Drug-Induced Liver Injury from Statins

Clin Liver Dis. 2020 Feb;24(1):107-119. doi: 10.1016/j.cld.2019.09.007.


The hydroxymethyglutaryl-coenzyme A reductase inhibitors (statins) are a commonly prescribed class of medication for the treatment of hyperlipidemia and coronary artery disease. This class of medication has several proven benefits, including reduction of mortality related to coronary artery disease. A major consideration when prescribing these drugs are the potential for adverse effects, mainly myalgias, myopathy, and hepatotoxicity. In this article, we summarize current data on statin-associated hepatotoxicity and highlight that the risk of clinically significant idiosyncratic drug-induced liver injury is actually quite small. We also review preclinical data suggesting potential hepatoprotective effects of statin therapy.

Keywords: Drug-induced liver injury (DILI); Hepatotoxicity; Hydroxymethylglutaryl-CoA reductase inhibitors; Liver function test; Statins.

Publication types

  • Review

MeSH terms

  • Alanine Transaminase / blood
  • Alkaline Phosphatase / blood
  • Bilirubin / blood
  • Chemical and Drug Induced Liver Injury / blood
  • Chemical and Drug Induced Liver Injury / etiology*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects*


  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Alanine Transaminase
  • Alkaline Phosphatase
  • Bilirubin