5 Reasons to Stop or Switch Statins

About 10% of statin users get aches and pains, says 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, says 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," he says.
• 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.

In rare cases, people who take statins can see an increase in liver enzymes. 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. 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, explains 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," Dr. O'Neill adds.

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• Some research suggests statins help with asthma symptoms. But a small study presented at a 2011 industry meeting found that people with asthma who took statins had more symptoms and worse lung function than patients who didn't take them.
• Lead researcher, Safa Nsouli, MD, director of the Danville Asthma and Allergy Clinic, in Danville, California, argues that statins boost production of cells in the immune system that cause inflammation and worsen asthma symptoms. More recently, he presented research showing that statins also worsen hay fever symptoms.

Asthma and seasonal allergy sufferers may need to have their medications adjusted to get better symptom control, he says.

If you are pregnant or thinking about having a baby, you should not take statins. Although the effect of statins during pregnancy is not clear, research has brought up concern of birth defects. Cholesterol is a building block for developing brains, hearts, and limbs.

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

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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," Dr. O'Neill says. The best bet may be not to take statins while the infection is being treated.