Lovastatin
(Mevinolin)
Lovastatin (Mevacor)
Mevinolin (Mevacor)
Lovastatin
( LOW-vah- STAT-in, me- VIN-oh-lin)
Pregnancy Category: X Apo-Lovastatin Mevacor (Rx)

Classification: Antihyperlipidemic

See Also: See also Antihyperlipidemic Agents--HMG-CoA Reductase Inhibitors.

Action/Kinetics: Isolated from a strain of Aspergillus terreus. Approximately 35% of a dose is absorbed. Extensive first-pass effect--less than 5% reaches the general circulation. Absorption is decreased by about one-third if the drug is given on an empty stomach rather than with food. Onset: within 2 weeks using multiple doses. Time to peak plasma levels: 2-4 hr. Time to peak effect: 4-6 weeks using multiple doses. Duration: 4-6 weeks after termination of therapy. Over 95% is bound to plasma proteins. Metabolized in the liver (its main site of action) to active metabolites. Over 80% of a PO dose is excreted in the feces, via the bile, and approximately 10% is excreted through the urine.

Uses: As an adjunct to diet in primary hypercholesterolemia (types IIa and IIb) in clients with a significant risk of CAD and who have not responded to diet or other measures. May also be useful in clients with combined hypercholesterolemia and hypertriglyceridemia. To slow the progression of coronary atherosclerosis in clients with CAD in order to lower total and LDL cholesterol levels. Primary prevention of risk of first heart attack, unstable angina, and coronary revascularization procedures in those with average to moderately elevated total cholesterol and LDL-cholesterol and below average HDL-cholesterol. Investigational: Diabetic dyslipidemia, nephrotic hyperlipidemia, familial dysbetalipoproteinemia, and familial combined hyperlipidemia.

Contraindications: [.]

Additional Contraindications: Use with mibefradil (Posicor).

Special Concerns: Carefully monitor clients with impaired renal function.

Side Effects: See Antihyperlipidemic Agents--HMG-COA Reductase Inhibitors. CNS: Headache, dizziness, insomnia, paresthesia, insomnia. GI: Flatus (most common), abdominal pain, cramps, diarrhea, constipation, dyspepsia, N&V;, heartburn, dysgeusia, acid regurgitation, dry mouth. Musculoskeletal: Myalgia, muscle cramps, pain, arthralgia, leg pain, shoulder pain, localized pain. Miscellaneous: Blurred vision, eye irritation, rash, pruritus, chest pain, alopecia.

Laboratory Test Alterations: Risk of elevated serum transaminases in clients with homozygous familial hypercholesterolemia.

Additional Drug Interactions: Grapefruit juice / Lovastatin plasma levels R/T liver metabolism; risk of myopathy and rhabdomyolysis Isradipine / Clearance of lovastatin

How Supplied: Tablet: 10 mg, 20 mg, 40 mg

Dosage
?Tablets
Adults/adolescents, initial: 20 mg once daily with the evening meal. Initiate at 10 mg/day in clients on immunosuppressants. Dose range: 10-80 mg/day in single or two divided doses, not to exceed 20 mg/day if given with immunosuppressants. Adjust dose at intervals of every 4 weeks, if necessary. If C _CR is less than 30 mL/min, use doses greater than 20 mg/day with caution.