statin and liver

Q: 54 years old male with a history of coronary artery disease (CAD) and on statins is admitted to ICU for chest pain. Review of the chart shows that patient's last liver function was checked two years ago. Patients on statin therapy should have their liver enzymes checked periodically?

A) True

B) False

Answer: B

The recent Food and Drug Administration (FDA) guidelines advise doing a liver function test (LFT) only before starting statin therapy and later ONLY if clinically indicated. It is recommended that statin should be either changed or the dose should be lowered if the ALT level goes beyond three times the upper limit of normal on two occasions. 

The risk of liver injury and need for follow-up is highest in the first 12 weeks, though the risk of complete liver failure is very low.

#hepatology

#pharmacology

References:

US Food and Drug Administration. FDA Drug Safety Communication: Important safety label changes to cholesterol-lowering statin drugs. February 28, 2012. Available at: http://www.fda.gov/Drugs/DrugSafety/ucm293101.htm (Accessed on February 2, 2023).