Check transaminases at baseline. Unless the patient has chronic stable liver disease, repeat only if signs/symptoms suggesting of hepatotoxicity occur.
Document any pre-existing muscle symptoms before starting a statin to establish a baseline.
If severe muscle symptoms or objective weakness occur, hold the statin and check creatinine kinase.
Check fasting lipid panel four to 12 weeks after statin initiation or dosage change, then every three to 12 months.
Check adherence to statin and lifestyle interventions if LDL drop less than expected. In patients with chronic inflammatory disease or HIV, check fasting lipids before and four to 12 weeks after starting a chronic anti-inflammatory drug or antiretroviral.
Ensure women of childbearing potential know to use reliable contraception, and to stop the statin one to two months before planning a pregnancy, or if they become pregnant.