Patients With Chronic Liver Disease/Cirrhosis Should Not Take Statin Medications

Abstract

3-Hydroxy-3-methyl-glutaryl-coenzyme A reductase inhibitors, a class of medications commonly known as statins, were originally developed to treat hypercholesterolemia by inhibiting the rate-limiting step in hepatic cholesterol biosynthesis, thus significantly lowering low-density lipoprotein, total cholesterol level, and to lesser extent, triglycerides and high-density lipoprotein. Besides myositis, hepatotoxicity is one of the most well-known potential adverse reactions of statin use. The risk for hepatotoxicity is small, but looms large in the mind of providers because hepatotoxicity is a major source of underprescription in chronic liver disease. Multiple studies have demonstrated the proven benefit of statin medications in decreasing cardiovascular morbidity and mortality. This brief review will help to dispel the misconception that statins are unsafe in chronic liver disease and may, in fact, have benefit in this population.