Table of contents:
- Statin cholesterol drugs can cause muscle pain
- What is rhabdomyolysis?
- What are the common signs and symptoms of rhabdomyolysis?
- Why should I care about the effects of this cholesterol drug?
Statins have been used for more than 20 years as safe and well-tolerated cholesterol medications. However, like any drug, statins can cause side effects - especially in people who are more sensitive. Statins can sometimes cause swelling and pressure pain in the muscles. When muscle pain continues so severe that it is debilitating, the condition is called rhabdomyolysis. Rhabdomyolysis can be fatal.
Statin cholesterol drugs can cause muscle pain
A relatively common side effect of statins is mild muscle pain. How these cholesterol drugs cause muscle pain is not fully understood. One theory is that statins affect protein production in muscle cells, which in turn slows down muscle growth.
Another theory argues that statins work to reduce levels of a natural substance in the body called coenzyme Q10. Coenzyme Q10 helps muscles produce energy. Decreased coenzyme levels mean that the muscles will produce less energy. With little energy, muscle cells cannot work properly. This in turn can lead to muscle soreness, muscle fatigue, and muscle weakness so that once simple tasks, such as climbing stairs or walking can make you uncomfortable and tired while on statins.
However, if this muscle pain continues so severe that it becomes debilitating over time with statin use, this may be a sign of rhabdomyolysis. Rhabdomyolysis is a rare side effect of statin cholesterol drugs and needs to be watched out for.
What is rhabdomyolysis?
Rhabdomyolysis is a rare syndrome characterized by severe muscle damage due to the death of muscle fibers, resulting in the contents of the fibers leaking into the bloodstream. Damage to the muscles then releases myoglobin into the bloodstream. Myoglobin is a protein that functions to store oxygen in muscles. Too much myoglobin in the blood can cause electrolyte imbalance to acute kidney failure.
What are the common signs and symptoms of rhabdomyolysis?
Common symptoms of rhabdomyolysis can be described as a triad of symptoms: muscle pain, swelling, weakness, and dark urine (usually reddish or purplish). The typical muscle pain symptoms of rhabdomyolysis can include stiffness and cramps.
Muscle pain that occurs is usually most pronounced in the muscles close to the base of the body such as the thighs and shoulders, lower back, and calves. How severe your muscle weakness is depends on the severity of the muscle damage.
Other symptoms and complaints that may occur include fatigue, lethargy, extreme thirst (hypovolemia; fluid and electrolyte deficiency syndrome), and heartbeat that is too fast and irregular. In some people, swollen and weak muscles can sometimes cause a discharge.
Irregular heart rhythm due to rhabdomyolysis can increase the risk of heart attack due to severe hyperkalemia (excess potassium in high amounts).
Why should I care about the effects of this cholesterol drug?
Untreated rhabdyomyolysis can lead to kidney failure.
Statins themselves are also the most widely used cholesterol drugs. Statins are a class of cholesterol drugs that are easily recognized because they all end in -statin, namely:
- Atorvastatin
- Cerivastatin
- Fluvastatin
- Lovastatin
- Mevastatin
- Pitavastatin
- Pravastatin
- Rosuvastatin
- Simvastatin
Not all statins mentioned above are available in Indonesia, but atorvastatin, pravastatin, simvastatin are examples of drugs covered by BPJS.
Risk factors that can increase the risk of rhabdomyolysis from this cholesterol drug can come from the active substance of the drug or the patient's own condition. That is:
- The type of statin drug. Pravastatin and fluvastatin are the types that cause less muscle damage because their effect is lower. Meanwhile, the use of simvastatin should be limited to 40 mg per day and to 20 mg per day if the drug is given together with the heart drug amlodipine.
- The presence of pre-existing nerve and muscle (neuromuscular) disorders
- Presence of hypothyroidism, acute or chronic renal failure, and obstructive liver disease
- The patient's genetic factor is the protein responsible for uptake of statins into cells
- Concomitant use with the following medicines: calcium channel blockers (diltiazem, verapamil), protease inhibitors for HIV and hepatitis C, amiodarone, juice or grapefruit, cyclosporine, fibrates, colchicine, niacin.
Avoid using statins with any of the drugs listed above to prevent the risk of drug interactions. Discuss with your doctor about the type, dosage rules, and how to use the cholesterol statin drug that is best for you.
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