Statin-induced myopathy risk

SLCO1B1 ferries statin drugs into the liver. A reduced-function variant lets statins build up in the blood, raising the chance of muscle pain, most relevant for simvastatin.

Possible results

Normal statin response. You have the normal-function version of SLCO1B1, the transporter that moves statin drugs into your liver. Statins are cleared as expected, so your risk of statin-related muscle problems from this gene is typical.

Higher statin muscle-pain risk. You carry one copy of a variant that slows how your liver takes in statin medications, especially simvastatin. The drug can build up to higher levels in your blood, which raises the chance of muscle aches if you take it. If you're ever prescribed a statin, it's worth mentioning to your doctor, who might choose a lower dose or a different one.

High statin muscle-pain risk. You have two copies of the reduced-function SLCO1B1 variant, so statins (especially simvastatin) clear slowly and can build up, raising the risk of muscle pain or weakness. If you ever need a statin, this is important to share with your doctor, who can usually pick a statin and dose that suit you.

Evidence & sources

Across global populations, about 2% of people carry two copies of this variant, and about 74% carry none.

CPIC provides dosing guidance for simvastatin based on this gene.

This variant appears in 65 published genetic studies: PubMed 18650507 · PubMed 19414484 · PubMed 22829776 · PubMed 23093944 · PubMed 23823483 · PubMed 24816252 · PubMed 27073872 · PubMed 28429243 · PubMed 29507422 · PubMed 30275531 · PubMed 30367059 · PubMed 30595370 · PubMed 31220337 · PubMed 31578528 · PubMed 31628463 · PubMed 31959995 · PubMed 32042192 · PubMed 32047095 · PubMed 32154731 · PubMed 32888493 · PubMed 32888494 · PubMed 32961594 · PubMed 33031748 · PubMed 33177712 · PubMed 34321204 · PubMed 34337532 · PubMed 34503513 · PubMed 34563731 · PubMed 34594039 · PubMed 34887591 · PubMed 35050183 · PubMed 35078996 · PubMed 35192695 · PubMed 35213538 · PubMed 35347128 · PubMed 35652242 · PubMed 35668104 · PubMed 35942816 · PubMed 36224396 · PubMed 36357675 · PubMed 36635386 · PubMed 36653534 · PubMed 36764567 · PubMed 37253714 · PubMed 37277652 · PubMed 37524825 · PubMed 37963177 · PubMed 38116116 · PubMed 38448586 · PubMed 38493369 · PubMed 38658550 · PubMed 38711861 · PubMed 39024449 · PubMed 39091897 · PubMed 39406924 · PubMed 39414775 · PubMed 39644095 · PubMed 39789286 · PubMed 39927731 · PubMed 40229599 · PubMed 40316537 · PubMed 40360795 · PubMed 40436827 · PubMed 40545721 · PubMed 41044249.

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