Which of the following is a major adverse effect to monitor with statin therapy?

• A. Myopathy and elevated liver enzymes
• B. Hypotension
• C. Hyperkalemia
• D. Hyperglycemia

Answer: (A)

Statin safety is mainly about muscle toxicity and liver injury. The major adverse effects to monitor are myopathy, which shows up as muscle pain or weakness (and can progress to rhabdomyolysis with dark urine), and hepatotoxicity, indicated by elevated liver enzymes. Because muscle symptoms can signal serious muscle breakdown, clinicians check creatine kinase if symptoms occur and monitor liver enzymes periodically, especially at treatment initiation or dose changes. If severe muscle symptoms or very high CK levels appear, statin therapy may be paused or adjusted. Hyperglycemia can occur in some people, but it’s not the primary safety concern to monitor compared with muscle damage and liver enzyme elevations. Hypotension and hyperkalemia are not typical statin-related adverse effects.