Statins, Muscle Pain and CoQ10; What You Need To Know

Here is a side effect of medications we should all be aware of; “up to 75% of people who take a statin medication to treat elevated cholesterol will suffer from muscle pain”.  Statins are currently the most effective medication available to decrease low density lipids.  They work by partially inhibiting the ability of the liver to produce cholesterol.

The category of medications called statins is well known for causing muscle aches and pains.  It is known that this class of medications may possibly decrease energy production in the muscles.  It is thought that this decrease in energy production may be related to the increase in muscle aches and pain.

If not monitored, this muscle pain syndrome may rarely develop into rhabdomyolysis.  Rhabdomyolysis is a condition that involves the breakdown of muscle fibers and their release into the blood system.  This may be damaging to the kidneys when the body attempts to filter the broken down muscle products out of the blood stream.

The first issue that comes up here is the fact that many people will stop taking their statin medications the moment they begin to feel any muscle pain.  These are important medications and work to help decrease the buildup of cholesterol on our blood vessel walls.  This buildup of cholesterol may lead to a heart attack or a stroke. 

Please, if you are taking a statin medication and begin to feel some muscle ache or pain, call your doctor or pharmacist to discuss your options before stopping your medication.  This is important therapy and there are a few different medications to choose from.  Some of the choices may be less likely to cause muscle ache and pain in different individuals.

The second issue that comes up is the understanding that people being treated with statin therapy have low levels of Coenzyme Q 10 (CoQ10).  CoQ10 is produced by the body and is necessary for the basic function of cells.  The unproven assumption is that if a patient supplements with CoQ10, this replacement therapy may help decrease the muscle aches and pains.

Some small anecdotal studies have shown that taking CoQ10 supplementation with your statin may reduce the muscle aches and pains associated with therapy.  The issue is, there have been no large, double-blind studies to support this theory.  Current medical guidelines do not recommend routinely taking CoQ10 as a supplement along with your statin therapy.

More importantly, CoQ10 is considered a dietary supplement under the Dietary Supplement Health & Education Act of 1994 (DSHEA).   This act clearly states that a company may make a claim about their product without having done studies or trials as long as the claim fits the appropriate wording.  Furthermore, the company does not need to get FDA approval before they produce and market their product.  It is the responsibility of the FDA to search out new products, test them for their “claims” and “product integrity” and then have the company pull them off the market if they do not meet standards.  This process may sometimes take months and even years.  The dietary supplement market is truly a Buyer-Be-Ware marketplace.

Bottom line; many people have testimonials about how well CoQ10 has worked for them to help their muscle aches and pains while they are taking their statin medications.  If you are taking a statin medication and begin to feel any aches and pains, please contact your doctor or pharmacist to discuss your options.

If you would like to listen to a Medication SpecificCounseling SessionTM discussing a specific statin medication, please registerto become a member of AudibleRxTM and then have full access to all of the counseling sessions for a full five years.   


Copyright AudibleRx (TM), all rights reserved. Please do not copy or publish or distribute without consent and approval from AudibleRx (TM).

Not likely, but why take the chance? (Penicillin Allergy)

The other day my technician called for a consult at the counseling counter, as they regularly do.  I approached the counter and began my discussion with the middle aged lady about her antibiotic prescription for her prolonged sinus infection.  She had been prescribed Amoxicillin/Clavulanate (AugmentinTM) to treat her sinus infection.

So, we are at the counter and we are discussing why she is to take this particular antibiotic, how she takes it, what to look for to tell if it is or isn’t helping and a host of other important counseling information we discuss during a face-to-face counseling session with a patient about their new medication.  Before we are complete, I ask if she has any medication allergies.   For me, this is a redundant check, knowing that the patient should have already been asked this question 2 or 3 times today before getting to this point. 

