A patient on statin therapy should be monitored for anticipated therapeutic response and potential adverse effects. Monitoring of LDL-C should be used only to assess response to therapy and adherence. It is not an appropriate measure of performance.


Issues to measure:

(1) change in serum LDL-C concentration relative to baseline and intensity of statin therapy

(2) evidence for adverse events

(3) need to change statin dose or to discontinue therapy


percent reduction in serum LDL-C =

= ((baseline LDL-C) – (current LDL-C)) / (baseline LDL-C) * 100%


Statiin Therapy

Expected Reduction

high intensity

>= 50%

moderate intensity



If the expected reduction in LDL-C is less than expected then consider:

(1) poor adherence to regimen

(2) drug or condition associated with increased statin elimination

(3) change in statin regimen


It is worth considering the reduction of a statin dose if 2 consecutive values for LDL-C are < 40 mg/dL (after overcompliance has been ruled out).


Usually additional tests are not indicated unless specific signs and symptoms occur:

(1) CK if muscle pain, tenderness, cramping, weakness or fatigue develop

(2) liver function tests for signs of hepatitis develop


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