[Mechanisms of rhabdomyolysis with statins].

Rhabdomyolysis is uncommon, but is a serious side-effect observed following statin use. The occurrence of fatal rhabdomyolysis reported in the USA since the introduction of statins in the market in the late eighties was very rare (0.15 cases per million patients treated per year). However, myopathy, defined as muscle symptoms associated with CK elevation is much more common (1-5%). Mechanism of statin-induced myopathy is not fully understood. Several hypotheses have been proposed: decreased cellular levels of isoprenoids and ubiquinone, increased rates of apoptosis, changes in chloride channels impairing cell-membrane hyperpolarization, and changes in the cell-membrane permeability. Interactions with other drugs, and preexisting metabolic alterations may predispose to myopathy.