Usually, a patient is asked about allergies by the nurse when they are taken into the exam room, by the prescribing physician when they are deciding which antibiotic is appropriate for this specific clinical condition and at the pharmacy intake counter if this is a new patient.  Furthermore, when the prescription is keyed into the computer profile there is a verification process that would flag the medication as inappropriate if there is an allergy to the medication, and then when the pharmacist fills or verifies the prescription we are able to check the allergy list on the patients receipt list.

Back to the question; I ask the patient if she has any allergies to any medications.  She states, yes, she is allergic to penicillin.  She states she thought it was in her chart and was sure the physician knew about it; however, she did not remember talking with the doctor or nurse about her allergies today.  I looked in the pharmacy computer and there was no documentation of penicillin allergy listed.  We have filled a few prescriptions for her over the past few years; however, she was not a regular monthly patient.

We discuss her allergy.  She states that she remembers her mother telling her that she had an allergic reaction to penicillin when she was in grade school.  She does not remember what the reaction was.   I followed up with a phone call to the patient’s physician.  The physician was skeptical of the allergy; yet grateful for the phone call.  He changed the antibiotic to azithromycin (ZithromaxTM), which is not related to penicillin’s yet is still effective for sinus infections.

We returned the amoxicillin/clavulanate prescription, processed the azithromycin prescription and then proceeded to have another counseling session at the counter.  Again, when we were done I verified that the patient does not have any allergies to azithromycin or its related antibiotics.  She stated no, only to penicillin’s. 

To learn more about specific antibiotics, or any other medication you may be interested in, please register to become amember of AudibleRxTM and then have full access to all of the Medication Specific Counseling SessionsTM.   Please visit the Medications Page at the AudibleRxTM website to see which counseling sessions are currently available.

Thanks for your support!


Copyright AudibleRx (TM), all rights reserved. Please do not copy or publish or distribute without consent and approval from AudibleRx (TM).

Blood Pressure & Renin (is there a connection?)

Has anyone ever heard the term Renin-Angiotensin-Aldosterone system (RAAS)? Maybe, or maybe not, however, this is a hormone system in your body that helps regulate fluid balance and blood pressure. After reading this blog, I hope that you will have just a little more amazement of all that our body does to keep us alive…while we are focusing on other seemingly important issuesJ

When the body recognizes that the blood volume is too low (i.e., when blood pressure is low), the kidneys release a substance called renin. The renin is then circulated through the blood stream and interacts with another substance called angiotensinogen, which comes from the liver.

The interaction of renin and angiotensinogen forms a substance called angiotensin. Next, a substance called angiotensin converting enzyme interacts with angiotensin and this forms a substance called angiotensin 2.

Finally, this substance called angiotensin 2 works directly on the blood vessels, causing them to constrict, which increases the blood pressure. Angiotensin 2 also stimulates the production of aldosterone from the adrenal cortex.

Aldosterone works on the kidneys to decrease the amount of sodium that is lost in the urine. This increases the amount of sodium circulating in the blood stream which in turn increases the volume of blood which will increase the blood pressure.

In a healthy individual this system works well to maintain adequate blood pressure. In an individual with slightly elevated blood pressure, an increase in the levels of angiotensin 2 will only aggravate the situation, increasing the blood pressure higher than is considered normal for prolonged and healthy living.

I took the time to discuss all of this so that you might have an idea of what the classification of some anti-hypertensive drugs means. I currently have two categories of medications used to decrease blood pressure listed on AudibleRx. Both categories work on the RAAS (renin-angiotensin-aldosterone system).

The first category is the ACE inhibitors (angiotensin converting enzyme inhibitors). These block the conversion of angiotensin to angiotensin 2. As we remember from above, angiotensin 2 works to constrict blood vessels. This class of medications limits the production of angiotensin 2, and therefore, it is helping to relax blood vessels.

The second category is the ARB's (angiotensin 2 receptor blockers). This class of medications works directly on the blood vessel, blocking the effects of angiotensin 2. By blocking angiotensin 2, the blood vessels are not stimulated and therefore stay relaxed.

