While generally noted in the first 3 months of statin therapy initiation, elevated aminotransferases have been observed to return to baseline in approximately 70% of patients with continued statin therapy, and in other cases, return to baseline with medication cessation.
Fortunately, severe liver injury is uncommon with statin use and is generally reversible without any intervention other than offending statin cessation.
The incidence of true liver injury caused by statin therapy is low (about 1 percent).
Of all statins, simvastatin and atorvastatin are responsible for most reported incidents of liver damage, but this is likely just due to the fact that they are prescribed the most.
Liver damage
Occasionally, statin use could cause an increase in the level of enzymes in the liver. These enzymes signal inflammation. If the increase is only mild, you can continue to take the drug. Rarely, if the increase is severe, you may need to try a different statin.
Which statin is safest for the liver? A low-dose statin like atorvastatin (Lipitor®) is safe for most patients, including those with mild liver enzyme abnormalities. Many people have fatty liver disease due to obesity.
Simvastatin, lovastatin, fluvastatin, and atorvastatin are metabolized by cytochrome P-450, while pravastatin, rosuvastatin, and pitavastatin remain almost unaffected by any hepatic metabolic processes.
Your healthcare provider may recommend stopping your statin if you have serious side effects. Sometimes they may suggest switching to a different statin, lowering your current dose, or changing to a different cholesterol-lowering treatment.
Side effects can vary between different statins, but common side effects include: headache. dizziness. feeling sick.
High-density lipoprotein (HDL) particles are called "good" cholesterol because some of them remove cholesterol from circulation and from artery walls and return it to the liver for excretion.
Early Signs of Liver Damage from Medication
Fever. Diarrhea. Dark urine. Jaundice, a condition that occurs when a substance called bilirubin builds up in the blood and causes the skin and whites of the eyes to appear yellow.
Statin therapy is associated with a reduced risk of non-alcoholic fatty liver in overweight individuals.
Carimi says it's best to stick with the medication. He says the risk is too high, even if you're now living a better, healthier lifestyle. However, if you haven't had a stroke or heart attack and you are taking statins due to high cholesterol numbers, ending statin use might be an option.
You usually have to continue taking statins for life because if you stop taking them, your cholesterol will return to a high level. If you forget to take your dose, do not take an extra one to make up for it.
If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
High cholesterol levels are considered: too high: between 5 and 6.4mmol/l. very high: between 6.5 and 7.8mmol/l. extremely high: above 7.8mmol/l.
Fear of side effects and perceived side effects are the most common reasons for declining or discontinuing statin therapy. Willingness to take a statin is high, among both patients who have declined statin therapy and those who have never been offered one.
By Lauran Neergaard • Published March 6, 2023
shows the cholesterol-lowering drug Nexletol made by Esperion Therapeutics Inc. Drugs known as statins are the first-choice treatment for high cholesterol but millions of people who can't or won't take those pills because of side effects may have another option.
Joseph A. Hill, M.D., Ph. D. The controversy in the United Kingdom started in 2013 when the British Medical Journal (BMJ) claimed statins were being overprescribed to people with low risk of heart disease, and that the drugs' side effects were worse than previously thought.
The American College of Cardiology and American Heart Association developed some prescription guidelines. Typically, if a person's LDL cholesterol (bad cholesterol) is 190 or higher, they're often advised to start a statin.
Although both atorvastatin and simvastatin have been studies, promising evidence exists supporting the use of atorvastatin in not only preventing cardiovascular events but also in slowing liver disease progression.