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Female Statin Patient With Muscle Cramping

A 62-year-old woman has a history of peripheral arterial disease and coronary artery disease had three stents placed over the past few years. She is a current smoker with hypertension that's being controlled with metoprolol and lisinopril.

For the past eight years, she has been on 40 mg of atorvastatin daily to treat high cholesterol. She recently visited an urgent care facility and was diagnosed with an upper respiratory infection and placed on clarithromycin.

As a new patient to you, she presents today with muscle cramping in both of her legs and denies any strenuous activity. A check of her creatine kinase revealed that its level was more than four times the upper limits of normal.

What is your diagnosis for this patient? What do you recommend as a treatment plan for her?