence, laboratory determination of CK level and statin discontinuation for 6 weeks (at a minimum).

Related articles

 * Myopathy
 * Statins

Used literature

 * 1) BEDNAŘÍK, Josef. Toxické a lékové myopatie. Neurológia pre praxi [online]. 2004, roč. -, vol. 3, s. 147, dostupné také z < http://www.solen.sk/index.php?page=pdf_view&pdf_id=901&magazine_id=3 >. ISSN 1335-9592.
 * 2) ↑ Skočit nahoru k:a b ŠTEFAN, Alušík. Nežádoucí účinky statinů – staří známí i noví hříšníci. Medical Tribune. 2011, roč. -, vol. 21, s. -, ISSN 1214-8911.
 * 3) ↑ GOLÁŇ, Lubor. Chyby a úskalí terapie statiny. Interní medicína pro praktické lékaře [online]. 2004, roč. -, vol. 1, s. 31-32, dostupné také z < http://www.medicinapropraxi.cz/pdfs/med/2004/01/08.pdf >.
 * 4) ↑ DOC. MUDR. VLADIMÍR SOŠKA, CSC,. Statiny a jejich lékové interakce [online]. ©2013. [cit. 2015-07-03]. < https://www.tribune.cz/clanek/29871-statiny-a-jejich-lekove-interakce >.