Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
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.
Angina is chest pain that is due to an inadequate supply of oxygen to the heart muscle.
Angina can be caused by coronary artery disease or spasm of the coronary
arteries. EKG, exercise treadmill, stress echocardiography, stress thallium, and cardiac
catheterization are important tests used in the diagnosis of angina.
Heart attack happens when a blood clot completely obstructs a coronary
artery supplying blood to the heart muscle. A heart attack can cause chest pain, heart failure, and electrical
instability of the heart.
Heart disease (coronary artery disease) is caused by a buildup of cholesterol deposits in the coronary arteries. Risk factors for heart disease include smoking, high blood pressure, heredity, diabetes, peripheral artery disease, and obesity. Symptoms include chest pain and shortness of breath. There are a variety of tests used to diagnose coronary artery disease. Treatment includes life-style changes, medications, procedures, or surgery.
Cholesterol is the most common type of steroid in the body. The treatment of elevated cholesterol involves not only diet but also weight loss, regular exercise, and medications. By understanding your cholesterol profile you can better manage your cholesterol levels.
Heart attacks are the major causes of unexpected, sudden death among men and women. A heart attack is also a significant cause of heart failure. Learn the risk factors for heart attack such as high blood pressure, diabetes, and other heart conditions. Lowering your risk factor, lifestyle changes, and in some cases medication are the most effective way of preventing a heart attack.
Cholesterol occurs naturally in the body. High blood cholesterol levels increase a person's risk of developing heart disease, heart attacks, strokes, TIAs, and more. In addition to medication (fibrates, statins, bile acid sequestrants, and niacin), lifestyle changes can be made to lower blood cholesterol levels
Coronary atherosclerosis is the hardening and narrowing of
the arteries that supply blood to the heart muscle. Coronary atherosclerosis is
the major cause of heart attacks. Heart
attacks
are the major cause of sudden unexpected death
among otherwise healthy adults in the prime of their lives. Heart attacks are
also a significant cause of heart failure (due to weakened heart muscle) in this
country. Heart failure considerably decreases a person's longevity and quality
of life. In dollar terms, coronary heart disease is costly. The total cost of
coronary artery bypass surgery, coronary
angioplasty and stenting, medications,
and hospitalizations exceeds 50 billion dollars annually.
Coronary atherosclerosis, and hence heart attacks, are preventable. A person
can significantly lower his or her risk of heart attack by lowering
high blood
pressure, controlling diabetes, stopping
cigarett...
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