Emphasizing statin safety in the hospitalized patient: a review

Am J Med. 2012 Sep;125(9):845-53. doi: 10.1016/j.amjmed.2012.02.022.


This review examines the safe use of statin therapy in the hospitalized patient. Available data support initiation of statin therapy during hospitalization in patients with acute coronary syndromes or established cardiovascular disease and in high-risk patients with diabetes mellitus and chronic kidney disease (except for those on maintenance hemodialysis). Because of the increased risk of cardiovascular disease, statins are given to solid-organ transplant survivors and those treated with protease inhibitors for human immunodeficiency virus. However, in the multidrug, acute illness hospital environment, safety considerations become paramount. We review the essentials of statin metabolism and drug-drug interactions to provide the hospital physician with information to minimize potentially serious adverse statin effects.

Publication types

  • Review

MeSH terms

  • Aryl Hydrocarbon Hydroxylases / metabolism
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / prevention & control*
  • Cholesterol, LDL / blood
  • Cholesterol, LDL / drug effects*
  • Cytochrome P-450 CYP2C8
  • Cytochrome P-450 CYP2C9
  • Cytochrome P-450 CYP3A / metabolism
  • Cytochrome P-450 Enzyme System / drug effects
  • Cytochrome P-450 Enzyme System / metabolism*
  • Drug Interactions*
  • Drug Labeling
  • Hospitalization
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects*
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / pharmacokinetics*
  • Immunosuppressive Agents / administration & dosage
  • Inpatients*
  • Kidney / drug effects*
  • Kidney / metabolism
  • Liver / drug effects*
  • Liver / enzymology
  • Meta-Analysis as Topic
  • Muscle, Skeletal / drug effects*
  • Muscle, Skeletal / metabolism
  • Organ Transplantation
  • Patient Education as Topic
  • Patient Safety
  • Randomized Controlled Trials as Topic


  • Cholesterol, LDL
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Immunosuppressive Agents
  • Cytochrome P-450 Enzyme System
  • CYP2C9 protein, human
  • Cytochrome P-450 CYP2C9
  • Aryl Hydrocarbon Hydroxylases
  • CYP2C8 protein, human
  • Cytochrome P-450 CYP2C8
  • Cytochrome P-450 CYP3A
  • CYP3A4 protein, human