lovastatin (Mevacor, Altoprev) - drug class, medical uses, medication side effects, and drug interactions by MedicineNet.com

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Medications and Drugs

Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD

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 coronary artery 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.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Tablets: 10, 20, and 40 mg. Extended release tablets: 10, 20, 40, and 60 mg.

STORAGE: Immediate release tablets should be stored between 5-30 C (41-86 F). Extended release tablets should be stored at room temperature, 20-25 C (68-77 F).

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.

DOSING: The dose range for lovastatin is 10-80 mg daily given preferably in the evening when it may be most effective. The usual staring dose is 20 mg once daily and the maximum dose is 80 mg daily. Blood cholesterol determinations are performed at regular intervals during treatment so that adjustments in dosage can be made.

DRUG INTERACTIONS: Decreased elimination of lovastatin could increase the levels of lovastatin in the body and increase the risk of muscle toxicity from lovastatin. Examples of drugs that decrease elimination of lovastatin include erythromycin (E-Mycin), ketoconazole (Nizoral), itraconazole (Sporanox), clarithromycin (Biaxin), telithromycin (Ketek), cyclosporine (Sandimmune), nefazodone (Serzone), and protease inhibitors such as indinavir (Crixivan) and ritonavir (Norvir). Large quantities of grape fruit juice (>1 quart daily) also will increase blood levels of lovastatin.

Amiodarone (Cordarone), verapamil (Calan, Verelan, Isoptin), danazol (Danocrine), cyclosporine (Gengraf, Neoral), niacin (Niacor, Niaspan, Slo-Niacin), gemfibrozil (Lopid) and fenofibrate (Tricor) also may increase the risk of muscle toxicity when combined with lovastatin. Patients taking amiodarone (Cordarone) or verapamil (Calan, Verelan, Isoptin) should not take more than 40 mg of lovastatin. Patients taking niacin (greater than or equal to 1 g/day), gemfibrozil (Lopid), fenofibrate (Tricor) or cyclosporine (Gengraf, Neoral) should not take more than 20 mg of lovastatin.