Primary Evaluation and Management of Statin Therapy Complications

Dean A. Seehusen, MD, MPH, FAAFP; Chad A. Asplund, MD; Dawn R. Johnson, DO; Kevin Horde, A. DO


South Med J. 2006;99(3):250-254. 

In This Article

Evaluation of Complaints

When a patient on statin therapy complains of muscle pain or weakness, a thorough history to evaluate for predisposition to myopathy and a physical examination focusing on tenderness to palpation and findings consistent with other causes of myopathy should be conducted. Other causes, such as strenuous exercise, should be ruled out. Initially, a creatine kinase level and a TSH should be drawn.[5] If the patient complains of brown urine or if CK levels are markedly elevated, renal function and urine myoglobin should be evaluated. If CK levels are elevated, a workup for other possible causes of myopathy should be initiated, including an ANA and CBC.[2] Figure 1 suggests a decision tree for evaluation and classification of muscle complaints.

Diagnostic decision tree for patients on statins presenting with muscular complaints.