title: Atorvastatin-induced acute elevation of hepatic enzymes and the absence of cross-toxicity of pravastatin.
abstract: Atorvastatin has been associated with liver injury. We reported here two cases of aminotransferases elevation within 12 h of low-dose atorvastatin therapy. Liver functions were fully recovered to the baseline level 11 days after discontinuation of atorvastatin treatment. The possible relative risk factors included advanced age, chronic and systemic diseases, and co-administration of cytochrome P450 3A (CYP3A) enzyme-dependent metabolic drugs or its inhibitors such as clopidogrel and diltiazem. No significant transaminase elevation was observed after switching to pravastatin. Thus, pravastatin might be safer than atorvastain in patients with chronic or systemic diseases, or with co-administration of CYP3A enzyme-dependent drugs.
authors.affiliation: Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Liu
authors.forename: Z
authors.initials: Z
authors.lastname: Cheng
authors.forename: L
authors.initials: L
authors.lastname: Ding
authors.forename: F
authors.initials: F
authors.lastname: Fang
authors.forename: K-A
authors.initials: KA
authors.lastname: Cheng
authors.forename: Q
authors.initials: Q
authors.lastname: Fang
authors.forename: G-P
authors.initials: GP
authors.lastname: Shi
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D000469:Alkaline Phosphatase / Q000097:blood; D000069059:Atorvastatin; D051544:Cytochrome P-450 CYP3A / Q000502:physiology; D006538:Heptanoic Acids / Q000009:adverse effects*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects*; D008099:Liver / Q000187:drug effects* / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D017035:Pravastatin / Q000009:adverse effects*; D011758:Pyrroles / Q000009:adverse effects*
chemical_list: D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin; D051544:Cytochrome P-450 CYP3A; C510163:CYP3A4 protein, human; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase; D017035:Pravastatin