Table 2.
Patient-related factors | Drug interactionrelated factors |
---|---|
Advanced age (especially >80 years old) | Gemfibrozil (contraindicated with statins) |
Female | Red yeast rice (contraindicated with statins) |
Low BMI | Niacin (limit to 1 g/day) |
Asian ethnicity | Macrolide antibiotics |
Presence of renal disease | Azole antifungals |
Presence of hepatic disease | Protease inhibitors |
Untreated hypothyroidism | Large quantities of grapefruit juice |
Low vitamin D levels | Nefazodone (discontinued antidepressant) |
Hypertension | Cyclosporine (avoid simvastatin, lovastatin and atorvastatin) |
Diabetes mellitus | Verapamil/diltiazem |
Biliary tract obstruction | Warfarin |
Personal or family history of SaMAEs | Digoxin |
Family history of myopathy | Amiodarone |
Genetic polymorphisms of the CYP isozymes | Ticagrelor (avoid simvastatin) |
Inflammatory or inherited metabolic muscle disease (e.g. McArdle’s disease or carnitine palmitoyltransferase II deficiency) | Colchicine |
Strenuous exercise | Fusidic acid |
Surgery with severe metabolic demands | Antipsychotics |
Alcohol abuse (independently predisposes to myopathy) | |
Drug abuse (e.g. cocaine, amphetamines or heroin) | |
High statin dose |
BMI = body mass index; SaMAEs = statin-associated muscle adverse events; CYP = cytochrome P450.