The figure below provides statin specific statin-associated musculoskeletal symptoms (SAMS) risk, also known as statin-induced myopathy risk, based on SLCO1B1 predicted phenotype and statin intensity.
Recommendations for new start or dose changes in statin therapy
This figure is for starting, changing dose, or selecting alternative statin therapy, for more specific recommendations see each individual statin table below, especially for fluvastatin and rosuvastatin, which utilize additional pharmacogenetic information.
Recommendations for patients on existing statin therapy
For patients on existing moderate SAMS risk statin therapy, if the statin has been continued at a stable dose for 4 weeks without symptoms suggestive of SAMS it may be reasonable to continue the moderate SAMS risk statin therapy, while if dosing has continued for less than 4 weeks clinicians can consider changing the statin or dose to a low SAMS risk regimen that meets the appropriate guideline recommended intensity.
For patients on existing high SAMS risk statin therapy, if the statin has been continued at a stable dose for at least 1 year without symptoms suggestive of SAMS it may be reasonable to continue the high SAMS risk statin therapy, while if dosing has continued for less than one year clinicians can consider changing the statin or dose to a low SAMS risk regimen that meets the appropriate guideline recommended intensity.

Reference
- Cooper-DeHoff RM et al. Clin Pharmacol Ther. 2022 May;111(5):1007-1021. PMID: 35152405.