Statins and elevated liver tests: what's the fuss?
Order liver function tests before starting statin therapy, 12 weeks after initiation, with any dose increase, and periodically for long-term maintenance therapy. Mild elevations of alanine aminotransferase (ALT) or aspartate aminotransferase (AST) (<3 times the upper limit of normal [ULN]) following statin therapy do not appear to lead to significant liver toxicity over time. Other medications that lower low-density lipoprotein (LDL), and might be substituted for statins, may not improve morbidity and mortality.
Onusko
Edward
E
Clinton Memorial Hospital/University of Cincinnati Family Medicine Residency Program, Wilmington, OH, USA. edonusko@cmhregional.com
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood* / Q000187:drug effects; D000924:Anticholesteremic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001219:Aspartate Aminotransferases / Q000097:blood* / Q000187:drug effects; D001291:Attitude of Health Personnel; D056486:Chemical and Drug Induced Liver Injury; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis / Q000517:prevention & control; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D014481:United States; D014486:United States Food and Drug Administration
D000924:Anticholesteremic Agents; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase