Self-medication to lower LDL cholesterol and to treat statin-associated muscle symptoms in patients with statin intolerance.

Background: Self-medication with supplements or over-the-counter drugs is very frequent despite limited evidence on efficacy and safety. Patients with statin intolerance (SI) may be prone to self-medication to lower low-density lipoprotein cholesterol (LDL-C) and to treat statin-associated muscle symptoms (SAMS).

Objective: To evaluate the use and predictors of self-medication in the prospective, multicenter Statin Intolerance Registry at baseline.

Methods and results: Among 1111 patients (mean age 66.1 [9.9] years, 57.7% female), 67.2% reported use of self-medication to lower LDL-C (43.8%, n = 487) or to treat SAMS (53.2%, n = 592). The most frequent self-medications used to treat SAMS were pain medication (31.1%), electrolytes (25.9%), and vitamin D (23.0%). The most commonly used supplements to lower LDL-C were omega-3 fatty acids (28.8%) and ginger/garlic (17.6%). Reporting self-medication was strongly associated with depressive symptoms (patient health questionnaire [PHQ-9] score) and experience of negative statin-related information. Use of self-medication to lower LDL-C was not associated with lower LDL-C levels. More than half (54.0%) of the patients reported negative statin-related influence from other people (mainly family and friends), the media, or both, which was associated with more frequent self-medication but similar LDL-C concentrations.

Conclusions: The majority of patients with SI used self-medication to lower LDL-C or to treat SAMS. Self-medication was not associated with lower LDL-C levels. Proactive communication and education on the limited efficacy and safety of supplements may be needed to support the utilization of lipid-lowering medications with proven cardiovascular benefits.