Do you need to monitor liver function tests in patients taking statins for hypercholesterolemia?

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No, at least not in patients with a baseline aspartate aminotransferase (AST) and alanine aminotransferase (ALT) <3 times the upper limit of normal (ULN) (SOR: A, based on 2 high-quality RCTs). The American College of Cardiology/American Heart Association (ACC/AHA) guidelines and the National Lipid Association's Statin Safety Task Force recommend checking ALT prior to starting statin therapy, and only if clinically indicated thereafter (SOR: C, based on consensus guidelines).

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