<Tr> <Td> Persons taking gemfibrozil, a non-statin cholesterol - lowering drug </Td> <Td> Atorvastatin </Td> <Td> Combining gemfibrozil and a statin increases risk of rhabdomyolysis and subsequently kidney failure </Td> </Tr> <Tr> <Td> Persons taking the anticoagulant warfarin </Td> <Td> Any statin </Td> <Td> The statin use may require that the warfarin dose be changed, as some statins increase the effect of warfarin . </Td> </Tr> <P> The most important adverse side effects are muscle problems, an increased risk of diabetes mellitus, and increased liver enzymes in the blood due to liver damage . Over 5 years of treatment statins result in 75 cases of diabetes, 7.5 cases of bleeding stroke, and 5 cases of muscle damage per 10,000 people treated . This could be because, as statins inhibit the enzyme (HMG - CoA reductase) that makes cholesterol, statins also inhibit the other processes of this enzyme, such as CoQ production, and CoQ production is important for muscle cells and in blood sugar regulation . </P> <P> Other possible adverse effects include neuropathy, pancreatic and liver dysfunction, and sexual dysfunction . The rate at which such events occur has been widely debated, in part because the risk / benefit ratio of statins in low - risk populations is highly dependent on the rate of adverse events . A Cochrane meta - analysis of statin clinical trials in primary prevention found no evidence of excess adverse events among those treated with statins compared to placebo . Another meta - analysis found a 39% increase in adverse events in statin treated people relative to those receiving placebo, but no increase in serious adverse events . The author of one study argued that adverse events are more common in clinical practice than in randomized clinical trials . A systematic review concluded that while clinical trial meta - analyses underestimate the rate of muscle pain associated with statin use, the rates of rhabdomyolysis are still "reassuringly low" and similar to those seen in clinical trials (about 1--2 per 10,000 person years). A systematic review co-authored by Ben Goldacre concluded that only a small fraction of side effects reported by people on statins are actually attributable to the statin . </P>

The overuse of statins may be toxic to which body organ