Drug-induced Muscle Damage: Statins for Cholesterol and Diabetes
Tablets are given to reduce cholesterol for people with high blood pressure or in diabetics. They can lead to muscle degradation leading to aches, pains and cramps of muscles, and eventually in severe cases damaging the kidney. This test is for you.:
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High cholesterol or lipid levels
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Risk of heart disease
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Diabetes
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Not taking cholesterol-lowering drugs as prescribed (due to pain)
The genetic test is the only confirmatory and predictive test for Statin-induced myopathy. This is because while most people have muscle pain, some don’t and the drug can still be debilitating for them because of the genetic variation.
Statins include drugs such as Atorvastatin, Simvastatin, Pravastatin, Fluvastatin and several others. The report will guide you on the risk of developing severe side-effects on this vital cholesterol-lowering medicine. If you have the mutation the report will further guide therapy. Whereas if you don’t have the mutation, then your inexpensive therapy could save you a lot of money.
People discontinue therapy or skip taking these vital drugs to avoid their side-effects. This would be more harmful. Whereas, with this test result, people at risk can stick to their prescribed medication and dosage, or change them with doctor’s guidance based on the genetic results. Be safe for life!
FAQ
What are the alternatives if I have intermediate or high risk?
While statins prevent cholesterol biosynthesis, there are other drugs that reduce dietary cholesterol absorption and have other modes of action. Further, a lower dose or use of a low-risk statin may be advised. But these are therapeutic decisions only your doctor can take considering your entire clinical history.
Why can’t I start with a low-risk statin or alternative drug?
Every drug has its indications and contraindications, and your doctor is in the best position to decide the most appropriate drug for you. Older drugs, which may include higher-risk statins, may be less expensive and have massive clinical evidence behind them.
Is routine creatine kinase monitoring recommended upon statin use?
Some professional bodies recommend routine creatine kinase monitoring, while others do not specify it. We think it is an additional tool to detect statin toxicity because not all patients experience muscle pain. However, there are several reasons for elevated creatine kinase, and statin toxicity need not be the cause. Your doctor is best qualified to decide its specific use and need for you.
Science
Genes tested: SLCO1B1
A common genetic mutation affects drug absorption in the liver. This leads to high levels of the medicine circulating in the body, thus damaging muscles. When muscle breaks down, it can cause pain (myalgia, myopathy) and in the long run can even lead to kidney damage due to severe rhabdomyolysis.
References
Ramsey LB et al. 2014, Clinical Pharmacology and Therapeutics
Carr DF et al. 2013, Clinical Pharmacology and Therapeutics
Link E et al. 2008, The New England Journal of Medicine
De Keyser CE et al. 2014, Pharmacogenetics and Genomics
Voora D et al. 2009, Journal of the American College of Cardiology