In this large population-based study of simvastatin initiators, current
users of 40mg simvastatin dailywere about five times as likely to be admitted
to hospital with, or die from, rhabdomyolysis as those taking
20 mg. The matched odds ratio (adjusted for socio-economic position
and a history of renal failure or impairment) in the case–control analysis
was 5.3 (95% CI 1.9–15.0). The absolute excess risk of rhabdomyolysis
associated with the use of the higher dose of simvastatin was about 10
per 100,000 person-years; the crude incidence rates in current users
of 20 mg and 40 mg were 2.1 (95% CI 0.7–4.8) and 11.5 (95% CI
7.1–17.5) per 100,000 person-years respectively.