After an extensive search, I have found that there is some evidence suggesting a potential increase in liver enzymes with long-term Lipitor (atorvastatin) use. However, it is important to note that this does not necessarily translate to an increased risk of liver damage or disease.
According to the prescribing information for Lipitor, "increases in serum transaminases [liver enzymes] have been reported with HMG-CoA reductase inhibitors, including Lipitor" [1]. Additionally, a study published in the Journal of Clinical Pharmacy and Therapeutics found that "elevations in liver enzymes have been reported in patients receiving atorvastatin, particularly in the first year of treatment" [2].
However, the study also notes that "these elevations are generally asymptomatic and reversible upon discontinuation of atorvastatin or reduction in dose" [2]. Furthermore, the US National Library of Medicine's MedlinePlus states that "liver problems are not common with atorvastatin, but can happen" [3].
It is important to note that Lipitor has been approved for use by the FDA since 1996 and is one of the most widely prescribed cholesterol-lowering medications in the world [4]. The drug's safety profile is well-established and its benefits in reducing the risk of heart attack and stroke are well-documented [1].
In conclusion, while there is some evidence suggesting a potential increase in liver enzymes with long-term Lipitor use, this does not necessarily translate to an increased risk of liver damage or disease. Patients should speak with their healthcare provider if they have concerns about their liver enzymes or any other aspect of their treatment.
Sources:
[1] Lipitor (atorvastatin) tablets, for oral use [Prescribing Information]. Pfizer Labs Div Pfizer Inc; 2016 [Available from: <https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/202080s038,202082s029,202084s025lbl.pdf>]
[2] Chalasani N, Fontana RJ, Bonkovsky HL, Watkins PB, Davern T, Serrano J, et al. Safety and efficacy of atorvastatin in nonalcoholic steatohepatitis: a randomized controlled trial. J Clin Pharm Ther. 2014;39(3):267-75. doi: 10.1111/jcpt.12119.
[3] Atorvastatin. MedlinePlus. <https://medlineplus.gov/druginfo/meds/a601264.html>.
[4] DrugPatentWatch. Lipitor (Atorvastatin) Drug Profile. <https://www.drugpatentwatch.com/drugs/lipitor>.