Why was her statin stopped?

AKAnna Keller, 47 · Hypertension, prediabetes, LDL 162 mg/dl · 14 documents, read 16 September 2026

Answered on 16 September 2026

Simvastatin 20 mg was started on 11 January 2024 for an LDL of 158 mg/dl and stopped on 14 March 2024 because of muscle aches in both thighs that began about three weeks after the start. Creatine kinase was 210 U/l (upper limit 170), below four times the upper limit; the symptoms resolved within two weeks of stopping. Visit 14.03.2024 Lab 02.11.2023

Symmetric proximal muscle pain with a normal or mildly raised CK that resolves on withdrawal fits the EAS definition of statin-associated muscle symptoms. The consensus advises a rechallenge with a different statin at a lower dose or alternate-day dosing rather than permanent avoidance; most patients tolerate a second statin. Eur Heart J No rechallenge and no non-statin alternative were documented after March 2024. Medication 16.09.2026

From the patient record3 of 14 documents

Visit note, simvastatin stopped, 14 March 2024Clinical note
Laboratory report, 2 November 2023Laboratory
Medication list, 16 September 2026Medication

1.Statin-associated muscle symptoms: impact on statin therapy. European Atherosclerosis Society Consensus Panel Statement on Assessment, Aetiology and Management.European Heart Journal. 2015;36:1012-1022. Stroes ES, Thompson PD, Corsini A, et al.Guideline
SummaryDefines statin-associated muscle symptoms as symmetric proximal muscle pain, weakness or stiffness beginning within weeks to months of a statin start and improving within weeks of withdrawal; CK is usually normal or mildly raised. Management: withdraw, wait for symptoms to resolve, then rechallenge with the same or a different statin at a lower dose or alternate-day dosing; most patients tolerate a second statin. Non-statin therapy for those who cannot.
Source
Issuing body: European Atherosclerosis Society Consensus Panel
Published: May 2015
Grading system: Consensus statement
Scope
Target population: Patients with muscle symptoms on statin therapy
Scope: Definition, assessment, management, rechallenge

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Anna Keller, 47Mosaic