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Muscle Weakness and Heart Disease

By Rosalyn Carson-DeWitt, MD

Updated November 12, 2008

(LifeWire) - Taking statins (cholesterol-lowering drugs) can rarely result in a potentially dangerous side effect called rhabdomyolysis. It's a condition in which muscles are damaged and break down, resulting in severe muscle pain, weakness and brown urine.

Sometimes, statin drugs interfere with the generation of proteins necessary for proper muscle functioning. This can cause symptoms of vague muscle aches and weakness throughout your body. Contact your doctor if this happens to you. Symptoms usually go away if you discontinue the medication.

If you continue taking the medication, the problem may become worse. Muscle cells and tissue may begin to break down, releasing huge quantities of the protein myoglobin into the bloodstream.

The result can overwhelm the kidney's filtering capacity, resulting in severe kidney damage. This may be followed by a life-threatening complication -- disseminated intravascular coagulation -- that affects your blood's ability to clot. Fortunately, this condition is rare in patients taking statins.

To test for rhabdomyolysis, your doctor may check your blood levels of creatinine kinase, a part of normal muscle tissue that increases in your blood when muscle cells are damaged or die.

Treatment of rhabdomyolysis starts with stopping the cholesterol-lowering drug. Other treatment includes ensuring adequate hydration, giving medications that make urine more alkaline, and giving diuretic medications to increase urine flow through kidneys. In severe cases, kidney dialysis may be required to clean the blood and relieve the strain on the kidneys.

Rhabdomyolysis is more likely if you are:

  • Taking particularly high doses of statin medications (atorvastatin 40 or 80 mg/day, fluvastatin 80 mg/day, pravastatin 40 mg/day, or simvastatin 40 or 80 mg/day)
  • Combining a statin drug with one or more of these:
  • More than 80 years old
  • A woman
  • Slight in frame and/or frail
  • Diabetic
  • Suffering from high blood pressure; high triglycerides; or thyroid, liver or kidney disease
  • Recuperating from a recent surgery
  • Drinking large quantities of grapefruit juice (more than a quart a day)
  • Exercising heavily on a regular basis

Here's more on the statin drugs.

Sources:

 Antons, Kenneth A. "Clinical Perspectives of Statin-Induced Rhabdomyolysis." American Journal of Medicine 119(2006): 400-9. 3 Nov 2008 <http://linkinghub.elsevier.com/retrieve/pii/S0002934306001847> (subscription required).



Jones, Peter H. and Michael H. Davidson. "Reporting Rate of Rhabdomyolysis with Fenofibrate + Statin Versus Gemfibrozil + Any Statin." The American Journal of Cardiology  95(2005): 120-2. 3 Nov 2008 <http://linkinghub.elsevier.com/retrieve/pii/S0002914904014602> (subscription required).



Schwartz, Janice B. "Cardiovascular Disease in the Elderly." Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine.   2007.


LifeWire, a part of The New York Times Company, provides original and syndicated online lifestyle content. Rosalyn Carson-DeWitt, MD, works as a medical writer, editor and consultant in Durham, NC. She served as editor-in-chief for two multi-volume MacMillan encyclopedias:  The Encyclopedia of Drugs, Alcohol and Addictive Behavior and Drugs, Alcohol and Tobacco: Learning About Addictive Behavior. She worked on the 18th edition of the Merck Manual of Diagnosis and Therapy, and she has written thousands of print and online articles for healthcare providers and consumers.

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