Statin induced myotoxicity: the lactone forms are more potent than the acid forms in human skeletal muscle cells in vitro.

Statins exist in both acid and lactone forms in vivo. High plasma levels of the lactone forms have been observed in patients with statin induced myopathy. In the present study, the hypothesis that lactone forms have a higher potency of inducing myotoxicity as compared to acid forms was investigated.