In "Label for Simvastatin Revised Again" (Drug Watch, May), Diane Aschenbrenner provides an excellent overview of the recently revised Food and Drug Administration (FDA) guidelines on simvastatin dosing.

She discusses the routine monitoring of liver enzymes and that serum creatinine kinase levels should be monitored periodically within the first year or with dose increments. Yet despite this dogma of routine monitoring of blood work, which was once considered the standard of care for patients on statin therapy, the FDA currently advises against this practice in asymptomatic individuals because it hasn't been shown to be a predictor of rare adverse statin-mediated reactions (http://1.usa.gov/x3VO6H). Although it may be prudent to measure a patient's baseline prior to initiating statin therapy, further laboratory monitoring should only be directed toward those who are symptomatic.

Aalok Patel, MD

Atlanta

Editor's note: The May Drug Watch was written before the FDA's recent revisions to statin labeling. See this month's Drug Watch for further information on the FDA's new recommendations.