Statin intolerance: now a solved problem

J Postgrad Med. 2011 Oct-Dec;57(4):321-8. doi: 10.4103/0022-3859.90085.

Abstract

Statins are the most effective and widely used drugs for treating dyslipidemia, a major risk factor for coronary heart disease. These are one of the safest hypolipidemic drugs but many patients are bound to discontinue statins due to their side effects. Hepatotoxicity, myotoxicity and peripheral neuropathy are important out of them. Discontinuation of statins leads to dylipidemia and its grave consequences. Hence, there should be enough strategies for statin intolerant patients, so that they can be saved from these consequences. These side effects can be avoided by the awareness of certain factors viz. potential drug interactions and dose adjustment according to patho-physiology of the patient. Baseline investigations for liver function and muscle toxicity should be done before initiating statin therapy. Here, we are discussing various options for statin intolerant hyperlipidemic patients such as lower and intermittent dosing of statins, alternate hypolipidemic drugs, red yeast rice, supplementation with coenzyme Q10 and vitamin D. A number of hypolipidemic drugs are in trial phases and hold promise for statin intolerant patients.

Publication types

  • Review

MeSH terms

  • Anticholesteremic Agents / therapeutic use
  • Chemical and Drug Induced Liver Injury / prevention & control*
  • Chemical and Drug Induced Liver Injury / therapy
  • Dietary Supplements
  • Fibric Acids
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects*
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Hyperlipidemias / drug therapy*
  • Life Style
  • Muscular Diseases / chemically induced
  • Muscular Diseases / therapy
  • Niacin
  • Ubiquinone / analogs & derivatives
  • Vitamin D

Substances

  • Anticholesteremic Agents
  • Fibric Acids
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Ubiquinone
  • Vitamin D
  • Niacin
  • coenzyme Q10