Proteinuria in higher doses particularly 40 mg. Effects on skeletal muscle eg, myalgia, myopathy &
rhabdomyolysis. Patients w/ pre-disposing factors for myopathy/rhabdomyolysis: Renal impairment, hypothyroidism, personal or family history of hereditary muscular disorders, previous history of muscular toxicity w/ another H MG-CoA reductase inhibitor or fibrate, alcohol abuse, age >70 yr, situations where an increase in plasma levels may occur, concomitant use of fibrates. If creatinine kinase levels are significantly elevated at baseline (>5 x ULN) treatment should not be started. Not recommended in concomitant w/ fibric acid derivatives including gemfibrozil, ciclosporin, nicotinic acid, azole antifungals, protease inhibitors & macrolides. Do not use in any patient w/ acute, serious condition suggestive of myopathy or predisposing to the development of renal failure secondary to rhabdomyolysis (eg, sepsis, hypotension, major
surgery, trauma, severe metabolic, endocrine & electrolyte disorders; or uncontrolled seizures). Patients who consume excessive quantities of alcohol &/or have a history of liver disease; secondary hypercholesterolaemia caused by hypothyroidism or nephrotic syndrome. Increased exposure in Asian patients. Galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption. Interstitial lung disease w/ long-term therapy. Patients at risk (fasting glucose 5.6-6.9 mmol/L, BMI >30 kg/m2
, raised triglycerides, HTN). Childn <10 yr.