This paper was published in the Medical Journal of Australia 2001 Nov 5;175(9):486-9
Study title and author:
Statin-associated myopathy.
Study title and author:
Statin-associated myopathy.
Hamilton-Craig I.
North Adelaide Cardiac Clinic, SA. admin@medped-aust.com
This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/11758079
North Adelaide Cardiac Clinic, SA. admin@medped-aust.com
This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/11758079
Dr Hamilton-Craig notes that myopathy (muscle disease) can be caused by all statins.
In this review he finds:
(a) The risk of myopathy is increased by: the use of high doses of statins, concurrent use of fibrates, concurrent use of hepatic cytochrome P450 inhibitors, acute viral infections, major trauma, surgery, hypothyroidism and other conditions.
(b) Cytochrome P450 are enzymes that give protection against potential toxicity from the foods and drugs (including statins) that we ingest by breaking down and eliminating the toxic substance. These enzymes are found primarily within liver cells as well as many other cell types. Cytochrome P450 inhibitors inhibit the effectiveness of cytochrome P450 enzymes and thereby increase the levels of statins in the body which leads to increased toxicity and more side effects. Cytochrome P450 inhibitors include: Amiodarone; (Cordarone), Azole Antifungals; Fluconazole (Diflucan), Itraconazole (Sporanox), Ketoconazole (Nizoral), Posaconazole (Noxafil, Posanol), Voriconazole (Vfend), Calcium Channel Blockers; (Amlodipine, Diltiazem, Verapamil), Cyclosporine; (Neoral), Danazol; (Cyclomen), Dronedarone (Multaq), Fibric Acid Derivatives; (Fenofibrate, Gemfibrozil), Glyburide; Grapefruit/Grapefruit Juice; Macrolide Antibiotics; Clarithromycin (Biaxin), Erythromycin, Nefazodone; Phenytoin; (Dilantin), Protease Inhibitors; Atazanavir (Reyataz), Boceprevir (Victrelis), Darunavir (Prezista), Fosamprenavir (Lexiva, Telzir), Indinavir (Crixivan), Lopinavir/Ritonavir (Kaletra), Nelfinavir (Viracept), Ritonavir (Norvir), Saquinavir (Invirase), Telaprevir (Incivek), Tipranavir (Aptivus), Ranolazine (Ranexa), Telithromycin (Ketek),
Ticagrelor (Brilinta).
(c) Statin-associated myopathy should be suspected when a statin-treated patient complains of unexplained muscle pain, tenderness or weakness.
(d) Statin therapy should be stopped in cases of suspected myopathy.