Simvastatin should not be given to patients with acute liver disease or unexplained persistent raised serum-aminotransferase concentrations. It should be avoided during pregnancy since there is a possibility that it could interfere with fetal sterol synthesis; there have been a few reports of congenital abnormalities associated with HMG-CoA reductase inhibitors. It should be discontinued if marked increase in serum-aminotransferase or creatine phosphokinase concentrations occur.
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