Statin Intolerance

Approach to Patients with a history of Statin intolerance due to muscle pain:

• Begin or intensify therapeutic diet and lifestyle changes

• Decrease the statin dose

• Stop the statin and retry later

• Decrease the statin and add ezetimibe

• Use a different statin or a statin like supplement
      Fluvastatin 80 mg daily
      Rosuvastain Qweek, 2X/week,  or QOD
      Rosuvastatin at 5 or 10 mg a day
      Atorvastatin 10-40 mg 3X/week
      Red Yeast Rice at 1800 mg BID

• Pulse Statin therapy

• Switch Class of hypolipidemic
      Use ezetimibe alone
      Combine ezetimibe and colesevalam

• Check Vitamin D level and replace if needed

• LDL cholesterol apheresis if qualified

• Add Coenzyme Q10 at 200 mg QD to the statin drug

Taken from Ann Intern Med 2009; 150:830-839, Becker, DL, et al, Red Yeast Rice for Dyslipidemia in Statin-Intolerant Patients.

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