Muscle aches are the most common reason people stop a statin such as atorvastatin (Lipitor) or rosuvastatin (Crestor). The aches are real, but studies show many of them are not actually caused by the statin, and when the statin is the cause, there are several good ways forward. Stopping cholesterol treatment altogether is rarely the best answer for someone at high heart risk.
Is it really the statin?
In blinded trials where people did not know whether they were taking a statin or a placebo, muscle symptoms showed up almost as often on the placebo. Exercise, low thyroid, low vitamin D and other medicines can also cause aches. Your provider may check a blood test called CK and your thyroid before deciding.
Options when a statin is the problem
- Pause and retry. A short break, then restarting the same or a lower dose, often works.
- Switch statins. Rosuvastatin and pravastatin are often tolerated when others were not.
- Take it less often. Long-acting rosuvastatin can work taken a few days a week.
- Ezetimibe (Zetia), a pill that lowers LDL by blocking cholesterol absorption, alone or with a low-dose statin.
- Bempedoic acid (Nexletol), a pill that rarely causes muscle symptoms and lowered heart attack risk in people who could not take statins.
- PCSK9 inhibitors such as evolocumab (Repatha) and alirocumab (Praluent), injections every two to four weeks that lower LDL dramatically, usually for people at the highest risk.
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When to stop and call
Severe muscle pain or weakness with dark, cola-colored urine can signal rhabdomyolysis, a rare but serious muscle breakdown. Stop the statin and seek care the same day.
Get help from Hope Integrative Medicine
If a statin is giving you trouble, we can sort out the cause and find a cholesterol plan you can stay on. Our primary care team in West Ashley sees patients in person and by telehealth across South Carolina, and new patients are often able to be scheduled within a week of requesting an appointment. Request an appointment.
This article is general health information and does not replace advice from your own provider. Never start, stop or change a medication without talking with your prescriber.
Frequently Asked Questions
Sometimes, but less often than people think. In blinded trials, muscle aches were reported almost as often on placebo as on a statin. Exercise, low thyroid, low vitamin D and other medicines can also cause aches.
Rosuvastatin (Crestor) and pravastatin are often tolerated by people who had aches on other statins, and a lower dose or every-other-day rosuvastatin can work for some.
Non-statin options include ezetimibe (Zetia), bempedoic acid (Nexletol) and PCSK9 inhibitors such as Repatha and Praluent. The right choice depends on how much your LDL needs to drop and your heart risk.