Lipid-lowering agents and myopathy.

Each of the lipid-lowering agents available today can cause myopathy. The severity of the muscle disorder may vary from trivial myalgias or elevations of creatine kinase in asymptomatic individuals to rhabdomyolysis with myoglobinuria, renal failure, and death. Fortunately, significant myopathy occurs at a low rate. However, the large number of individuals taking these medications renders it a significant problem. Although the pathophysiology of the myopathy remains speculative, its occurrence appears to be dose related. Consequently, the total dosage of lipid-lowering drug consumed, the concomitant use of other medications that affect their blood levels, and the individual's specific drug-metabolizing enzyme profile may contribute to this toxicity.