Atorvastatin 40 → Rosuvastatin 5 mg + ezetimibe 10 mg (14 wks update): Background: Male, 52, coronary artery disease, on atorvastatin 40 mg with persistent thigh... — what worked for others here?
Background: Male, 52, coronary artery disease, on atorvastatin 40 mg with persistent thigh aching (about 5/10) and LDL-C of 71 mg/dL. Protocol: With my cardiologist, I had CK (normal), TSH, vitamin D (24 ng/mL) and ALT checked. I stopped atorvastatin for 3 weeks, and the aching dropped to 1/10. I then started rosuvastatin 5 mg plus ezetimibe 10 mg daily, took vitamin D3 2,000 IU, and stopped a red yeast rice capsule I had been taking on the side. Result at week 14: aching about 1-2/10, LDL-C 58 mg/dL, ApoB 69 mg/dL, ALT normal. Takeaway: the combination gave a larger LDL drop than high-dose single therapy without the muscle burden for me. It is one person's experience and not a recommendation.
FDA DailyMed labeling for ezetimibe (Zetia) reports about an additional 21-25% LDL-C lowering when added to a statin, and the Crestor label lists 5 mg as the lowest approved dose. The 2022 ACC Expert Consensus Pathway supports adding non-statin therapy when LDL-C remains above goal on tolerated statin therapy.