Specifically, lipophilic statins (those that dissolve more readily in lipids such as oils and fats) may be more effective for preventing liver cancer than hydrophilic statins (those that dissolve more readily in water).
A low-dose statin like atorvastatin (Lipitor®) is safe for most patients, including those with mild liver enzyme abnormalities.
Large randomized trials have proven the safety of low to moderate doses of lovastatin, pravastatin, simvastatin, atorvastatin, and rosuvastatin, showing no significantly increased risk of liver biochemistry abnormalities.
Atorvastatin is the most common cause of clinically significant liver injury among statins with a reported incidence of 1/17 000 users.
It's possible, although unlikely, that one particular statin may cause side effects for you while another statin won't. It's thought that simvastatin (Zocor) may be more likely to cause muscle pain as a side effect than other statins when it's taken at high doses.
The risk of hepatic injury caused by statins is estimated to be about 1 percent, similar to that of patients taking a placebo. Patients with transaminase levels no more than three times the upper limit of normal can continue taking statins; often the elevations will resolve spontaneously.
If you've made lifestyle changes through diet and exercise that have lowered your cholesterol levels, you may not need to continue taking a statin. These changes can help reduce your risk of heart attack, stroke, or blocked arteries while allowing you to take one less medication.
Before starting to take statins, you should have a blood test to check how well your liver and kidneys are working. You should also have a routine blood test to check the health of your liver 3 months after treatment begins, and again after 12 months.
Statins Effects on Liver Histology in NAFLD Individuals
The majority of these studies were known to show improvement [33, 34]. In one of a larger RCT, atorvastatin and combined treatment (atorvastatin + fenofibrate) were more effective than fenofibrate alone, while they also reduced the liver echogenicity [35].
Statins or 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase inhibitors are one of the most commonly prescribed medications in cardiac patients. Just like any other class of drugs, they have the potential to cause liver injury over time even with judicious use.
Statin therapy is associated with a reduced risk of non-alcoholic fatty liver in overweight individuals.
Atorvastatin or fluvastatin are usually recommended because there is no need to adjust the dose according to the glomerular filtration rate [28]. In patients without diagnosed atherosclerotic cardiovascular disease, it is indicated a moderate dose of statin, such as atorvastatin 20 mg daily [28].
Nexletol: New Drug Lowers Cholesterol Without Side Effects of Statins.
People who are unwilling or unable to take statins have limited options for other cholesterol-lowering medications. One possible choice is bempedoic acid, which was approved by the U.S. Food and Drug Administration (FDA) in 2020.
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. Just take your next dose as usual the following day.
If you're taking a statin medication to lower your cholesterol, you will need to keep taking your prescription, or your cholesterol will likely go back up. Stopping your statin can put you at risk of having heart disease and other preventable health problems like stroke and heart attack from high cholesterol.
If your risk is very low, you probably won't need a statin, unless your LDL is above 190 mg/dL (4.92 mmol/L). If your risk is very high — for example, you've had a heart attack in the past — a statin may be helpful even if you don't have high cholesterol.
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.
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.
People who did take statins consumed more calories and fat over time, and gained more weight. The study also showed that statin users had a faster increase in body mass index (BMI) than those who didn't use statins.
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.
A newer drug called Nexletol was approved in 2020 by the FDA to treat high cholesterol, but the new study published in NEJM shows that the drug also reduces the risk of heart disease. Researchers believe this data supports using Nexletol as a safe and effective alternative for many people who cannot take statins.
Ezetimibe. Ezetimibe is a tablet that lowers cholesterol. It may be prescribed if statins cannot be taken, or alongside a statin for extra cholesterol-lowering. It's a 'cholesterol absorption inhibitor' that limits the absorption of cholesterol in the small intestine.