Current package inserts for statins in South Africa contraindicate their use during pregnancy, based on the theory that a decrease in cholesterol synthesis could cause foetal harm. However, based on recent changes announced by the FDA, the SAMF has modified its recommendation.
Statin use for primary prevention should still be avoided, with cessation 1-2 months before a planned pregnancy or immediately on a pregnancy diagnosis. However, for high-risk patients with familial hypercholesterolaemia or those using statins for secondary prevention, a statin can still be considered.
The hydrophilic statins pravastatin or rosuvastatin may be preferable as placental transfer may be lower. Women of childbearing potential on statin therapy should still be advised to use effective contraceptive methods.