Are Statins Bad for You? 5 Reasons to Stop or Switch Statins

Muscle Pain and Weakness

About 10% of statin users get aches and pains, said William W. O'Neill, MD, a cardiologist and medical director of Henry Ford Health System's Center for Structural Heart Disease at Henry Ford Hospital in Detroit. The higher your dose, the more likely you are to experience aches and pains.

For most people, the solution is a simple tweak, said Antonio M. Gotto Jr., MD, professor of medicine at Weill Cornell Medicine in New York City. "Before you give up on a statin, try a different dose or a different statin."

Much less common—but more serious—is rhabdomyolysis, in which muscle cells break down and release proteins such as myoglobin that damage kidneys. It typically causes severe shoulder, thigh, and/or lower back pain. If confirmed by your doctor, you must stop taking your statin.

Increased Liver Enzymes

In rare cases, people who take statins can see an increase in liver enzymes, according to the American College of Cardiology. The risk may be higher if you take other cholesterol-lowering medications along with statins.

People on statins used to undergo periodic liver enzyme testing. But routine testing is no longer required due to a lack of evidence that it made a difference in identifying these rare events, according to the Food and Drug Administration (FDA). Instead, patients may be tested before starting a statin and again as needed.

Liver enzyme testing is individualized based on each patient's risk factors, said Alfred Casale, MD, chair of the Geisinger Heart Institute in Danville, Pennsylvania. If enzymes are elevated, options include stopping or switching statins.

"Just because you have problems with one statin doesn't mean you will have problems with all of them," said Dr. O'Neill.

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Worsening Asthma and Hay Fever

In 2011 a small study presented at the American College of Allergy, Asthma & Immunology Annual Scientific Meeting found that statins may worsen asthma control. The researchers found the patients taking statins had more airway inflammatory obstruction at three, six and 12 months compared to those not on statins.

However, other research suggests statins help with asthma symptoms. For instance, a 2021 study publised in the The Journal of Allergy and Clinical Immunology concluded that statin use was associated with a reduced risk of asthma-related emergency department visits, hospitalizations, and systemic steroid use in patients with asthma.

Potential Pregnancy

If you are pregnant, you should stop taking statins, says the FDA. The agency reviewed decades of data of use of statins in pregnant women and reported that it did not find an increase in major birth defects associated with use of statins during pregnancy. However, the FDA did find that there was insufficient date on statin use in pregnant women to determine if there is a drug-associated risk of miscarriage. The FDA also advises that patients do not breastfeed when taking a statin because the medicine may pass into breast milk and pose a risk to the baby.

If you are taking a statin, tell your healthcare provider immediately if you become pregnant or are thinking about having a baby. Women who are breastfeeding should also not take statins.

Using Antibiotics or Antifungal Drugs

If you develop an infection and your doctor recommends treatment with an antibiotic or antifungal drug, make sure he or she knows you are taking a statin. "You are at greater risk of muscle damage when you take these medications with a statin," said Dr. O'Neill.

A 2018 study in Oxford Medical Case Reports clarifies that rhabdomyolysis, which is muscle tissue breakdown, is a well-documented side effect of statin therapy and that the risk is greater with the concurrent use of drugs incuding antibiotics, antifungals, protease inhibitors, and calcium channel blockers.

The best bet may be not to take statins while the infection is being treated.