Statins are widely used to lower “bad” (LDL) cholesterol in order to prevent heart attacks and strokes. The most common side effects of the statins are gastrointestinal — nausea, gas, upset stomach. Less common are headache, dizziness, rash, and sleep disturbances.
Statins work by blocking a substance your body needs to make cholesterol. They may also help your body reabsorb cholesterol that has built up in plaques on your artery walls, preventing further blockage in your blood vessels and heart attacks.
Statins include well-known medications such as atorvastatin (Lipitor), simvastatin (Zocor), lovastatin (Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor) and others. Lower cost generic versions of many statin medications are available.
Most doctors believe that statins are safe for long-term use, and important liver injury is rare. Nevertheless, statins can injure the liver. The most common liver-related problem caused by statins is mild elevations in blood levels of liver enzymes (ALT and AST) without symptoms. Clinical studies have found elevations in 0.5% to 3% of patients who take statins.
If the increase is only mild, you can continue to take the drug. If the increase is severe, you may need to stop taking it, which usually reverses the problem. If left unchecked, increased liver enzymes can lead to permanent liver damage. Certain other cholesterol-lowering drugs, such as gemfibrozil (Lopid) and niacin, increase the risk of liver problems even more in people who take statins.
Patients with obesity have an increased chance of developing diabetes, non-alcoholic fatty liver disease (NFALD), and elevated blood cholesterol levels. Patients with fatty liver often have no symptoms, and the abnormal tests are discovered when routine blood testing is done. Recent studies have found that statins can be used safely to treat high blood cholesterol in patients who already have fatty liver and mildly abnormal liver blood tests when the statin is started. In these patients, doctors may choose to use statins at lower doses and monitor liver enzyme levels regularly during treatment.
Nevertheless, idiosyncratic liver toxicity capable of causing severe liver damage (including liver failure leading to liver transplantation) has been reported with statins. The frequency of severe liver disease caused by satins is likely in the range of 1-2 per million users. As a precaution and because liver problems may develop without symptoms, the FDA labeling information advises that liver enzyme blood tests should be performed before and 12 weeks following the initiation of statin treatment or increase in dose, and periodically thereafter (for example, every six months.)
If you have been diagnosed with high cholesterol and are prescribed a statin such as Crestor, be sure that you are faithful to your blood draws and keeping your doctors up to date on all side effects you may be experiencing. This drug may also have interaction with other drugs, so be sure to tell your pharmacist right away if you are taking it. It is also not recommended you stop taking it on your own, unless your doctor informs you to do so. If you need more information about this drug, please speak with your pharmacist or your doctor as soon as possible.
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