statins and myasthenia gravis

Last edited 09/2023 and last reviewed 10/2023

Statins and myasthenia gravis

Globally, there has been a very small number of reports of new-onset or aggravation of pre-existing myasthenia gravis with atorvastatin, pravastatin, lovastatin, fluvastatin, simvastatin, rosuvastatin and pitavastatin (single-ingredient and fixed-dose combination products) (1)

• patients who are taking statins should be advised to be alert to new symptoms for myasthenia gravis, or worsening symptoms of pre-existing myasthenia gravis, and to seek medical advice if these occur (1)

Advice for healthcare professionals (1):

• there have been some suspected reports of new-onset or aggravation of pre-existing myasthenia gravis or ocular myasthenia associated with statin use; the current frequency of these adverse events is not known but given the extensive use of statins in the population, the reports are understood to be very infrequent
  
  
• the majority of UK reports note that the patient recovered after stopping statin treatment, while a minority continued to experience symptoms; recurrence of symptoms has been reported when patients restarted on the same or a different statin
  
  
• refer patients presenting with suspected new-onset myasthenia gravis after starting statin therapy to a neurology specialist – it could be necessary to discontinue statin treatment depending on the assessment of the individual benefits and risks
  
  
• advise patients with pre-existing myasthenia gravis to be alert to aggravation of symptoms while taking a statin - it could be necessary to discontinue statin treatment depending on the assessment of the individual benefits and risks
  
  
• report suspected adverse drug reactions associated with statins on a Yellow Card

Reference:

• Drug Safety Update volume 17, issue 2: September 2023: 1.