[Statins: hepatotoxicity and monitoring].

Statins are among the most widely prescribed drugs throughout the industrialized world. Their benefits in primary and secondary prevention of cardiovascular events are undeniable. An asymptomatic increase in aminotransferase levels, generally less than 3 times the upper limit of normal range, is often observed in patients receiving statins. It is dose-dependent and often regresses even though treatment continues. A significant increase in aminotransferase levels is very rare in patients receiving statins Cases of hepatocellular, cholestatic, and mixed pattern liver injuries have been described, but severe hepatitis is rare. Cases mimicking autoimmune hepatitis have been described. There is usually no cross hepatotoxicity between the different statins. When indicated, statins may be used in patients with nonalcoholic fatty liver, chronic viral hepatitis or compensated cirrhosis. Statins should not be used in patients with decompensated cirrhosis.