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2015 ; 17
(12
): 69
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Statin Intolerance: the Clinician s Perspective
#MMPMID26490078
Stulc T
; Ce?ka R
; Gotto AM Jr
Curr Atheroscler Rep
2015[Dec]; 17
(12
): 69
PMID26490078
show ga
Muscle problems and other adverse symptoms associated with statin use are
frequent reasons for non-adherence and discontinuation of statin therapy, which
results in inadequate control of hyperlipidemia and increased cardiovascular
risk. However, most patients who experience adverse symptoms during statin use
are able to tolerate at least some degree of statin therapy. Given the profound
cardiovascular benefits derived from statins, an adequate practical approach to
statin intolerance is, therefore, of great clinical importance. Statin
intolerance can be defined as the occurrence of myalgia or other adverse symptoms
that are attributed to statin therapy and that lead to its discontinuation. In
reality, these symptoms are actually unrelated to statin use in many patients,
especially in those with atypical presentations following long periods of
treatment. Thus, the first step in approaching patients with adverse symptoms
during the course of statin therapy is identification of those patients for whom
true statin intolerance is unlikely, since most of these patients would probably
be capable of tolerating adequate statin therapy. In patients with statin
intolerance, an altered dosing regimen of very low doses of statins should be
attempted and, if tolerated, should gradually be increased to achieve the highest
tolerable doses. In addition, other lipid-lowering drugs may be needed, either in
combination with statins, or alone, if statins are not tolerated at all.
Stringent control of other risk factors can aid in reducing cardiovascular risk
if attaining lipid treatment goals proves difficult.
|Cardiovascular Diseases/*drug therapy
[MESH]
|Drug Tolerance
[MESH]
|Humans
[MESH]
|Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage/adverse
effects/*therapeutic use
[MESH]
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