Statin myopathy pearls

1. Occurs in fifteen percent of those receiving statins

3.  Risk factors for include: 
      higher dose statin
      statin myopathy in a first degree relative
      older age
      female
      small build
      concurrent systemic disease (renal, hepatic, or diabetes)
      multiple medications including fibrates, nitrates and cyt P450 metabolized drugs
genetic polymorphisms may exist

4.  Time course of onset usually one month but may be delayed years

5.  Presentation:  weak, high CK, irritability on EMG

6.  Co Q depletion may play a role, but studies have not shown CoQ is helpful

7.  Immune mediated myopathies can follow withdrawal of statin.

8.  fibrates, nitrates and ezetimibe also can cause myopathy