Statin Induced Muscle Pain

Statins (HMG-CoA Reductase ACE Inhibitors) are used as a cholesterol-lowering medication in people with, or at risk of, cardiovascular disease.  A cholesterol-lowering diet should be tried before statin use.  If LDL cholesterol (bad cholesterol) is not reduced through diet and life-style approaches, a statin may be prescribed by your doctor.  In general, statins lower LDL cholesterol (bad cholesterol) and raise HDL cholesterol (good cholesterol).  Examples of statins include

  • rosuvastatin (Crestor),
  • lovastatin (Mevacor),
  • atorvastatin (Lipitor),
  • pravastatin (Pravachol), and
  • simvastatin (Zocor).

Vytorin combines simvastatin and ezetimibe.  Ezetimibe blocks the absorption of cholesterol in the intestines.

Statins reduce the risk of heart attack, reduce the risk of stroke and reduce the coronary death rate in people with cardiovascular disease and in people at risk of cardiovascular disease.  Like all medications prescribed, there are side effects.  This article will focus on myalgia (muscle pain) and myopathy (muscle weakness) which can occur with statin use.  Other side effects include peripheral neuropathy, lupus-like syndrome and liver function abnormalities.

The instance of myalgia (muscle pain) ranges from 5% to 10%.  Patients describe myalgias as either muscle pain or muscle cramps.  These symptoms either resolve on their own or resolve by temporarily lowering and/or stopping the dose.

A less common side effect associated with statin use is myopathy (muscle weakness).  Myopathy commonly involves skeletal muscle tissue, and patients may present with complaints of generalized muscle weakness of the upper arms and upper legs or muscle fatigue.  This is the most common presentation of myopathy. An even less common example of myopathy is rhabdomyolysis which occurs approximately .1% of the time.  Rhabdomyolysis is a condition in which massive muscle injury leads to kidney failure.

In summary, statins are medically significant because they reduce the risk of heart attack, reduce the risk of stroke and reduce the coronary death rate.  Myalgias, which are described as muscle pain or muscle cramps occur approximately 5-10% of the time.  Myopathy (muscle weakness), which includes rhabdomyolysis, occurs much less often as do other side effects, including lupus-like syndrome and peripheral neuropathy.

Consult with your doctor if you develop muscle pain, muscle cramps or muscle weakness after beginning a statin.

Jose Veliz MD is the medical director of Palomar Spine & Pain, in Escondido, CA (North San Diego County).

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