Research has shown that if your cholesterol is too high, your chances for having a heart attack or stroke are increased. Certain lifestyle changes, such as regular exercise, low-fat diet and weight loss, can lower your cholesterol, but you may also need medications to attain optimal levels. While some of these medications will reduce your risk for heart attack, they do have side effects, and they can interact with other medications or alcohol.
Drugs for Lowering Cholesterol
Several kinds of drugs are available for treating high cholesterol. In general, these medications interfere with the absorption of cholesterol from your intestine, or they inhibit the synthesis or accelerate the metabolism of cholesterol in your liver. The choice of a drug is based on the results of your blood tests and on your physician's preference. Currently, statin drugs are among the most popular agents for lowering cholesterol.
Statins and the Liver
Statin medications lower cholesterol by inhibiting an enzyme that synthesizes cholesterol in your liver. But statins are not totally innocuous agents. From your liver's point of view, these medications are potentially toxic substances that must be broken down and eliminated from your body. Specialized enzymes called cytochromes participate in this process, but they may not fully protect your liver from harm. When statins or other drugs damage your liver, the injury is reflected in rising levels of liver enzymes in your bloodstream.
Alcohol and the Liver
The effects of excessive alcohol consumption on the liver are well known. According to the National Institute on Alcohol Abuse and Alcoholism, over 20,000 deaths from cirrhosis, or end-stage liver disease, can be attributed to alcohol consumption every year in the United States. As is the case with statins, your liver uses enzymes, such as alcohol dehydrogenase and aldehyde dehydrogenase, to detoxify alcohol. If you drink excessively, other enzymes, such as cytochromes, are recruited to participate in the task. No matter how much you drink, the byproducts of alcohol metabolism are toxic to liver cells.
Combined Effects
Even though different enzymes are employed to metabolize cholesterol-lowering drugs and alcohol, the potential for liver injury when both alcohol and statins are consumed is additive. Furthermore, the side effects that can result from taking a statin drug, such as muscle damage, can be worsened by the concurrent use of alcohol. In order to minimize these risks, information sheets for statin drugs include warnings about using alcohol and statins together. For example, Pfizer, the manufacturer of a widely prescribed statin called Lipitor, recommends that you "tell your doctor if you drink more than two glasses of alcohol daily" before you start taking its drug.
Considerations
Even if you don't drink alcohol, it is standard practice for your doctor to evaluate your liver function with a blood test before you start taking a statin drug and every four to six months thereafter. Obviously, physicians and drug manufacturers recognize the potential for these medications to cause liver damage. If you drink alcohol, your risks for liver injury are compounded when you take statins. Therefore, it is vital that you accurately disclose information about your alcohol intake before you begin taking these medications. If your alcohol consumption increases later on, you should convey this information to your doctor.
