Indications for ZYPITAMAG:
Adjunct to diet to reduce elevated total-C, LDL-C, ApoB, and TG, and to increase HDL-C in primary hyperlipidemia and mixed dyslipidemia.
Limitations of Use:
Effect on cardiovascular morbidity and mortality has not been determined.
Individualize. Initially 2mg once daily; may increase after 4 weeks to max 4mg once daily. Moderate to severe renal impairment (CrCl 15–59mL/min, or ESRD with hemodialysis): initially 1mg once daily; max 2mg once daily. Concomitant erythromycin: max 1mg daily. Concomitant rifampin: max 2mg daily.
Active liver disease. Unexplained, persistent elevated serum transaminases. Concomitant cyclosporine. Pregnancy. Nursing mothers.
Increased risk of myopathy and rhabdomyolysis esp. in renal impairment, uncontrolled hypothyroidism, age ≥65yrs, higher dose. Discontinue if markedly elevated CK levels occur or myopathy is confirmed or suspected; suspend if a predisposition to development of renal failure secondary to rhabdomyolysis develops. Immune-mediated necrotizing myopathy; monitor. Monitor liver function prior to initiation and as clinically indicated. Discontinue immediately if serious liver injury with clinical symptoms and/or hyperbilirubinemia or jaundice occurs. Substantial alcohol ingestion. Advise females of reproductive potential to use effective contraception during treatment.
HMG-CoA reductase inhibitor.
See Contraindications. Avoid gemfibrozil. Potentiated by erythromycin, rifampin (see Adults). Increased risk of myopathy with concomitant fibrates, colchicine, niacin (≥1g/day); consider risk/benefit.
Myalgia, back/extremity pain, diarrhea, constipation; myopathy, rhabdomyolysis, increases in CK, liver enzymes, HbA1c and fasting serum glucose; rare: cognitive impairment, fatal/non-fatal hepatic failure.
Generic Drug Availability:
Tabs—30, 90, 100, 500, 1000