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Cholesterol lowering drugs may induce myopathy
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Statin drugs such as Lipitor, Zocor, Prevachol and Mevacor, when used appropriately, may reduce the relative risk of cardiovascular disease by about 25% and are thus some of the most widely used drugs in the world.
An often neglected side-effect of statin drugs, however, is their ability to induce a condition called rhabdomyolysis, or myopathy. This condition happens to a small number of patients and can be potentially life-threatening.
One difficulty in addressing this potential side-effect is that there is no accepted definition of statin myopathy and definitions that are published are not consistent. Rates in controlled trials appear to be low, but inconsistent definitions and exclusions of potentially affected patients make these studies difficult to compare. A number of observational studies suggest an increased incidence between 5% and 10%.
Clinical features of myopathy include pain, weakness, heaviness, stiffness or cramping. The proposed interval between the onset of statin prescription and the onset of symptoms is said to be an average of 6.3 months and it generally takes 2-3 months after withdrawal of the drug for the symptoms to diminish.
Recommendations for managing potential myopathy side-effects include dose reduction, alternate day dosing of a long-acting statin, using an alternative statin, or possibly the use of coenzyme Q supplements.
Coenzyme Q can be depleted with the use of statin medications and patients taking statin medications should be on a regime of coenzyme Q to begin with. A suggested dose of coenzyme Q is 300 mg/day according to one recent study, although more research is needed to standardize a repletion dose corresponding to a statin regimen.
Of course, anyone on a statin should already be following a heart healthy diet, which helps the medication do its job at the lowest possible dosage.
More about: coenzyme Q and heart health
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