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Suggest Alternative Medicine For Simvastatin To Avoid Elevated Lipase And Amylase Levels
Question: I am 58 years male - I normally suffer from high cholesterol levels - not due to my diet or lack of exercise( just my liver producing )
Due to intake of statin 10mg ( rosuvastatin) my pancreatic levels - amylase & lipase went up. Discontiued my intake of statin for almost 6 months and my cholesterol levels went high - total cholestrol 268 / LDL - 184 .
Now my levels of lipase and amylase are normal. Have started taking Simvastatin 20 mg upon advice of my doctor. Could you advice the best form of statin to avoid the side effects of my lipase and amlyase going up again.
Due to intake of statin 10mg ( rosuvastatin) my pancreatic levels - amylase & lipase went up. Discontiued my intake of statin for almost 6 months and my cholesterol levels went high - total cholestrol 268 / LDL - 184 .
Now my levels of lipase and amylase are normal. Have started taking Simvastatin 20 mg upon advice of my doctor. Could you advice the best form of statin to avoid the side effects of my lipase and amlyase going up again.
Brief Answer:
With statin use, the liver enzymes are mild, reversible and non toxic
Detailed Answer:
Hi,
I understand your query.
What are the liver enzyme levels, mostly are mildly elevated? If they are mildly raised you can continue rosuvastatin. Suppose if you have unusual fatigue or weakness, loss of appetite, pain in your upper abdomen, dark-colored urine, or yellowing of your skin or eyes, then only you can change the statin. Also the risk towards the liver is more and toxic if you are alcoholic or have kidney disease and less weight. So choosing the right dose is important too.
Also the currently available data does not support doing so in the “asymptomatic” patient on a statin. Most of the time, this biochemical findings of raised enzymes is not correlated with histopathological changes and therefore does not meet criteria as a true indicator of liver injury.
Suppose you have symptoms that I mentioned above, as per medical literature and studies, if one statin is causing muscle pains, you can be switched to other type of statin keeping a tab / goal of LDL levels. So in your case if Rosuva is causing problems only to liver, muscle pains or mentation, you can shift to Simvastatin and that was rightly done by your doctor. If not you can still stick to Rosuva.
You can check for liver enzymes after 12 weeks and not more frequently.
The good thing about raised liver enzymes on statin use is, mild, reversible and not toxic always.the levels come down sooner as soon as the statin is stopped. That means it is reversible.
Hope this allays your fears. Just continue simvastatin as per dose.
With statin use, the liver enzymes are mild, reversible and non toxic
Detailed Answer:
Hi,
I understand your query.
What are the liver enzyme levels, mostly are mildly elevated? If they are mildly raised you can continue rosuvastatin. Suppose if you have unusual fatigue or weakness, loss of appetite, pain in your upper abdomen, dark-colored urine, or yellowing of your skin or eyes, then only you can change the statin. Also the risk towards the liver is more and toxic if you are alcoholic or have kidney disease and less weight. So choosing the right dose is important too.
Also the currently available data does not support doing so in the “asymptomatic” patient on a statin. Most of the time, this biochemical findings of raised enzymes is not correlated with histopathological changes and therefore does not meet criteria as a true indicator of liver injury.
Suppose you have symptoms that I mentioned above, as per medical literature and studies, if one statin is causing muscle pains, you can be switched to other type of statin keeping a tab / goal of LDL levels. So in your case if Rosuva is causing problems only to liver, muscle pains or mentation, you can shift to Simvastatin and that was rightly done by your doctor. If not you can still stick to Rosuva.
You can check for liver enzymes after 12 weeks and not more frequently.
The good thing about raised liver enzymes on statin use is, mild, reversible and not toxic always.the levels come down sooner as soon as the statin is stopped. That means it is reversible.
Hope this allays your fears. Just continue simvastatin as per dose.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Thanks for the input - Due to side effect of the statin Rosuva, my pancreatic levels of Amylase and lipase were increasing. There is no change in my liver profile while taking the statin. Does taking a statin increase the levels of lipase and amylase as a side effect ? If no, then, this increase could be due to a different reason.
I have since yesterday started taking 20mg of simvastatin and 5mg of folic in order to bring my levels to normal and continue with a smaller dosage thereafter.
Would increase in pancreatic levels be due a different reason ?
I have since yesterday started taking 20mg of simvastatin and 5mg of folic in order to bring my levels to normal and continue with a smaller dosage thereafter.
Would increase in pancreatic levels be due a different reason ?
Brief Answer:
Look for other reasons for raised amylase and lipase, statins are rare
Detailed Answer:
Hi,
I would suggest to look for other reasons for raised Amylase and Lipase. Your triglycerides are also raised. If no other cause is found then you can look into Statin induced pancreatitis.
There were few observational studies that say that statins can be toxic to pancrease, causing pancreatitis. But this all proved to be unscientific on major co hort studies.
But one theory was doing rounds, regarding the mechanism of action, of statin-induced Acute Pancreatitis are speculated to be drug interactions through CYP3A4.
Pravastatin is said to have rarely influence the CYP3A4.
So if simvastatin also raises Amylase and Lipase you can shift to Pravastatin.
Look for other reasons for raised amylase and lipase, statins are rare
Detailed Answer:
Hi,
I would suggest to look for other reasons for raised Amylase and Lipase. Your triglycerides are also raised. If no other cause is found then you can look into Statin induced pancreatitis.
There were few observational studies that say that statins can be toxic to pancrease, causing pancreatitis. But this all proved to be unscientific on major co hort studies.
But one theory was doing rounds, regarding the mechanism of action, of statin-induced Acute Pancreatitis are speculated to be drug interactions through CYP3A4.
Pravastatin is said to have rarely influence the CYP3A4.
So if simvastatin also raises Amylase and Lipase you can shift to Pravastatin.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Priyanka G Raj
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