Taking statins when you have a muscle wasting condition

Statins are medicines that lower your chance of getting some heart and circulation conditions.

Many people with muscle wasting conditions can take statins. In some cases, the doctor may recommend taking a lower dose or having extra check-ups to help prevent muscle problems. This is because the potential side effects of statins can have a bigger impact when your muscles are already weakened.

Statins lower the amount of bad cholesterol (LDL cholesterol) in your blood. Having too much LDL cholesterol can increase your chance of getting cardiovascular disease (CVD).

CVD includes conditions like coronary heart disease, heart attack, and stroke. Your doctor may recommend taking statins if you have CVD or there’s a high chance you’ll get it.

Taking a statin reduces your chance of getting CVD but cannot prevent it completely. If you already have CVD, statins can help stop it getting worse. Your doctor will also recommend a healthy lifestyle to lower your risk.

Like all medicines, statins can cause side effects in some people. One possible side effect is muscle pain. This may be more likely if you have a muscle wasting condition or a family history of one. Because muscles are already affected in these conditions, any new muscle symptoms can understandably be more worrying and may have a bigger impact on daily life.

A very small number of people taking statins may develop myasthenia gravis. If you already have this condition, your doctor will monitor you carefully as your symptoms may get worse after taking statins.

Statins can sometimes cause muscle problems. In other cases, they may make an existing muscle condition worse or reveal it.

If you’re thinking of taking statins, your doctor will check that they’re suitable for you. They will check your general health and ask about your history of muscle problems. They may offer you a blood test to measure your creatine kinase (CK) level. CK is normally found in your muscles. If muscles are damaged, CK can pass into the blood.

If your CK level is high, your doctor may advise you not to take statins or to start with a low dose. However, they might still recommend taking statins, especially if the benefits outweigh the risks. Knowing your CK level before treatment can help if you develop new or worsening muscle symptoms later. If statins are not suitable for you, your doctor may suggest alternatives.

Speak to your doctor or neuromuscular team before taking statins. They can explain the possible benefits and risks.

If you decide to take statins, you’ll usually take them once a day. Your doctor will tell you the right dose and when to take them. Some medicines and foods, such as grapefruit juice, can stop statins working properly. It’s important to read the information leaflet that comes with your medicine.

Common side effects of statins include:

• Muscle pain
• Joint stiffness
• Increased blood sugar levels
• Feeling sick (nausea)
• Difficulty passing poo (constipation) or loose and runny poo (diarrhoea)
• Passing wind
• Headache

Side effects do not affect everyone but if you do get any speak to your doctor. Side effects often get better over time. If one type of statin does not suit you, your doctor may recommend a different one.

It’s important to tell your doctor about any unexplained muscle pain, tenderness, or weakness. They should measure the CK level in your blood. If it’s very high or higher than before you started treatment, they may advise you to stop taking statins.

Get medical help straight away if you experience the following combination of symptoms:

• Have sudden, severe muscle pain, tenderness, and weakness
• Have dark-coloured urine (brown, red or cola-coloured)
• Feel unwell and have flu-like symptoms

These symptoms can be caused by serious muscle damage, called acute rhabdomyolysis. It’s rare, affecting up to 1.5 in 100,000 people who take statins.

Your doctor will tell you what dose of statins they’re giving you, and how to take them. They will also explain how statins may benefit you and what side effects to look out for. As with any medication, the decision to use statins should be made based on your individual needs, after carefully weighing up the risks and benefits.

You can also find general information about statins on the NHS and British Heart Foundation websites.