Lipid-Lowering Agents That Cause Drug-Induced Hepatotoxicity

Abstract

The effort to reduce cardiovascular risk factors, including hyperlipidemia, has led to the increased use of lipid-lowering agents. Hyperlipidemic patients often have underlying fatty liver disease, however, and thus may have elevated and fluctuating liver biochemistries. Therefore, caution should be applied before attributing elevated liver tests to lipid-lowering agents. Data indicate that patients who have chronic liver disease and compensated cirrhosis should not be precluded from receiving statins to treat hyperlipidemia. Several recent studies and expert opinion currently fully endorse statin use in patients who have nonalcoholic fatty liver disease and other chronic liver disease if clinically indicated.

HDL abnormalities in nephrotic syndrome and chronic kidney disease

“…The most common adverse effect of niacin is skin flushing, which occurs in the majority of patients 115 . In addition, niacin can cause hepatotoxicity, hyperuricaemia, and hyperglycaemia 116,117 . The induction of hyperglycaemia and new onset diabetes mellitus by high doses of niacin can be harmful in patients with CKD, both with or without diabetes mellitus 118 .…”

To Study the Prevalence of Non-Alcoholic Fatty Liver Disease in Type 2 Diabetes and to Correlate it with Lipid profile and Glycated Hemoglobin in a Hospital

“…Our study also showed that there is no significant elevation of liver enzymes in statin group as feared due to the rare and dose related hepatotoxicity of statin. Some studies also showed that statins can cause diabetes mellitus and glucose intolerance, but in our study group all were DM-2 and they did not show elevated HbA1c levels as compared to non statin group [27][28][29][30] .…”

Withholding Statins in Patients with Underlying Liver Disease: Wise or Unwise?

“…Ironically, several of these alternative agents are associated with clinically apparent hepatotoxicity as well (10). Maybe, it is just time for us to remember that more than nearly 1,000 drugs have been linked to abnormalities of liver function tests, the vast majority of which are only mild in nature.…”