The National Cholesterol Education Project6 states that “the incidence of clinically important transaminase elevations in the large statin trials is the same for statins as for placebo. Progression to liver failure is exceedingly rare, if it occurs.” They further state that the use of statins for persons with decompensated liver disease or advanced cirrhosis depends on clinical judgment, but that their use in NASH is considered safe.
The FDA states that statins are contraindicated in cholestasis and active liver disease, and that statins should be discontinued when liver enzymes increase to 3 times the upper limits of normal.
