Pasanen et al
To date, only putative mechanisms have been put forth for statin–fibrate-associated myopathy
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Myopathy is more common when high doses of simvastatin (eg, 80 milligrams) are used, but some people get myopathy with lower doses
Acute kidney injury secondary to myoglobinuria and rare fatalities have occurred as a result of rhabdomyolysis in patients
Slight changes in peak plasma concentrations and AUC of simvastatin and simvastatin acid observed
Introduction Statins are oral hypolipidaemic drugs and amongst the most widely prescribed medications worldwide [ 1 ]; in the United Kingdom (UK) alone, ~7
3 and 4
Use concomitantly with caution and weigh benefits against risks of concomitant use; no dosage adjustment required
Simvastatin and lovastatin are the only statins requiring bioactivation
These findings expand the results of a recent genome wide association study of statin myopathy with CK > 3 times normal to milder, statin-induced, muscle side effects
Pasanen et al
Avoid combination
Statin medications are used in the management and treatment of hypercholesteremia
33 Among the statins, a growing body of evidence suggests that the influence of dose may be the greatest for simvastatin
The Prediction of Muscular Risk in Observational Conditions (PRIMO) study reported a myopathy rate of 10
This SLCO1B1 variant affects the plasma concentrations of the following statins (listed from most to least affected) ( 21 , 22 ): Introduction
The risk is also greater in patients taking an 80 mg daily dosage of simvastatin compared with patients taking lower simvastatin dosages and compared with patients using other statins with similar or greater LDL-C-lowering efficacy [see Adverse In a wide range of patients with and without heart disease, 1-5 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) reduce cardiovascular morbidity and mortality
ÞBecause Chinese patients have an increased risk for myopathy with The C max and AUC of total simvastatin acid (naive simvastatin acid plus that derived by hydrolysis of the lactone) were increased 17-fold and 19-fold respectively, and the half-life was increased by 25%
115 Patients with MD may be prone to develop statin myopathy
Alirocumab and Evolocumab: no drug-drug interactions
The risk is also greater in patients taking an 80 mg daily dosage of ZOCOR compared with patients taking lower ZOCOR dosages and compared with patients using other statins with similar or greater LDL -C-lowering efficacy [see ADVERSE