Atorvastatin should not be given to patients with active liver disease or unexplained persistent raised serum-aminotransferase concentrations occur. It should be avoided during pregnancy since there is a possibility that it could interfere with fetal sterol synthesis; there have been a number of reports of congenital abnormalities associated with statins. Statins may cause myopathy and rhabdomyolysis, especially at higher doses and they should be used with caution in patients at risk of rhabdomyolysis and particularly in patients taking drugs that increase plasma concentrations of the statin; the statin should be discontinued if creatine phosphokinase increases significantly or if myopathy is diagnosed. Some statins, such as fluvastatin, pravastatin, rosuvastatin, and simvastatin, should be used with caution in patients with severe renal impairment.
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