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).
Simvastatin, lovastatin, fluvastatin, and atorvastatin are metabolized by cytochrome P-450, while pravastatin, rosuvastatin, and pitavastatin remain almost unaffected by any hepatic metabolic processes.
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.
A low-dose statin like atorvastatin (Lipitor®) is safe for most patients, including those with mild liver enzyme abnormalities.
Bempedoic Acid: A Statin Alternative to Reduce Cholesterol
Bempedoic acid is sold under the brand name Nexletol on its own and as a combination drug with ezetimibe called Nexlizet.
The incidence of true liver injury caused by statin therapy is low (about 1 percent).
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.
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.
Acetaminophen. Taking acetaminophen in excess is the leading cause of drug-induced liver injury.
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.
While statin-induced hepatocellular liver injury is predominantly self-limiting and generally resolves within 6 months of offending agent cessation, some cases had autoimmune features and were treated with a brief steroid course to accelerate resolution.
A Statin Alternative Lowers Heart Attack Risk by 23 Percent, Drug Trial Shows. People who can't or won't take statin medications to reduce LDL cholesterol may want to talk to their doctor about bempedoic acid (Nexletol).
Cholesterol-enriched lipoproteins deliver cholesterol to the liver via the LDL receptor for further metabolism and biliary excretion (Fig.
Statins should not be taken if you have liver disease or if blood tests suggest that your liver may not be working properly. This is because statins can affect your liver, and this is more likely to cause serious problems if you already have a damaged liver.
Clinical and experimental studies have indicated that statins may be beneficial in preventing NAFLD, NASH and fibrosis. Interestingly, larger effects have been demonstrated for higher dosage and longer duration of statin use, supporting the potential benefits of statin treatment.
Crestor may result in changes in liver function and in some cases, may cause liver failure. Liver problems are most common during a patient's first three months taking Crestor. It is recommended that doctors perform liver enzyme testing before patients begin a Crestor regimen.
Statin can promote hepatic lipogenesis, which influences the hepatic LDL receptor expression. These effects may increase hepatic fatty infiltration. The impact of statin therapy on hepatic histology in non-alcoholic fatty liver disease is unclear [9] [10] [11] [12].
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.
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.
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].
The new bempedoic acid drug – currently called Nexletol – is being developed by US-based Esperion Therapeutics and will go to the Therapeutics Goods Administration for approval for use in Australia.
MONDAY, March 6, 2023 (HealthDay News) -- Not everyone can tolerate statins to reduce their high cholesterol, but now a new study finds the medication bempedoic acid (Nexletol) reduced the combined rate of bad cardiovascular events by 13%.
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.