Statins are a type of medication used to treat high cholesterol and some common heart health problems.
A potentially common side effect of statins is muscle pain. While it is typically harmless, it may require medical attention in rare cases.
In this article, we’ll explore why statins cause muscle pain, how long it may last, other side effects, and how to know when you should seek medical care for statin-related muscle pain.
Statins and Muscle Pain
For people who take statins, a common side effect is muscle pain. It may feel like weakness, soreness, or tiredness.
It can range from mild discomfort to pain strong enough to disrupt everyday activities.
Not everyone who takes statins will get muscle pain.
The actual risk of muscle pain found in clinical trials is around 1-5%, with rates comparable in the placebo groups.
People who are 40 and older more commonly experience musculoskeletal pain. Also, the percentage of people in that age group who take statins and experience muscle pain is higher.
Researchers have found an interesting phenomenon with statins, though: people who expect to get muscle pain or negative side effects from them tend to have a higher occurrence of perceived muscle pain.
This is what is called a “nocebo” effect.
In rare cases, statins can cause serious muscle damage known as rhabdomyolysis.
This potentially life-threatening condition can lead to severe muscle pain, kidney failure, liver damage, and death.
The risk of this is very low, but may be increased in people who take statins at high doses or with certain other drugs.
If you take statins, it’s important to ensure that your medical provider and pharmacist know the other medications, OTC drugs, and supplements you take to avoid interactions.
Always follow prescription instructions closely.
Who gets statin-related muscle pain?
Most people who take statins will not get muscle pain from the medication.
Risk factors for being more likely to notice this side effect include:
- 80 or older
- Assigned female at birth
- Low body weight
Other medical conditions may increase the risk of side effects from statins, including muscle pain. Examples of the medical conditions include:
Why do statins cause muscle pain?
Not a single definitive cause is known for why statins cause muscle pain.
It is most likely a combination of factors, including:
- Higher amount of type II muscle fibers
- Mitochondrial dysfunction
- Problems breaking down proteins (protein prenylation impairment)
- Low vitamin D levels
There are other possible reasons someone may experience muscle pain while taking statins.
A medical professional can assess risk factors and health history and consider side effects from other medications to determine the cause.
Do all statins cause muscle pain?
While all statins work similarly in the body, there are some minor differences between the medications. Some statins may be more likely to cause muscle pain than others.
Simvastatin is more associated with muscle pain, while fluvastatin is less likely to cause it.
Overall, how a person responds to each type of statin still depends on their own physical health and genetic factors.
How long will statin-related muscle pain last?
Most people who experience muscle pain from statins notice the side effect shortly after they start the medication.
In most cases, the pain is short-term and resolves within a few weeks, as the body adjusts to the medication.
If the pain lasts longer or becomes more severe, let your medical provider know right away. It could be a sign of a serious reaction to statins or could be caused by a different condition.
What Are Statins?
Statins are a type of prescription medication that helps reduce LDL cholesterol. This is sometimes referred to as “bad” cholesterol.
Statins are frequently prescribed because they have a strong safety profile in most cases and can significantly reduce the risk of heart attack and stroke.
Uses of Statins
Medical providers use statins to help lower LDL cholesterol in people with high levels.
HDL cholesterol, or “good” cholesterol, should be in a balanced ratio with LDL for the best cardiovascular health.
Statins can help lower LDL and restore this balance.
Statins are also prescribed for other reasons, including reducing risks and complications from heart attack and stroke. More than 30% of adults over age 40 take a statin medication.
There are several different types of statins, including:
- Simvastatin (Zocor)
- Fluvastatin (Lescol)
- Atorvastatin (Lipitor)
- Rosuvastatin (Crestor)
- Lovastatin (Mevacor)
Common Side Effects
Statins tend to cause some other side effects, in addition to muscle pain.
- Increased risk for type 2 diabetes
- Lowered testosterone levels in people with penises
- Erectile dysfunction
- Kidney or liver problems
If a medical provider has prescribed a statin medication, they believe that the benefit for your health outweighs the potential for side effects.
Managing Muscle Pain Caused by Statins
If you take statins and develop muscle pain, a healthcare provider has many potential ways to address it.
- Dosage adjustment: Depending on your dose, reducing it could help to improve muscle pain. But if your LDL cholesterol is not well-controlled on a lower dose, a medical provider may add another medication or suggest specific lifestyle adjustments to support optimal cholesterol levels.
- Check for interactions: A healthcare provider may ask for a complete, detailed list of the other medications you take, as well as any dietary supplements, herbs, and even specific foods. Sometimes unintentional drug interactions increase negative side effects. Specifically, they may make sure that you are not taking calcium channel blockers, heart rhythm drugs, immunosuppressants, certain antidepressants, some hormone therapies, antifungal drugs that end in -azole, or antibiotic medications that end in -mycin. Grapefruit juice should also be avoided.
- Taking a break: A medical provider may have you stop taking statins for a few weeks or a month, to determine whether your muscle pain resolves after the drug is out of your system. If the pain resolves, they may prescribe a different statin or a different type of medication. If the pain does not resolve, they will investigate the cause of the muscle pain.
- Trying a different medication: If statins cause muscle pain, a healthcare provider may switch you to a different type of cholesterol-lowering drug like adenosine triphosphate-citrate lyase (ACL) inhibitors (Nexletol), bile acid sequestrants (cholestyramine, colesevelam, others), or PCSK9 inhibitors (alirocumab, evolocumab).
- Considering underlying conditions: A medical provider may suggest blood tests to check for abnormal thyroid hormone levels, since this can increase the chance for muscle-related side effects from statins.
- Regular physical activity: If you don’t already exercise, getting regular physical activity may decrease the physical pain. For most individuals, 150 minutes per week of moderate exercise is important. If you already exercise regularly, your medical provider may ask about the intensity level and frequency. In some cases, excessive exercise or high-intensity activity may contribute to muscle pain.
When to Seek Medical Attention for Muscle Pain
For most people, statin-related muscle pain is not serious.
While the pain may be uncomfortable and, in some cases, may interfere with everyday activities, it is not a sign of a severe medical complication.
Rarely do statins lead to serious muscle damage that can be life-threatening. Rhabdomyolysis requires emergency medical attention and includes symptoms such as:
- Extreme muscle pain
- Weakened muscles
- Brown or red urine
If you notice these signs, go to the nearest emergency room or call 911.
Medical providers will run blood and urine tests to determine the cause of these serious symptoms.
Rhabdomyolysis only happens to a few out of every million people who take statins.
While it is very rare, the odds increase if you take high-dose statins or take other medications that increase the risk for side effects or interactions.
Even if you do not notice these serious signs, but you feel consistent muscle pain while taking a statin drug, speak with a healthcare provider.
They will assess your health and situation to determine other possible causes and will help find a solution.
You do not have to live with muscle pain that alters your ability to function since there are alternative ways to treat high LDL cholesterol and related conditions.
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Frequently Asked Questions
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National Trends in Statin Use and Expenditures in the US Adult Population From 2002 to 2013. (2017).
Prevalence of Musculoskeletal Pain and Statin Use. (2008).
Protein Prenylation: Enzymes, Therapeutics, and Biotechnology Applications. (2015).
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Statin Safety and Associated Adverse Events: A Scientific Statement From the American Heart Association. (2018).
The nocebo effect in the context of statin intolerance. (2016).
Vitamin D Serum Levels in Patients with Statin-Induced Musculoskeletal Pain. (2019).