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- What is lovastatin, and how does it work (mechanism of action)?
- 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?
- What is the dosage for lovastatin?
- Which drugs or supplements interact with lovastatin?
- Is lovastatin safe to take if I'm pregnant or breastfeeding?
- What else should I know about lovastatin?
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 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.
Quick GuideLower Your Cholesterol, Save Your Heart
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).
Reference: FDA Prescribing Information
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Angina SymptomsAngina 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.
Lipitor (atorvastatin) is a drug in the statin drug classed prescribed to patients to lower blood cholesterol, LDL, and triglycerides, elevate HDL cholesterol, to prevent angina, stroke, heart attack, congestive heart failure, revascularization procedures in heart disease, and prevent heart attacks, and strokes in patients with type 2 diabetes. Side effects of Lipitor include:
- Urinary tract infections (UTIs)
- Joint pain
- Common cold
- Intestinal gas
Drug interactions, dosing, and pregnancy and breastfeeding safety should be reviewed prior to taking any medication.
Cholesterol Drugs SlidesWhen diet and exercise aren't enough, should you turn to drugs? Learn cholesterol basics, drug classes, and available drugs along with their benefits and side effects.
Drugs: What You Should Know About Your DrugsImportant information about your drugs should be reviewed prior to taking any prescription drug. Side effects, drug interactions, warnings and precauctions, dosage, what the drug is used for, what to do if you miss a dose, how the drug is to be stored, and generic vs. brand names.
HDL vs. LDL Cholesterol Differences
HDL (high-density lipoprotein), or the "good" cholesterol, and LDL (low-density lipoprotein), or the "bad" cholesterol, are lipoproteins that carry cholesterol through the veins and arteries of the body. HDL and LDL combined, is your "total" blood cholesterol. The difference between the two are that high levels of the "good," or HDL cholesterol, may protect against narrowing of the blood vessels in the body, which protects you against heart attack, stroke, and other cardiovascular diseases. But high levels of LDL, or the "bad" cholesterol, may worsen the narrowing of the blood vessels in the body, which puts you at a greater risk of stroke, heart attack, and cardiovascular diseases, some of which are life threatening.
Triglycerides are found in body fat and from the fats you eat. Triglycerides levels in the blood reflect what you have eaten recently. HDL and LDL cholesterol levels show what you have been eating over a long period of time. If you eat a fatty meal your triglyceride levels will be elevated for a short period of time. If you continue to eat a diet high in fat your triglyceride levels will continue to rise. The liver transfers the triglycerides into body fat, or cholesterol, which raises LDL and lowers HDL levels in the blood.
Healthy (normal) total blood cholesterol levels are determined by the levels of HDL, LDL, and triglycerides in the blood. Talk with your doctor or other health care professional if you are concerned about your cholesterol levels, which can easily be determined with a simple blood test.
VLDL, or very-low- lipoproteins, is a third type of cholesterol. VLDL is another type of "bad" cholesterol that the liver produces, which contains a high amount of triglycerides.
REFERENCE: American Heart Association. "HDL (Good), LDL (Bad) Cholesterol and Triglycerides." Updated: Jul 05, 2017.
Heart AttackHeart 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 Attack and Atherosclerosis 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
Leading a healthy lifestyle with a heart healthy low-fat diet, and exercise can help prevent heart disease and heart attack.
Heart Attack TreatmentA 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.
Heart Disease (Coronary Artery Disease)
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:
- High blood pressure
- High cholesterol
- Family history
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.
Cholesterol QuizHigh cholesterol can be a dangerous condition. Take the Cholesterol Quiz to understand what high cholesterol means in terms of your health risks.
High Cholesterol: Frequently Asked QuestionsCholesterol 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
Liver Blood TestsAn initial step in detecting liver damage is a simple blood test to determine the presence of certain liver enzymes in the blood. Under normal circumstances, these enzymes reside within the cells of the liver. But when the liver is injured, these enzymes are spilled into the blood stream, and can lead to diseases like fatty liver, type 2 diabetes, obesity, and hepatitis. Several medications also can increase liver enzyme test results.
Lower Cholesterol Levels with Diet and Medication
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
- 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
- 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.
RhabdomyolysisRhabdomyolysis is a rapid deterioration and destruction of skeletal muscle. Some of the causes of rhabdomyolysis include:
- severe burns,
- muscle trauma,
- electrolyte imbalance,
- medications (statins),
- viruses, and
simvastatinZocor (simvastatin) belongs to the drug class of statins and is prescribed for lowering cholesterol and triglyceride levels. Side effects, drug interactions, warnings and precautions, and patient safety information should be reviewed prior to taking any medication.
Statins is a class of drugs prescribed to lower blood cholesterol. Statins also are prescribed for preventing and treating atherosclerosis. Common side effects of statins are
- constipation, and
Serious side effects can occur.
Examples of statins available in the US are
- atorvastatin (Lipitor),
- fluvastatin (Lescol, Lescol XL),
- lovastatin (Mevacor, Altoprev),
- pravastatin (Pravachol),
- rosuvastatin (Crestor),
- simvastatin (Zocor), and
- pitavastatin (Livalo).
Drug interactions, dosing, storage, and pregnancy safety should be reviewed prior to taking this medication.
Triglyceride TestTriglycerides are a common form of fat that we digest. Triglycerides are the main ingredient in animal fats and vegetable oils. Elevated levels of triglycerides are a risk factor for heart disease, heart attack, stroke, fatty liver disease, and pancreatitis. Elevated levels of triglycerides are also associated with diseases like diabetes, kidney disease, and medications (for example, diuretics, birth control pills, and beta blockers). Dietary changes, and medication if necessary can help lower triglyceride blood levels.