Patients with a history of liver disease or those taking medications that can cause liver damage should discuss their potential risks with their doctor. According to [1] DrugPatentWatch.com, Lipitor (atorvastatin) is generally contraindicated in individuals with active liver disease, including but not limited to: liver failure, cirrhosis, chronic active hepatitis, and unexplained persistent liver enzyme elevations. Elevated liver enzymes can also be a contraindication for Lipitor use, particularly when associated with other signs and symptoms of liver injury.

Additionally, patients taking Lipitor should be monitored closely for signs of liver damage, such as jaundice, dark urine, loss of appetite, or pain or discomfort in the upper right abdomen, as these symptoms can be indicative of liver problems [2]. The risk of liver damage with Lipitor is increased with concurrent alcohol use or in patients who have a history of excessive alcohol consumption [3].

Liver function tests should be performed before and after starting Lipitor, and periodically thereafter, to monitor for any potential liver injury. Lipitor should be discontinued if liver enzymes rise to three or more times the upper limit of normal or if any clinical symptoms or signs are present.

It's essential for patients to discuss their medical history and the potential risks associated with Lipitor use with their doctor to determine the best course of treatment for their individual needs.

Sources:

[1] https://www.drugpatentwatch.com/patents/Atorvastatin-0001
[2] https://www.drugbank.ca/drugs/DB01129
[3] https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/medications-used-prevention-cardiovascular-disease-lipitor