GENERIC NAME: lovastatin
BRAND NAME: Mevacor, Altoprev
DRUG CLASS AND MECHANISM: Lovastatin belongs to a class of cholesterol-lowering drugs called HMG-CoA reductase inhibitors, or, more commonly "statins." Other statins include simvastatin (Zocor), atorvastatin (Lipitor), fluvastatin (Lescol), and rosuvastatin (Crestor). Statins reduce cholesterol by inhibiting an enzyme in the liver (HMG-CoA reductase) that is necessary for the production of cholesterol. In the blood, statins lower total cholesterol, low density lipoprotein (LDL) cholesterol ("bad" cholesterol) and triglycerides. LDL cholesterol is believed to be an important cause of atherosclerosis and coronary artery disease (cardiovascular disease). Lowering LDL cholesterol levels slows and may even reverse coronary artery disease. Statins also increase high density lipoprotein (HDL) cholesterol ("good" cholesterol). Raising HDL cholesterol levels, like lowering LDL cholesterol, may slow coronary artery disease. The FDA approved lovastatin in August 1987.
PRESCRIBED FOR: Lovastatin is used for reducing total cholesterol and LDL cholesterol, and triglycerides, and for increasing HDL cholesterol in patients with elevated blood cholesterol levels (hypercholesterolemia). Lovastatin is used for reducing the risk of heart attacks, angina, coronary revascularization procedures in individuals without symptomatic cardiovascular disease, average to moderately elevated cholesterol levels and below average HDL cholesterol levels. It also is used for slowing the progression of coronary atherosclerosis in individuals with coronary heart disease.
SIDE EFFECTS: The most common side effects of lovastatin are:
Hypersensitivity reactions also have been reported.
The most serious potential side effects are liver damage and muscle inflammation or breakdown. Lovastatin shares side effects, such as liver and muscle damage associated with all statins. Serious liver damage caused by statins is rare. More often, statins cause abnormalities of liver tests. Abnormal tests usually return to normal even if a statin is continued, but if the abnormal test value is greater than three times the upper limit of normal, the statin usually is stopped. Liver function tests should be performed at the beginning of treatment and then as needed thereafter. Inflammation of the muscles caused by statins can lead to a serious breakdown of muscle cells called rhabdomyolysis. Rhabdomyolysis causes the release of muscle protein (myoglobin) into the blood. Myoglobin can cause kidney failure and even death. When used alone, statins cause rhabdomyolysis in less than 1% of patients. To prevent the development of rhabdomyolysis, patients taking lovastatin should contact their healthcare provider immediately if they develop unexplained muscle pain, weakness, or muscle tenderness.
Statins have been associated with increases in HbA1c and fasting serum glucose levels as are seen in diabetes. There are also post-marketing reports of memory loss, forgetfulness, amnesia, confusion, and memory impairment. Symptoms may start one day to years after starting treatment and resolve within a median of three weeks after stopping the statin.
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