[2014] 1.4.34 Advise people who are being treated with a statin to seek medical advice if they develop muscle symptoms (pain, tenderness or weakness). If this occurs, measure creatine kinase. [2008] 1.4.35 If people report muscle pain or weakness while taking a statin, explore other possible causes of muscle pain or weakness and raised creatine kinase if they have previously tolerated statin therapy for more than 1.4.36 Do not measure creatine kinase levels in asymptomatic people who are being treated with a statin. [2008] 1.4.37 Measure baseline liver transaminase enzymes (alanine aminotransferase or aspartate aminotransferase) before starting a statin. Measure liver transaminase within 3 months of starting treatment and at 12 months, but not again unless clinically indicated. [2008] 1.4.38 Do not routinely exclude from statin therapy people who have liver transaminase levels that are raised but are less than 3 times the upper limit of normal. [2008] 1.4.39 Do not stop statins because of an increase in blood glucose level or HbA1c. (See the recommendations on assessing for risk of diabetes mellitus in NICE's guideline on preventing type 2 diabetes.) [2014] 1.4.40 Statins are contraindicated in pregnancy: Advise women of childbearing potential of the potential teratogenic risk of statins and to stop taking them if pregnancy is a possibility. Advise women planning pregnancy to stop taking statins 3 months before they attempt to conceive and to not restart them until breastfeeding is finished. Intolerance of statins 1.4.41 If a person is not able to tolerate a high-intensity statin aim to treat with the maximum tolerated dose. [2014] 1.4.42 Tell the person that any statin at any dose reduces CVD risk. 