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A table highlighting the key messages by NICE when dealing with statin-related adverse effects
Advice and Monitoring for Adverse Effects | Recommendations |
---|---|
Advise people on statins | • Potential interactions with other drugs/foods/supplements • Consult pharmacist/prescriber for advice • Restart statin if stopped due to interactions or intercurrent illnesses |
Before offering a statin | • Ask about muscle symptoms history • if associated or not with previous lipid-lowering therapy • if they have ➡️ measure creatine kinase levels |
Muscle symptoms and creatine kinase levels | • >5 times upper limit measure CK after 7 days if CK levels are still 5 times ULN ➡️ Do not start statin ❌ • Raised but <5 times: ✅Start at a lower dose |
Risk of muscle adverse effects | • Low risk of muscle pain, tenderness, weakness is small • Extremely low risk of severe effects ( rhabdomyolysis ) |
Unexplained muscle symptoms | • Advise seeking medical advice • Measure creatine kinase if this happens |
Muscle symptoms with normal creatine kinase | • Reassure unlikely due to statin, explore other causes • If they report muscle pain, tenderness or weakness and CK is < 5 times ULN -reassure that symptoms are unlikely due to statins |
Asymptomatic individuals on statins | • No... |
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