Primary evaluation and management of statin therapy complications

HMG-CoA reductase inhibitors (statins) have become one of the most commonly prescribed classes of medications in the United States. While serious adverse events are rare, less serious events are frequently seen. Published guidelines recommend initial screening labs as well as ongoing monitoring of liver enzymes during therapy. Up to 5% of patients will have some muscle complaints while taking statins. Therefore, primary care clinicians will often be faced with real or potential complications of statin therapy. There are well established risk factors for development of these complications. Being aware of a patient's risk and using the lowest effective dose minimizes the occurrence of adverse events. The great majority of these abnormalities either do not require discontinuation of therapy or require only brief interruption of therapy. Judicious and systematic use of laboratory testing will minimize needless evaluation and premature discontinuation of statin therapy.