Statins (e.g., Atorvastatin, Simvastatin)
Absolute Contraindications
- Active liver disease
- Pregnancy and breastfeeding
- Severe renal impairment (dose adjustment required)
Main Side Effects
- Muscle toxicity: Myopathy or rhabdomyolysis
– Those at increased risk: Elderly, personal or family hx of muscle disorders, hx of liver disease & high alcohol intake - Hepatotoxicity (elevated liver enzymes)
- GI upset (nausea, diarrhoea)
Main Interactions
- Grapefruit juice (increased toxicity risk)
- Macrolide antibiotics (e.g., clarithromycin) – increased myopathy risk
- Warfarin (may enhance anticoagulant effect)
Main Monitoring Requirements
- Baseline liver function tests and CK (if symptomatic)
- Monitor lipids after 3 months, then periodically
Pregnancy & Breastfeeding
- Contraindicated in both