This Is MS Multiple Sclerosis Community: Knowledge & Support

This is a multiple part question.

Statins and Avonex have warnings about liver damage, does anyone think taking both is a serious health risk? Has anyone encountered problems taking both? Do we know more about the details of the risks to the liver and if they act in the same or different ways?

Has anyone found a neuro that would perscribe a statin? If you have low cholesterol, does that mean you can't get a statin? Thanks for any thoughts. napay

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My Starting Point
Understanding MS 101: Doctor Talk and People Talk<br /><br />

Hi napay

I'll respond to your questions by reporting my experience.

I do think taking both Avonex and statins can be a potentially serious health risk. I was on both Avonex and lipitor for a time (about 4 months). My liver enzymes became elevated and lipitor was discontinued. It was explained to me that the Avonex and lipitor probably acted "synergistically" with regard to their potential impact on the liver, but I don't really know if they act in the same or different ways.

My neuro was not willing to prescribe the lipitor, but my primary care physician was when I presented her with information about its potential as a treatment for MS. I generally think it's far more likely you'd be able to obtain a prescription from a primary care doc than a neuro, but some neuros are more open than others. My neuro is pretty strict. If the clinical evidence is not in, he won't go there.

A couple of things to think about. If you're on Avonex, your neuro should be checking your liver enzymes routinely, so hopefully any problems will be identified early. You may also want to think about Milk Thistle as a supplement to help maintain healthy liver function. And, if a primary care doc gives you a prescription for a statin, they should also be checking your liver function.

I would hope that routine monitoring would prevent serious damage.

btw I appreciate your perioidic in depth research reports on various topics.

Sharon

I can appreciate your comments completely. Our Neuro is convervative. We're still on Avonex and I'll keep reviewing supplements until I think I've exhausted available info. Thank you for your comments on my other posts - I have my own approach to this sort of thing and I'm happy to know that you liked it. I made a new post today about vitamin c. ciao, napay

_________________
My Starting Point
Understanding MS 101: Doctor Talk and People Talk<br /><br />

My reply to the first post is two years too late but this may be of interest:

http://www.naturalnews.com/023176.html

"The researchers found that high-dose statins caused 2.4 times as many cases of liver damage as low-dose statins, or 271 cases per 100,000 patients."

That's 1 in 370. Which is not bad...

It goes on to say that Lipitor is 4.5 times more likely to cause damage at a high dose than a low one, but since it doesn't give figures for damage at a low dose it's tricky to work that one out.. Maybe it's around 1 in 165? Still not too bad... .


-edit-
thinking further, they don't even define 'high' and 'low'

Looking around it seems that a high dose is, as I'm sure you guessed, generally accepted to be 80mg.

Here's another similar link looking at Statins and liver toxicity:

http://www.medicationsense.com/articles ... 01907.html

"These findings are consistent with the results seen previously in the maximum-dose Lipitor studies. In the heart attack study, the number of subjects developing liver injury with maximum-dose Lipitor was 5.5 times greater than with low-dose Lipitor.1 In the stroke study, the rate was 4.5 times greater with maximum-dose Lipitor than with placebo.2 Thus, if 10 million patients are prescribed maximum-dose Lipitor, between 400,000 and 550,000 patients will sustain liver injuries. Most of these injuries will be minor and reversible with discontinuation of the drug. However, it is also likely that some of these liver injuries will be serious or life-threatening. Statin medications have been linked on occasion with liver failure."

Here the odds are not so great - 1 in 25...

I take "High Dose" Lipitor for my MS; i.e. 80mg/day. As Lipitor does not have to be taken at a certain time of the day (unlike some statins), I split my dose into three smaller doses. The reason I do this is twofold. 1) to give me better medicated coverage throughout the 24 hours 2) I *think* the lower peak plasma level may limit the risk of poisoning (such as which might cause liver damage)

Thanks C.O.B. And how often do you have liver enzyme levels checked? I am just in the process of trying to get a prescription myself you see.

I got them checked fairly often in the start, as I was also being monitored because I started Rebif (no one knew at the time they were a bad mix)

As they were OK, my GP (that prescribes my Lipitor) isn't too concerned, and the longer I have gone without any problems, the more comfortable he is. I probably get em checked about 4 times a year. I actually push it, as I like to know my uric acid levels, and they are on the same test results.

Thanks for that!