In which populations is statin use contraindicated or used with caution?

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Statins carry specific safety considerations for certain groups. Pregnancy is a clear contraindication because statin exposure can affect fetal development. In someone with active liver disease, statins are avoided since the risk of hepatotoxicity is a major concern and liver function should be evaluated before and during therapy. In advanced chronic kidney disease, drug levels and the risk of adverse effects can be higher, so dosing may need adjustment and the patient should be monitored closely for muscle symptoms and other signs of toxicity. Because of these factors—avoid in pregnancy, caution or avoidance in active liver disease, and careful dose adjustment with monitoring in advanced CKD—the option that includes all of these considerations is the best fit. Obesity alone does not contraindicate statin use, and it’s not correct to say there are no special population considerations.