When I take statins, my arm muscles hurt. Could it be that my muscles have dissolved?

A friend told Huazi that he had found plaques in his carotid artery, and the doctor asked him to take statins for prevention. But after taking it for a while, he felt pain in the muscles of his arms. He had seen that statins can cause rhabdomyolysis, so he was very scared and stopped taking the drugs. He asked Huazi what to do?

Huazi told him that there was no need to worry too much. Although statins may cause adverse reactions such as rhabdomyolysis, the actual incidence rate was very low. As long as creatine kinase (CK) was monitored well and it was not exceeded, there was no need to worry.

1. Statins can cause muscle damage. Statins are commonly used lipid-regulating drugs that not only inhibit the formation of cholesterol, but also reverse the effect on atherosclerotic plaques, increasing the density of plaques, reducing their volume, increasing the stability of plaques, and preventing plaques from rupturing and inducing thrombosis.

However, muscle damage may occur when taking statins. The specific factors causing the damage are still unclear. It may be that the protein metabolism in muscle cells is affected, or it may be that the synthesis of coenzyme Q10 is affected, which ultimately leads to muscle cells not being able to work normally, causing pain and fatigue.

2. What is rhabdomyolysis? The muscle cells of the human body are divided into three types, namely cardiac muscle, skeletal muscle, and smooth muscle. The cardiac muscle and skeletal muscle have striations on them, so they are called striated muscles. When striated muscle cells are damaged, the cell membrane cannot maintain its integrity, resulting in the leakage of myoglobin, creatine kinase, potassium ions and other substances in the striated muscle cells.

Myoglobin is a large molecule protein. If a large amount of myoglobin is released, it will reach the kidneys with the blood, block the kidney sieve structure, and cause acute renal failure, which is life-threatening. At this time, symptoms such as severe muscle pain, severe fatigue, and soy sauce-colored urine will appear.

3. The incidence of myopathy caused by statins is not high. Statins can cause muscle damage and may cause rhabdomyolysis, but the incidence is not high. In clinical trials, the incidence of muscle damage caused by statins is between 1.5% and 5%; the risk of inducing rhabdomyolysis is between 0.04% and 0.2%. For every 1 million statin prescriptions issued, the risk of death is 0.15.

So overall, the probability of statins causing rhabdomyolysis is not high, and it is even rarer to cause life-threatening consequences. Moreover, it often occurs in patients with multiple diseases who need to be treated with multiple drugs. Statins are irreplaceable in preventing myocardial vascular diseases. When used, the benefits far outweigh the risks, and it is not recommended to stop using them at will.

4. How to reduce muscle damage caused by statins 1. Avoid high-dose use: Muscle damage caused by statins is related to the dosage of the drug. It is not recommended to use high-dose statins for treatment.

2. Pay attention to age and gender differences: Muscle damage caused by statins is more likely to occur in elderly patients, especially those over 80 years old; it is more likely to occur in women than in men; and it is more likely to occur in thin and short people.

3. Pay attention to disease factors: People with chronic renal insufficiency, hypothyroidism, infection, trauma, surgery, and heavy physical labor are prone to muscle damage. People with the above diseases should use statins with caution under the guidance of a doctor.

4. Pay attention to genetic factors: Cytochrome P450 isoenzymes or drug transporter encoding genes are polymorphic, which will affect the adverse reactions of statins. Those with a family history of myalgia caused by taking statins should use them with caution.

5. Pay attention to the influence of other drugs: The use of macrolide antibiotics, antifungal drugs, cyclosporine, verapamil, amiodarone, protease inhibitors, large amounts of grapefruit juice, etc. may affect statins (simvastatin, lovastatin, atorvastatin, etc.) metabolized by CYP3A4 enzymes, increasing the probability of adverse reactions. Therefore, try to avoid the combination with the above drugs.

6. Pay attention to creatine kinase (CK) monitoring: When statins cause muscle damage, the CK value will increase significantly. When the CK value does not exceed 5 times the normal upper limit (1000U/L), the drug can be used normally, and if it exceeds, it needs to be discontinued.

7. Switch to another statin: After myalgia symptoms occur while using a certain statin, you can switch to another statin to continue treatment after stopping the medication and waiting for the symptoms to subside.

8. Combination medication: Reduce the dosage of statins. If low-density lipoprotein cholesterol (LDL-C) cannot be controlled to the target, consider combining it with the cholesterol absorption inhibitor ezetimibe to reduce the occurrence of muscle damage.

9. Supplement coenzyme Q10: Studies have shown that muscle damage caused by statins is related to reduced coenzyme Q10 synthesis. You can try to supplement coenzyme Q10 to alleviate myalgia symptoms.

In summary, when using statins to prevent cardiovascular and cerebrovascular diseases, it is possible to cause muscle damage, myalgia, and fatigue. However, most of them are mild and can be tolerated. Only a very small number of people will develop rhabdomyolysis, and it is even rarer to be life-threatening. Pay more attention to the monitoring of CK values, seek medical attention in time if abnormalities are found, and adjust the medication under the guidance of a doctor to prevent the occurrence of serious adverse reactions.

If you have any questions about medication, please consult a doctor or pharmacist in time. I am pharmacist Huazi. Welcome to follow me and share more health knowledge.