STATIN-ASSOCIATED INTOLERANCE AND ITS PREVENTION

The review analyzes the literature data, which covers the intolerance of statins associated with myopathy. The article gives a definition of statin intolerance, analyzed data from a randomized, controlled trials, where are indicated frequency of statin-associated myopathy, its symptoms in juxtaposition with an increase in creatine kinase activity. It is noted that the frequency of complications depends on the applied statin, its dose, duration, the use of other risk factors that contribute to the development of myopathy. It is indicated that polypharmacy - the joint use of statins with such drugs as anti-inflammatory (glucocorticoids), immunosuppressants (cyclosporine), antipsychotics, antiviral (protease inhibitors), macrolides, antifungal, lipid modifying (gemfibrozole), cytochrome P450 inhibitors and substances causing dependence (alcohol, opioids) may contribute to the development of statin-associated myopathy. Risk factors are also age over 75 years, low body mass index, female gender, high level of physical activity, multi-system diseases - hypothyroidism, diabetes, infections, hepatic dysfunction, biliary obstruction, organ transplantation, severe injuries, hypovitaminosis D, metabolic lesions, etc. Methods of therapy of patients with statin-associated myopathy, namely, dose changes, duration of administration, regimen of application (twice a week instead of daily), replacement of the drug and the use of other lipid-lowering agents, as well as nutritional and complementary therapy are considered.