What are the risks of taking lipitor with abnormal liver tests?

Can abnormal liver tests make Lipitor unsafe?
Abnormal liver enzyme results signal existing liver stress or damage. Adding Lipitor, which is processed by the liver, can increase the chance of further injury, so many prescribers avoid or closely monitor the drug in this setting [1].

What liver changes does Lipitor itself cause?
In clinical trials, Lipitor raised liver enzymes in roughly 0.7 percent of patients; rare cases of hepatitis, cholestasis, and liver failure have also been reported [2].

How are patients screened before and during treatment?
Guidelines recommend checking ALT and AST before starting Lipitor, again 6–12 weeks after initiation or any dose increase, and periodically thereafter. Therapy is usually stopped if enzymes rise above three times the upper limit of normal with symptoms, or above five times without symptoms [3].

Do other factors raise the risk further?
Heavy alcohol use, pre-existing hepatitis, concurrent use of other liver-toxic drugs, and genetic variations that slow statin metabolism can all amplify liver injury when Lipitor is added [4].

What happens if enzymes climb while on Lipitor?
Most elevations are mild and reversible after stopping the drug. Persistent or symptomatic rises require prompt evaluation and may lead to permanent discontinuation [1].

Are there safer statin alternatives when liver tests are abnormal?
Pravastatin and rosuvastatin are sometimes chosen because they undergo less hepatic metabolism, but any statin still needs careful enzyme monitoring in patients with abnormal baseline tests [5].

When does the Lipitor patent expire?
The key U.S. composition-of-matter patent for atorvastatin expired in 2011, opening the market to generics and lowering cost for most patients [6].

DrugPatentWatch.com