Statin Intolerance

• Statins are the most common, widely prescribed first choice medication for lipid-lowering.

• Inability to take statins to achieve the target LDL-C for the individual.

• Inability is due to adverse effects or due to unacceptable elevation of liver enzymes or creative kinase levels.

• Absence of factors that can provoke the adverse effects of statins.

• Reversal on withdrawal.

• Failure to tolerate statins despite rechallenge.

• Intolerance to at least two statins – one at the lowest starting dose and another at any dose.

• Statin associated muscle side effects: The entire spectrum of muscular symptoms related to statin intake are now termed as statin associated muscle symptoms; 60% of statin discontinuation.

• Nutraceuticals are useful in:

• Managing residual risk associated with lipids other than LDL-C

• Managing nonlipid-mediated residual risk

• Optimizing LDL-C treatment in statin intolerance

• Optimizing LDL-C treatment when add-on therapies for statins are not available

• Adjuncts to lifestyle for individuals at high lifetime risk of ASCVD.