Which of the following are concerns of statins?

All of the above

(E) is the correct answer here. All of the above are concerns regarding statins. AST/ALT elevations are indicators of liver toxicity. This is very rare but it can occur. The levels of these enzymes are based on upper limit of normal (ULN). If a patient is 50x normal, there is a problem. This is known as rhabdomyolysis. Skeletal muscle cells break down so much that acute kidney failure becomes a grave concern. In this situation, the statins may be stopped. For the curious ones, the urine turns a dark brown. Therefore, its important to obtain a baseline CK just to keep track. Drug-drug interactions are huge and that is due to CYP enzyme metabolism. This will be discussed in greater detail, but the information is important to have when dealing with certain statins. With all this discussion about adverse effects, it may seem that statins are bad. On the contrary, for many, statins are well-tolerated and actually work. These are effects of which clinicians must be aware.