Lovastatin

— THERAPEUTIC CATEGORIES —
  • Hyperlipoproteinemias

Lovastatin Generic Name & Formulations

General Description

Lovastatin 10mg, 20mg, 40mg; tabs.

Pharmacological Class

HMG-CoA reductase inhibitor.

How Supplied

Contact supplier

Lovastatin Indications

Indications

To reduce risk of MI, unstable angina, and coronary revascularization procedures in patients without symptomatic cardiovascular disease (CVD), average to moderately elevated total-C and LDL-C, and below average HDL-C. Primary hypercholesterolemia (Types IIa and IIb) to reduce elevated total-C and LDL-C when response to nondrug therapy is inadequate. To slow progression of coronary atherosclerosis in patients with coronary heart disease to lower total-C and LDL-C. Adjunct to nondrug therapy to reduce total-C, LDL-C and apo B in patients 10–17yrs of age (≥1yr post-menarche) with heterozygous familial hypercholesterolemia if LDL-C remains >189mg/dL, or if LDL-C remains >160mg/dL with either family history of premature cardiovascular disease (CVD) or if patient has at least 2 other CVD risk factors.

Lovastatin Dosage and Administration

Adult

Give with evening meal. ≥17yrs: initially 10–20mg once daily, may increase at 4 week intervals; max 80mg/day in single or divided doses. Concomitant danazol, diltiazem, dronedarone, verapamil: initially 10mg/day; max 20mg/day. Concomitant amiodarone: max 40mg/day. Severe renal insufficiency (CrCl<30mL/min): 20mg/day; caution with dose increases.

Children

<10yrs: not recommended. 10–17yrs: initially 10–20mg once daily, may increase at 4 week intervals. Usual range: 10–40mg/day; max 40mg/day.

Lovastatin Contraindications

Contraindications

Active liver disease. Unexplained, persistent elevated serum transaminases. Concomitant strong CYP3A4 inhibitors (eg, itraconazole, ketoconazole, posaconazole, HIV protease inhibitors, boceprevir, telaprevir, erythromycin, clarithromycin, telithromycin, nefazodone). Pregnancy (Cat.X). Nursing mothers.

Lovastatin Boxed Warnings

Not Applicable

Lovastatin Warnings/Precautions

Warnings/Precautions

Discontinue if myopathy, elevated CPK levels occur; suspend if a predisposition to development of renal failure secondary to rhabdomyolysis develops. Monitor liver function before starting therapy and repeat as clinically indicated. History of liver disease. Alcoholism. Homozygous familial hypercholesterolemia.

Lovastatin Pharmacokinetics

See Literature

Lovastatin Interactions

Interactions

See Contraindications. Increased risk of myopathy with strong CYP3A4 inhibitors, danazol, diltiazem, dronedarone, verapamil, amiodarone. May be potentiated by voriconazole, ranolazine; consider dose adjustment of lovastatin. Avoid gemfibrozil, cyclosporine, grapefruit juice >1 quart daily. Caution with, other fibrates, macrolides, niacin (≥1g/day), colchicine. Monitor oral anticoagulants. Inhibition of endogenous steroid production with spironolactone, ketoconazole, cimetidine.

Lovastatin Adverse Reactions

Adverse Reactions

GI upset, headache, rash, pruritus, myalgia, dizziness, blurred vision, elevated serum transaminases, myopathy, rhabdomyolysis with renal dysfunction; increased HbA1c and fasting serum glucose, cognitive impairment; rare: immune-mediated necrotizing myopathy.

Lovastatin Clinical Trials

See Literature

Lovastatin Note

Notes

Formerly known under the brand name Mevacor.

Lovastatin Patient Counseling

See Literature