CoQ10 and L-carnitine for Statin Myalgia?

James J DiNicolantonio

Disclosures

Expert Rev Cardiovasc Ther. 2012;10(10):1329-1333. 

In This Article

STRENGTH Trial

The STRENGTH trial confirmed the results of SEARCH. STRENGTH randomized 509 patients to pravastatin 10 mg, simvastatin 20 mg or atorvastatin 10 mg with each of these statins being increased to doses of 40, 80 and 80 mg if indicated, respectively.[15] The SLCO1B1*5 allele was associated with myalgia and CK elevations. Carriers of the SLCO1B1 allele were at a twofold greater relative risk of mild statin-induced side effects with the majority having normal CK levels.

In the STRENGTH trial, the risk of adverse events was greatest for simvastatin and negligible for those on pravastatin. STRENGTH showed that switching patients who are experiencing muscle pains on simvastatin to pravastatin is a justifiable approach. Some have considered screening for the SLCO1B1*5 allele to determine which statin should be initiated first. However, the majority of patients experiencing statin myalgias were the patients taking simvastatin 80 mg, making genetic testing an unreasonable option.[15]

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