To reduce risk of MI, unstable angina, and coronary revascularization procedures in patients without symptomatic cardiovascular disease (CVD), average to moderately elevated total-C and LDL-C, and below average HDL-C. Adjunct to diet in primary hypercholesterolemia and mixed dyslipidemias (Types IIa and IIb) to lower elevated total-C, LDL-C, apo B, and TG, and to increase HDL-C, when response to nondrug therapy alone is inadequate. To slow progression of coronary atherosclerosis in patients with coronary heart disease by lowering total-C and LDL-C.
Swallow whole. Individualize. ≥20yrs: 20–60mg once daily at bedtime; adjust at intervals of ≥4 weeks. Elderly (≥65yrs), renal insufficiency, diabetes: initially 20mg once daily at bedtime. Concomitant danazol, diltiazem, verapamil: max 20mg/day. Concomitant amiodarone: max 40mg/day. Severe renal insufficiency (CrCl<30mL/min): usual max 20mg/day.
<20yrs: not recommended.
HMG-CoA reductase inhibitor.
Active liver disease. Unexplained persistent elevated serum transaminases. Pregnancy (Cat.X). Nursing mothers. Concomitant strong CYP3A4 inhibitors (eg, itraconazole, ketoconazole, posaconazole, HIV protease inhibitors, boceprevir, telaprevir, erythromycin, clarithromycin, telithromycin, nefazodone).
Discontinue if myopathy, elevated CPK levels occur; suspend if a predisposition to development of renal failure secondary to rhabdomyolysis develops. Monitor liver function before starting therapy and repeat as clinically indicated. History of liver disease. Alcoholism. Homozygous familial hypercholesterolemia.
See Contraindications. Increased risk of myopathy with strong CYP3A4 inhibitors. May be potentiated by voriconazole, ranolazine; consider dose adjustment of lovastatin. Avoid gemfibrozil, cyclosporine, grapefruit juice >1 quart daily. Caution with, other fibrates, macrolides, niacin (≥1g/day), colchicine. Monitor oral anticoagulants. Inhibition of endogenous steroid production with spironolactone, ketoconazole, cimetidine.
Nausea, abdominal pain, insomnia, dyspepsia, headache, asthenia, myalgia, infection, accidental injury, elevated serum transaminases, myopathy, rhabdomyolysis with renal dysfunction; rare: immune-mediated necrotizing myopathy.
This product was formerly named Altocor.