CYP3A4 and hypothyroidism: The leading risk factors for statins ADRs are genetic factors (eg, SLCO1B1, CYP3A4/5, and ABCG2), comorbidities (kidney failure, liver dysfunction, hypothyroidism, diabetes mellitus), very young or very old age, female sex, and drug-associated factors (dosage, statin type, and concomitant therapy with OATP1B1, ABCG2, and/or CYP3A4/5 inhibitors, eg, ketoconazole, cyclosporine) (59,66-68).