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Diabetes.Taking lovastatin, lisinopril. Elevated liver enzyme due to acetominophen. Is lovastatin safe?

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My girlfriend has had type 1 diabetes for 3 years now and went for a blood test, she had an HDL of 90, LDL of 220, total cholesterol of about 313, she is now on lovastatin 10 mg and lisinopril 2.5 mg. A1C was 4.7. Her liver enzymes were also elevated because she was taking Acetominophen for an extended period of time after breaking her leg 9 months ago.

Is the 10 mg lovastatin enough to bring down her high cholesterol ?

Also, about how long will it take for her liver to recover before she can start taking pain medicine again? Is there a pain medicine you could recommend that would be less hard on her liver?
Posted Tue, 7 May 2013 in Diabetes
Answered by Dr. Om Lakhani 15 hours later

Here are answers to your questions

1. Is 10 mg Lovastatin enough : The answer is no. When LDL is 220 we need to increase the dose of Statin. We need to reduce the LDL level to atleast <100. I generally prefer Rosuvastatin over Lovastatin because of better efficacy at a lower dose.

2. How long will it take the liver to recover: That depends on many parameters, you need to give me a liver function test report for me to the judge the liver status at present. However are you sure the cause of raised enzymes is acetaminophen alone ? With her lipid profile. the possibility of Non Alcoholic steatohepatitis (NASH) also needs to be considered in which case we need to add some other medications for liver enzymes.

3. Pain Medicine safe in liver : Unfortunately there is no pain killer that is completely safe in liver disease. If required you can consider acetaminophen as it is the safest in a lower dose.

Her diabetes control is fine at present. Does she have any other autoimmune disease. Type 1 Diabetes have autoimmune etiology and other autoimmune disease (including that of liver) need to be considered as other diagnosis of abnormal liver enzymes.

Hope this is helpful. If you have any more queries, please feel free to ask.

With warm regards
Dr. Om Lakhani, MD.
Above answer was peer-reviewed by
Follow-up: Diabetes.Taking lovastatin, lisinopril. Elevated liver enzyme due to acetominophen. Is lovastatin safe? 41 minutes later
Thank you, what dosages of lovastatin or Rosuvastatin would you recommend her to start off with?

I plan on mentioning this to her primary physician so that we can get the dosage raised or medicine changed. Im also going to mention the possibility of XXXXXXX how can we test to see if she has this? What medications would be needed if she does have this?

Answered by Dr. Om Lakhani 7 hours later

Since rosuvastatin is more efficient we can start at the same dose of 10mg and upgrade later on after seeing the LDL on follow up.
XXXXXXX has no specific test apart from a biopsy which is not required at present. XXXXXXX may be suspected based on your Liver function test report. Pioglitazone and vitamin E are used in XXXXXXX

Above answer was peer-reviewed by
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