Do statins and alcohol consumption mix?

You’ve already given up burgers, pizza, doughnuts, and ice cream in an attempt to lower cholesterol levels. Now your doctor is recommending that you join the 25% of people over age 40 who are on statin therapy to get your LDL cholesterol into the safe zone. Does this mean you are going to need to give up your favorite adult beverages, too?

We’ve got good news! Probably not—at least not for the sake of your Lipitor or Crestor prescription.

Is it safe to mix statins and alcohol?

“Statins in general are safe with alcohol consumption,” says Dr. Eugene Yang, MD, a member of the American College of Cardiology Prevention Council and medical director of the University of Washington Medicine Eastside Specialty Center in Bellevue, Washington. 

Of course, just as with many rules, there are exceptions to this one. 

Liver inflammation

“In some cases, statins can lead to mild inflammation of the liver as a potential side effect, so if people consume alcohol in excess and they have the statins causing some mild liver inflammation, then that could make it worse,” Dr. Yang says. 

However, the risk of liver inflammation as a statin side effect is so low that the Food and Drug Administration no longer recommends routine monitoring of liver function for patients taking statins, Dr. Yang points out (routine monitoring used to be standard).

Liver disease

The concern, experts say, is most applicable to those who have some sort of underlying liver-related problem, such as nonalcoholic fatty liver disease.

“Statins are processed in the liver, so if your liver is impaired in any way it might not be able to process the medication in the same way a healthy liver could,” says Dr. Jennifer Bacci, Pharm.D., an assistant professor at the University of Washington School of Pharmacy. 

For this reason, she recommends that anyone with chronic liver disease completely abstain from alcohol while taking statins (abstinence from alcohol is recommended for all people with chronic liver disease, statins or not). 

Excessive alcohol use

And if you don’t have liver issues? You still need to have an honest conversation about alcohol use with your doctor before starting statin therapy, she says, and you also need to make sure you are not exceeding the recommended daily guidelines for alcohol use (one drink per day for women; two drinks per day for men) because it is excess alcohol consumption that can lead to problems in the general population.

The bottom line: statins and alcohol are (mostly) safe

Despite the encouraging news about statins and alcohol consumption, Dr. Yang says it isn’t unusual for patients to feel apprehensive about mixing the two. If you are worried, speak to your doctor about a baseline liver function test, which Dr. Yang provides to patients when there are concerns. 

If the tests come back abnormal, Dr. Bacci says that would be a signal to do some additional information gathering.