QuestionSBA
QuestionChoice
There is no current indication to stop statin therapy. Statins should be discontinued if serum transaminases are greater than 3 times the upper limit of the reference range, or there are side effects which the patient cannot cope with.
10028553
b
Stop atorvastatin 20mg
QuestionChoice
Other classes of lipid lowering drugs include ezetimibe, fibrates and new monoclonal antibodies. At this stage there is no indication for stopping or switching to a different medication.
10028556
e
Switch to a fibrate
QuestionChoice
This is the dose for secondary prevention of cardiovascular events. There is currently no indication for this and given the ALT increase, it would be unwise to increase the dose at this stage.
10028555
d
Increase to atorvastatin 80mg
QuestionChoice
Although the ALT has increased since commencing treatment, current guidance is that unless serum transaminases are greater than 3 times the upper limit of the reference range, there is no need to discontinue statin therapy.
10028552
a
Continue atorvastatin 20mg
QuestionChoice
There is no indication for stopping or switching the statin for this patient.
10028554
c
Switch to simvastatin
Concept
Chapter
2693
6087
Statins
Topic
329
General Practice
18113
Case Presentation: A 54-year-old woman attends the GP to discuss her most recent blood test results. She was commenced on atorvastatin 20mg PO ON for primary prevention of cardiovascular events. She describes no issues with the medication and reports no side effects. Her blood test results are below. **Investigations** ALT before treatment: 21 (10 - 50 IU/L) ALT 3 weeks later: 65 (10 - 50 IU/L) 

Question: Select the most appropriate decision option with regard to the atorvastatin based on these data.
a