Lovatin

Indications

Lovastatin is a statin used together with a low-fat diet to lower LDL ("bad") cholesterol and total cholesterol and to raise HDL ("good") cholesterol in people with high cholesterol. It is also used to slow the hardening of the heart arteries and to lower the risk of heart attack and related heart problems in people at risk.

How It Works

Lovastatin blocks HMG-CoA reductase, an enzyme the liver needs to make cholesterol. With less cholesterol being made, the liver removes more LDL cholesterol from the blood. This reduces the fatty build-up in blood vessels over time.

Dosage and Administration

Usual adult starting dose: 20 mg once daily with the evening meal. The doctor may adjust the dose at intervals of 4 weeks or more, within a range of 10 mg to 80 mg a day (given once daily or in two divided doses). Extended-release tablets are taken at bedtime. Take the regular tablets with food, as this helps absorption. Continue the diet and keep taking it even when you feel well.

Interactions

Do not take with strong CYP3A4 inhibitors such as Itraconazole, Ketoconazole, Clarithromycin, Erythromycin, HIV protease inhibitors, or with Gemfibrozil or Ciclosporin, as these greatly raise the risk of muscle damage. Lower doses are needed with Amiodarone, Verapamil, Diltiazem, Danazol and Niacin. Avoid large amounts of grapefruit juice. It may increase the effect of Warfarin.

Contraindications

Do not use if you are allergic to Lovastatin, have active liver disease or unexplained raised liver enzymes, are pregnant or breastfeeding, or are taking the strong interacting medicines listed above.

Side Effects

Common side effects include headache, constipation, wind, indigestion, stomach pain, nausea, muscle aches and dizziness. Rarely, statins can cause serious muscle breakdown, liver problems, memory problems or a small rise in blood sugar.

Get urgent medical help if you have unexplained muscle pain, tenderness or weakness, especially with fever or dark urine, yellowing of the skin or eyes, or swelling of the face or difficulty breathing.

Pregnancy and Lactation

Do not use in pregnancy, as it may harm the developing baby. Use reliable contraception if you could become pregnant, and stop taking it and tell your doctor if you become pregnant. Do not use while breastfeeding.

Precautions and Warnings

Liver tests may be done before starting. Tell your doctor if you drink a lot of alcohol, have kidney disease, an underactive thyroid, diabetes or past muscle problems. The risk of muscle problems is higher in older people and at higher doses. Your doctor may pause treatment before major surgery.

Overdose

There is limited experience of overdose. Seek medical help if a large amount has been taken; treatment is supportive with monitoring of liver and muscle tests.

Therapeutic Class

Lipid-lowering agent (HMG-CoA reductase inhibitor, statin).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.