Question

A 65-year-old man is prescribed simvastatin 40mg ON for primary prevention of cardiovascular disease. Routine blood tests are arranged prior to starting. His baseline ALT is 75 U/L (normal range <40 U/L). What is the most appropriate action regarding the simvastatin prescription?

Accepted Answer

Do not start simvastatin and investigate liver function further

Answer

Start simvastatin 10mg ON and recheck LFTs in 4 weeks

Answer

Start simvastatin 40mg ON as planned and recheck LFTs in 3 months

Answer

Start an alternative lipid-lowering agent e.g. ezetimibe

Answer

Refer to a hepatologist before considering statins

Practice question

A 65-year-old man is prescribed simvastatin 40mg ON for primary prevention of cardiovascular disease. Routine blood tests are arranged prior to starting. His baseline ALT is 75 U/L (normal range <40 U/L). What is the most appropriate action regarding the simvastatin prescription?