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Statin muscle symptoms — GPhC CRA MCQ

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HardCardiovascular TherapeuticsStatin muscle symptomsGPhC CRA

A patient taking atorvastatin 80 mg daily developed severe generalised muscle pain, weakness and dark urine three days after starting clarithromycin. What is the best response?

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Correct answer: E — Withhold atorvastatin and arrange urgent assessment for rhabdomyolysis and renal injury

Option E is correct: clarithromycin can raise atorvastatin exposure, and severe muscle symptoms with dark urine suggest rhabdomyolysis requiring statin withdrawal and urgent CK and renal assessment. Option A ignores a potentially fatal adverse effect. Option D substitutes another high-risk CYP3A4 statin. Option B delays assessment despite myoglobinuria. Option C removes the precipitating antibiotic but inappropriately continues atorvastatin after rhabdomyolysis is suspected.

Reference: Atorvastatin SmPC: https://www.medicines.org.uk/emc/product/14487/smpc