It turns out that some statins may be better at preventing liver cancer than others. 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.
Atorvastatin causes elevations in transaminases greater than 3-fold the ULN in approximately 0.5% of all cases, with an absolute risk of 1.2% with high-intensity therapy. Atorvastatin is the most common cause of clinically significant liver injury among statins with a reported incidence of 1/17 000 users.
Fortunately, severe liver injury is uncommon with statin use and is generally reversible without any intervention other than offending statin cessation.
Post hoc data from three large prospective randomized clinical trials (n>11, 000) suggest that specific statins (mainly atorvastatin) ameliorate NAFLD/NASH and reduce CVD events twice as much as in those with normal liver function.
Which cholesterol-lowering drug is the safest? Overall, statins are safe as a class of drugs. Serious adverse events are very rare. Among the individual medications, studies have shown that simvastatin (Zocor®) and pravastatin (Pravachol®) seem to be safer and better tolerated than the other statins.
Liver disease: Liver disease can also be a severe side effect of Crestor. Your doctor should do blood tests to check your liver before you start taking Crestor. They should also do these tests if you have symptoms of liver disease while you take the drug.
You wouldn't need any additional liver enzyme tests unless you begin to have signs or symptoms of trouble with your liver. Contact your doctor immediately if you have unusual fatigue or weakness, loss of appetite, pain in your upper abdomen, dark-colored urine, or yellowing of your skin or eyes.
According to a research review people who take simvastatin (Zocor) or pravastatin (Pravachol) may experience fewer side effects.
For the purposes of this definition, the lowest daily starting doses of statins are proposed as rosuvastatin 5 mg, atorvastatin 10 mg, simvastatin 20 mg, lovastatin 20 mg, pravastatin 40 mg, fluvastatin 40 mg, and pitavastatin 2 mg.
Statins are the most common medicine for high cholesterol. They reduce the amount of cholesterol your body makes. You take a tablet once a day. You usually need to take them for life.
The findings suggest that statins are safe to be administered to NAFLD patients including people with increased transaminase (< 3 times - upper limit of normal). The reviewed studies indicate that statins may reduce cardiovascular risk.
Based on currently available data, statin therapy, at low-to-moderate doses, seems to be safe and has low liver toxicity. Treatment of dyslipidaemia in patients with non-alcoholic fatty liver disease is recommended and may also improve liver function tests.
Low dose statins like atorvastatin (Lipitor) are safe in patients with mild liver disease (for example, patients with fatty liver and mildly abnormal liver tests in the blood such as ALT and AST).
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.
The overall risk of DILI with statin use is estimated to be approximately 1 in 100,000 with the estimated risk of ALF being approximately 1 in 1,000,000.
PCSK-9 inhibitors thus reduce cholesterol levels by maintaining higher levels of LDL receptors that remove cholesterol from the blood. Currently, PCSK-9 inhibitors are limited in use as they must be administered as shots. Further research into them could expand their use as an alternative to statins.
"Statin-induced hepatotoxicity is a myth," he wrote in Lancet. About 10% of patients see liver enzymes rise after starting a statin, which can exceed the threshold of three times the upper limit of normal for 1%, but these eventually return to normal even when continuing the same statin, Bader noted.
There are changing data on the occurrence of these negative hepatic effects, recommendations on their actual risk, monitoring required, and safety of use in those with preexisting hepatic disorders. Based on reviewed literature, statins appear to be associated with a very low risk of true and serious liver injury.
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.
A: It's very unlikely that fatty liver is caused by rosuvastatin (Crestor) or any of the other statin drugs. In fact, some studies suggest that low to moderate doses of a statin may actual help heal fatty liver. The medical term for fatty liver is non-alcoholic fatty liver disease (NAFLD).
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.
In extremely rare cases, serious liver injury and even liver failure has occurred with Lipitor. Your risk of abnormal liver function increases with higher doses of Lipitor.