Medication Specific Counseling Sessions™ for both of these categories can be found in the membership area of AudibleRx. Please visit and register to become a member. Membership allows full access to all of the Medication Specific Counseling Sessions.

ACEI's (angiotensin converting enzyme inhibitors)

  • Benazepril (Lotensin-tm)
  • Enalapril (Vasotec-tm)
  • Lisiniopril (Prinivil-tm, Zestril-tm)
  • Quinapril (Accupril-tm)
  • Ramipril (Altace-tm)
ARB's (angiotensin II receptor blockers)

  • Candesartan (Atacand-tm)
  • Irbesartan (Avapro-tm)
  • Losartan (Cozar-tm)
  • Olmesartan (Benicar-tm)
  • Valsartan (Diovan-tm)

Copyright AudibleRx, all rights reserved. Please do not copy or publish or distribute without consent and approval from AudibleRx.

Year One

When I began AudibleRxTM back in July of 2011 I really had no idea what I was getting myself into.  I had the simple idea that I wanted to bring Medication Specific Counseling SessionsTM, in audio format, to the general public, with the intent of helping folks understand what they do and don’t know about their medications so they may take educated questions back to their own pharmacist or doctor. 

After a bit of research, I realized that one of the best ways to get the word out about my product was to start a blog page.  According to Google, the idea is to blog, twice weekly, for at least 12 months.  This will help increase the ranking in internet search engines and help my site be found.  Then, once someone is at the AudibleRxTM blog page, they may then click through to the counseling website.

So, I have been blogging twice weekly (almost each week) for over 12 months now.  The process is beginning to work.  I have and am receiving many clicks on my blog and quite a bit of follow through to my counseling website! 

Over the past year I have put focus on many important broad topics that surround pharmacy each and every day such as:

Dietary Supplements
Mail-Order Pharmacy
Medication Responsibility
Community Pharmacy
…and many, many other topics.

I also covered quite a few topics that are of a day to day practical nature such as:

Pill Color
Black Box Warning
Medication Storage
Grapefruit & Medications
Sunscreen Numbers
…along with others.

Of course, I have also discussed many Medication Topics.  When new Medication Specific Counseling SessionsTM are added to the counseling page website, they are introduced with the blog.  I take a moment to describe the disease state and how the medications work.  I then provide a link to the counseling page website if there is any interest in learning more about that particular category of medications.

This coming year I am going to relax a little on the frequency of my blogs.  My goal is to write at least three blogs each month, and the focus will be on Medication Topics.   I am putting my effort at developing more counseling sessions.  I would like to provide counseling sessions for the top 20% of the medications that comprise 80% of all prescriptions written.  I currently have most of the top 100 medications prescribed and will be there soon!

Individual membership is a good deal.  Signing up with AudibleRxTM for $14.95 gives you complete access to all of the Medication Specific Counseling SessionsTM.  

Group membership is another direction AudibleRxTM is heading.  A group membership might be used in one of the following situations.

  • Community Pharmacy where the Pharmacist would like to give their patients access to audio information along with their written information following their own medication counseling session. This would allow patients an afterhour’s method of listening to a pharmacist talk to them about their medication.
  • Clinic or Office Setting where the practitioner would like to give their patient a way to listen to all of the important counseling information about a specific medication. This would benefit patients who receive samples from the clinic or would like to have a counseling session about a medication before picking it up from their pharmacy.
  • Employer Sponsored Wellness Benefit to encourage their employees to participate in their own pharmaceutical care. This would benefit employees who get their prescriptions via mail order or a big store pharmacy and do not have easy access to a pharmacist. This will help the employees understand the important questions to take back to their own pharmacist or doctor.

If you feel that this may be a benefit to your business or work place in any way, please send me a note and I will forward you a Group Membership Two Month Trial Contract so you may try it out.

Thank you everyone for all of your support!

Copyright AudibleRx (TM), all rights reserved. Please do not copy or publish or distribute without consent and approval from AudibleRx (TM).