
GENERIC NAME: lovastatin
BRAND NAME: Mevacor, Altocor
DRUG CLASS AND MECHANISM: Lovastatin is a cholesterol-
lowering
medicine. It inhibits the production of cholesterol by the
liver. It
lowers overall blood cholesterol as well as blood LDL
cholesterol levels.
LDL cholesterol is believed to be the "bad"
cholesterol that is
primarily responsible for the development of coronary artery
disease.
Lowering LDL cholesterol levels retards progression and may
even reverse
coronary artery disease.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 10, 20, and 40 mg. Extended release tablets: 10, 20, 40, and 60 mg.
STORAGE: Tablets should be stored at room temperature
in a
tightly closed container.
PRESCRIBED FOR: High LDL cholesterol is usually first
treated
with exercise, weight loss in obese individuals, and a diet low
in
cholesterol and saturated fats. When these measures fail,
cholesterol-lowering medications such as lovastatin can be
added. The
National Cholesterol Education Program (NCEP) has published
treatment
guidelines for use of these medications. These treatment
guidelines take
into account the level of LDL cholesterol as well as the
presence of other
risk factors such as diabetes, hypertension, cigarette smoking,
low HDL
cholesterol level, and family history of early coronary heart
disease. The
effectiveness of the medication in lowering cholesterol is dose-
related.
Blood cholesterol determinations are performed in regular
intervals during
treatment so that dosage adjustments can be made. A reduction
in LDL
cholesterol level can be seen two weeks after starting therapy.
DOSING: May be taken on an empty or full stomach. The
medication
seems to be most effective when given with the evening meal.
DRUG INTERACTIONS: Lovastatin is generally well-
tolerated by
most patients. The medication should be used with caution in
patients with
alcohol or other liver diseases. Persistent abnormal liver
tests during
treatment are rare, but may lead to the discontinuation of the
medication.
Rare cases of muscle inflammation (myositis) and breakdown have
been
reported with lovastatin. Muscle breakdown causes release of
muscle
protein (myoglobin) into the blood and kidney tubules,
resulting in kidney
failure. Severe muscle breakdown and kidney failure have been
reported
when lovastatin is used together with gemfibrozil (Lopid).
Therefore their
concomitant use is discouraged. The risk of muscle breakdown is
also
increased when lovastatin is given together with other
medications, such
as cyclosporine (Sandimmune), erythromycin and nicotinic acid.
Therefore,
lovastatin should be used with caution and in lower doses when
medications, such as cyclosporine are also needed. Lovastatin
should not
be used by children. It is not habit forming.
PREGNANCY: Lovastatin may cause fetal harm, and should
not be
given to pregnant women.
NURSING MOTHERS: Lovastatin should not be used by
nursing
mothers because of potential adverse side effects to the
nursing infant.
SIDE EFFECTS: Side effects are rare. Minor side
effects include
constipation, diarrhea, gas, heartburn, headache, insomnia.
Major side
effects include abdominal pain or cramps, blurred vision,
dizziness,
itching, muscle pain or cramps, rash, yellowing of the skin or
eyes.
Last Editorial Review: 12/31/1997
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