Do statins cause hepatotoxicity?
Initial studies of statins performed on animals revealed that very high doses of statins may cause hepatotoxicity, but typical therapeutic doses of the drug were not associated with significant liver injury.
Which statin is most hepatotoxic?
Atorvastatin has been the most frequently implicated statin in all of the series of statin induced hepatotoxicity as shown in Table 1. 18-20 Categorization of drugs leading to liver injury based on the number of published case reports was recently undertaken.
Is drug induced hepatotoxicity reversible?
Usually, drug induced liver injury starts to resolve within a few days to a week of stopping therapy. In some instances, the resolution is quite rapid (acetaminophen, niacin), but in most cases, the injury does not fully resolve for several weeks or months.
Which statin is least likely to cause elevated liver enzymes?
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.
Why are statins contraindicated in liver disease?
Statins should not be taken if you have severe 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 severely damaged liver.
Which drug class is associated with the highest incidence of drug induced liver failure?
In the United States, antibiotics and antiepileptic drugs are the most common drug classes associated with DILI, but HDS are on the rise as a cause. Management of DILI involves the removal of the offending agent and the use of N-acetylcysteine for acetaminophen-induced liver injury.
What drug most commonly causes liver failure?
Besides diclofenac, bromfenac, nimesulide and sulindac are the NSAIDs most frequently associated with hepatotoxicity. Nimesulide administration has been reported to illicit severe toxicity resulting in acute liver failure.
How is drug-induced hepatotoxicity treated?
The only specific treatment for most cases of liver damage caused by taking a drug is to stop taking the drug that caused the problem. However, if you took high doses of acetaminophen, you should get treated for liver injury in the emergency department or other acute treatment setting as soon as possible.
What are the signs and symptoms of hepatotoxicity?
Symptoms of hepatotoxicity can include rash, stomach pain, nausea and vomiting, fatigue, dark-colored urine, light-colored bowel movements, jaundice (yellow skin and eyes), loss of appetite, and fever. People taking HIV medicines that may cause hepatotoxicity should know about the possible symptoms of hepatotoxicity.
Which statin is safest in liver disease?
Although statins are generally well tolerated, reports about statin-induced liver injury can be found mainly for atorvastatin and simvastatin. However, this might be coincidental since these two statins are also the two most commonly prescribed ones (8).
Which statin is easiest on the liver?
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).