Supportive Medications
Your doctor may recommend additional treatments when you have MASH, especially if you also have other conditions like high cholesterol, high blood pressure, or diabetes.
“While most of these drugs do not target liver-related outcomes directly, they are important modifiers of cardiovascular mortality, which is the most common cause of death in individuals with MASH,” says Anahita Rabiee, MD, an assistant professor of digestive diseases at Yale School of Medicine in New Haven, Connecticut.
Statins
Medications in this class include:
- Atorvastatin (Caduet, Lipitor)
- Fluvastatin
- Lovastatin (Mevacor, Altoprev)
- Pitavastatin (Livalo, Zypitamag)
- Pravastatin
- Rosuvastatin (Crestor, Ezallor Sprinkle)
- Simvastatin (FloLipid, Vytorin, Zocor)
Statins can cause side effects including:
- Headache
- Nausea
- Dizziness
- Gas
- Diarrhea
- Constipation
- Muscle pain
- Memory loss or confusion
Rarely, they can also cause kidney damage, muscle tissue breakdown, or high blood sugar.
Statins can also potentially lead to liver damage, however, the medications are generally considered safe for people with MASH.
Antihypertensive Drugs
It’s important to keep your blood pressure within a healthy range to lower your heart attack and stroke risk when you have MASH. If your levels are high (typically above 130/80 mmHg), your doctor may recommend an antihypertensive medication to help lower your blood pressure.
Medications in this class include:
- Angiotensin-converting enzyme (ACE) inhibitors, such as benazepril (Lotensin), captopril (Capoten), and enalapril (Epaned and Vasotec)
- Angiotensin II receptor blockers (ARBs), such as azilsartan medoxomil (Edarbi), candesartan (Atacand), eprosartan mesylate (Teveten), and losartan (Cozaar)
- Calcium channel blockers, such as amlodipine, clevidipine, felodipine, diltiazem, and verapamil
- Diuretics (water or fluid pills), such as thiazide diuretics (hydrochlorothiazide or chlorthalidone), loop diuretics (furosemide or bumetanide), or potassium-sparing diuretics (triamterene or amiloride)
Common side effects of antihypertensive drugs can include:
- Cough
- Diarrhea
- Constipation
- Dizziness
- Trouble getting or maintaining an erection
- Feeling nervous
- Weakness and fatigue
- Nausea or vomiting
- Skin rash
- Unintended weight loss or weight gain
Diabetes Drugs
If your doctor hasn’t prescribed semaglutide, which is approved to treat both MASH and high blood sugar, they could recommend another type of injectable or oral treatment to help keep your blood sugar levels within a healthy range.
Medications may include:
- Metformin (Glucophage)
- Dipeptidyl peptidase 4 (DPP-4) inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), or linagliptin (Jentadueto)
- Sodium-glucose cotransporter 2 (SGLT2) inhibitors, such as canagliflozin (Invokana), dapagliflozin (Farxiga), or empagliflozin (Jardiance).
- Sulfonylureas, such as glipizide (Glucotrol, Glucotrol XL), glimepiride (Amaryl), or glyburide (Micronase, Glynase)
- Thiazolidinediones (TZDs), such as pioglitazone (Actos) and rosiglitazone (Avandia)
Different diabetes drugs can cause different side effects. Depending on the medication your doctor prescribes, you may experience side effects such as:
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