When they were developed a quarter century ago, statins were thought to have few side effects. But after millions of people began taking them, possible problems became apparent. They include:

• Liver damage. When statins were first approved, liver monitoring was required, but now the Food and Drug Administration (FDA) requires liver tests before statin use and afterward only if symptoms appear.

• Memory loss. The FDA has received reports of memory loss, confusion, and other cognitive problems, but the agency maintains such symptoms are reversible. I’m not certain they are, so I don’t recommend statins for elderly patients.

• Diabetes. Statins can raise blood sugar; this increases the risk of Type 2 diabetes. Blood sugar levels must be monitored when taking a statin.

• Muscle damage. Statins can cause a type of progressive muscle wasting called rhabdomyolysis. This rare side effect can result in liver damage, kidney failure, and even death. Damage to the tendons has also been reported.