From the Guidelines
If you're experiencing muscle aches that might be related to statin medication, you should not stop taking it on your own for two weeks without consulting your healthcare provider first. Instead, contact your doctor promptly to discuss your symptoms. Statins (like atorvastatin, simvastatin, or rosuvastatin) can cause muscle pain in some people, but abruptly stopping them can potentially lead to cardiovascular risks 1. Your doctor may recommend temporarily stopping the medication under supervision, reducing the dose, trying a different statin, or changing your dosing schedule. They might also want to check your creatine kinase levels through a blood test to assess muscle damage. The muscle aches could be related to the statin's effect on muscle cell metabolism or could have other causes entirely. While confirming if the statin is causing your symptoms is important, this should be done with medical guidance to ensure your overall health is protected. Some key points to consider when evaluating statin-associated muscle symptoms include:
- The symptoms are more likely to be statin-associated if they are bilateral, involve proximal muscles, and have their onset within weeks to months after initiation of statins 1.
- A thorough assessment of symptoms is recommended, in addition to evaluation for non-statin etiologies, assessment of predisposing factors, and a physical exam 1.
- The approach to statin-associated side effects should include discontinuation of statin therapy until resolution of symptoms and subsequent rechallenge to verify recurrence of muscle-related symptoms 1. It's also important to note that true complete statin intolerance is uncommon, and a careful history can help determine whether symptoms are consistent with statin-related effects 1. In patients with possible statin-associated side effects, avoiding complete discontinuation of statin treatment is strongly recommended, and clinicians should strive to find the highest tolerated statin dose that is as close to the guideline recommendation as possible 1.
From the Research
Statin-Associated Muscle Symptoms
- Statin-associated muscle symptoms (SAMS) are a common side effect of statin therapy, reported by 5-25% of patients 2, 3.
- The etiology of SAMS is heterogeneous and may be related to pharmacological and nonpharmacological effects of statins 2, 3.
- SAMS can seriously impair quality of life and cause complications, including rhabdomyolysis in rare cases 2.
Management of Statin-Associated Muscle Symptoms
- If a patient experiences muscle aches while taking statins, it is recommended to assess the symptoms and rule out other potential causes before attributing them to statin use 4, 3.
- In some cases, switching to a different statin or reducing the dose may be beneficial 5, 2, 3.
- Providers may recommend stopping the statin, continuing with monitoring, or reducing the dose 6.
- Patient-centered approaches, including lifestyle interventions and communication strategies, can help mitigate SAMS and improve medication adherence 3.
Temporary Discontinuation of Statins
- There is no clear evidence to support temporarily discontinuing statins for 2 weeks to verify whether the muscle aches are caused by the statin 5, 2, 6, 4, 3.
- However, if a patient is experiencing muscle symptoms, it is essential to discuss the potential benefits and risks of continuing or discontinuing statin therapy with their healthcare provider 5, 2, 4, 3.