What is lovastatin, and how does it work (mechanism of action)?
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.
What brand names are available for lovastatin?
Is lovastatin available as a generic drug?
Do I need a prescription for lovastatin?
What are the side effects of lovastatin?
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.
What is the dosage for lovastatin?
The dose range for lovastatin is 10-80 mg daily given preferably in the evening when it may be most effective. The usual starting 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.
Which drugs or supplements interact with lovastatin?
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), boceprevir (Victrelis), telaprevir (incivek), voriconazole (Vfend), and protease inhibitors such as indinavir (Crixivan) and ritonavir (Norvir). They should not be combined with lovastatin.
Large quantities of grape fruit juice (>1 quart daily) also will increase blood levels of lovastatin and should be avoided.
Amiodarone (Cordarone), verapamil (Calan, Verelan, Isoptin), diltiazem (Cardizem), danazol (Danocrine), niacin (Niacor, Niaspan, Slo-Niacin), colchicine, ranolazine (Ranexa), gemfibrozil (Lopid), and fenofibrate (Tricor) also may increase the risk of muscle toxicity when combined with lovastatin. Cyclosporine or gemfibrozil should not be combined with lovastatin. Patients taking amiodarone (Cordarone) should not exceed 40 mg daily of lovastatin. Patients taking verapamil, diltiazem, or danazol should start with 10 mg and should not exceed 20 mg of lovastatin daily. Patients taking niacin (greater than or equal to 1 g/day), fenofibrate (Tricor) or cyclosporine (Gengraf, Neoral) should not take more than 20 mg of lovastatin.
Is lovastatin safe to take if I'm pregnant or breastfeeding?
Pregnant women should not use lovastatin because the developing fetus requires cholesterol for development, and lovastatin reduces the production of cholesterol. Lovastatin should only be administered to women of child bearing age if they are not likely to become pregnant.
Because of the risk of adverse effects to the developing infant, lovastatin should not be administered to nursing mothers.
What else should I know about lovastatin?
What preparations of lovastatin are available?
Tablets: 10, 20 and 40 mg. Extended release tablets: 10, 20, 40, and 60 mg.
How should I keep lovastatin stored?
Immediate release tablets should be stored between 5 C - 30 C (41 F - 86 F). Extended release tablets should be stored at room temperature, 20 C - 25 C (68 F - 77 F).
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Lovastatin (Mevacor, Altoprev) is in the drug class of statins. Lovastatin (Mevacor, Altoprev) is prescribed for reducing total cholesterol and triglycerides in patients with elevated cholesterol levels. Side effects, drug interactions, and pregnancy safety should be reviewed prior to taking this medication.
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Heart disease (coronary artery disease) occurs when plaque builds up in the coronary arteries, the vessels that supply blood to the heart. Heart disease can lead to heart attack. Risk factors for heart disease include: Smoking High blood pressure High cholesterol Diabetes Family history Obesity Angina, shortness of breath, and sweating are just a few symptoms that may indicate a heart attack. Treatment of heart disease involves control of heart disease risk factors through lifestyle changes, medications, and/or stenting or bypass surgery. Heart disease can be prevented by controlling heart disease risk factors.
Rhabdomyolysis is a rapid deterioration and destruction of skeletal muscle. Some of the causes of rhabdomyolysis include: severe burns, muscle trauma, coma, seizures, electrolyte imbalance, medications (statins), viruses, and bacteria. Treatment of rhabdomyolysis depends on the cause.
Angina is chest pain due to inadequate blood supply to the heart. Angina symptoms may include chest tightness, burning, squeezing, and aching. Coronary artery disease is the main cause of angina but there are other causes. Angina is diagnosed by taking the patient's medical history and performing tests such as an electrocardiogram (EKG), blood test, stress test, echocardiogram, cardiac CT scan, and heart catheterization. Treatment of angina usually includes lifestyle modification, medication, and sometimes, surgery. The risk of angina can be reduced by following a heart healthy lifestyle.
Cholesterol (Lowering Your Cholesterol)
High cholesterol and triglyceride levels increase the risk of cardiovascular disease. Getting your cholesterol and triglyceride levels in an optimal range will help protect your heart and blood vessels. Cholesterol management may include lifestyle interventions (diet and exercise) as well as medications to get your total cholesterol, LDL, HDL, and triglycerides in an optimal range.
A 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.
Fatty Liver (NASH)
Nonalcoholic fatty liver disease or NASH occurs due to the accumulation of abnormal amounts of fat within the liver. Fatty liver most likely caused by obesity and diabetes. Symptoms of fatty liver disease are primarily the complications of cirrhosis of the liver; and may include mental changes, liver cancer, the accumulation of fluid in the body (ascites, edema), and gastrointestinal bleeding. Treatment for fatty liver includes avoiding certain foods and alcohol. Exercise, weight loss, bariatric surgery, and liver transplantation are treatments for fatty liver disease.
HDL vs. LDL Cholesterol (Good and Bad)
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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
Heart Attack Treatment
A heart attack involves damage or death of part of the heart muscle due to a blood clot. The aim of heart attack treatment is to prevent or stop this damage to the heart muscle. Heart attack treatments included medications, procedures, and surgeries to protect the heart muscle against injury.
Low Cholesterol Diet
Cholesterol is naturally produced by the body, and is a building block for cell membranes and hormones. Low-density lipoprotein (LDL) cholesterol is the "bad" cholesterol, and high-density lipoprotein (HDL) cholesterol is the "good" cholesterol. High levels of LDL and low levels of HDL cholesterol put a person at risk for heart attack, stroke, transient ischemic attack (TIA or mini stroke), and peripheral artery disease. High cholesterol can be lowered by eating foods that lower cholesterol, for example, eat more high soluble fiber foods (oatmeal, oat bran, vegetables, and certain fruits), use olive oil, eat foods fortified with plant sterols and stanols, soy, nuts, and omega-3 fatty acids. Foods that raise LDL or bad cholesterol include foods high in saturated and trans fats, fatty meats, limit egg yolks, limit milk products, limit crackers, muffins, and snacks, and avoid unhealthy fast foods that are high in fat and sugar High cholesterol treatment includes lifestyle changes (diet and exercise), and medications such as statins, bile acid resins, and fibric acid derivatives.
Heart Attack Prevention
Heart disease and heart attacks can be prevented by leading a healthy lifestyle with diet, exercise, and stress management. Symptoms of heart attack in men and women include chest discomfort and pain in the shoulder, neck, jaw, stomach, or back. Women experience the same symptoms as men; however, they also may experience: Extreme fatigue Pain in the upper abdomen Dizziness Fainting Leading a healthy lifestyle with a heart healthy low-fat diet, and exercise can help prevent heart disease and heart attack.
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