Abstract

Statins are widely used drugs for both primary and secondary prevention of various cardiovascular disorders. Cases have been reported on statin-induced hepatitis where the elevation of liver enzymes leads to hepatotoxicity. Here we present a patient with atorvastatin induced hepatotoxicity and the mechanism accelerated by clopidogrel use. The drugs which are metabolised by CYP450 can increase the risk of hepatitis. CYP4503A4 enzyme metabolises both atorvastatin and clopidogrel. In this case, clopidogrel has shown the synergistic effect which is responsible for the significant liver injury.

Key words: Hepatotoxicity Coronary artery disease Alanine transaminase Aspartate aminotransferase Medication non-compliance RUCAM Score