ORIGINAL USES (ON-LABEL)
In combination with dietary changes to reduce increased total and LDL-cholesterol levels, primary prevention of coronary artery disease (patients without symptomatic disease with average to moderately elevated total and LDL-cholesterol and below average HDL-cholesterol), coronary heart disease.
In combination with dietary measure to treat adolescent patients (10–17 years of age, females greater than one year past the date of menstruation), high cholesterol levels related to certain types of hereditary disease
BRAND NAME Altocor, Altoprev, Mevacor
DRUG CLASS
Anti-lipid (HMG-CoA reductase inhibitor)
DESCRIPTION
Lovastatin inhibits an enzyme that your body uses in the production of cholesterol.
Not for use if you have active liver disease, are pregnant or breast-feeding.
May cause increases in laboratory tests used to monitor liver function. These tests should be performed before and every 4–6 weeks during the first 12–15 months of therapy and periodically thereafter.
Can also cause severe muscles aches that are a symptom of a more serious disorder (rhabdomyolysis) in which the muscle fibers break down. If this disorder progresses, decreases in kidney function may also occur. Risk is increased with the combination use of clarithromycin, danazol, diltiazem, fluvoxamine, indinavir, nefazodone, nelfinavir, ritonavir, verapamil, troleandomycin, cyclosporine, fibric acid derivatives, erythromycin, niacin, azole antifungals, or large quantities of grapefruit juice.
DRUG INTERACTIONS
Azole antifungals, ciprofloxacin, clarithromycin, diclofenac, doxycycline, erythromycin, imatinib, isoniazid, nefazodone, nicardipine, propofol, protease inhibitors, quinidine, and verapamil. Stop lovastatin therapy during concurrent clarithromycin, erythromycin, itraconazole, or ketoconazole therapy.
Cyclosporine, clofibrate, fenofibrate, gemfibrozil, niacin, warfarin, levothyroxine may be increased by lovastatin. Digoxin, norethindrone, and ethinyl estradiol levels, cholestyramine
FOOD INTERACTIONS
Avoid intake of large quantities of grapefruit juice (greater than or equal to 1 quart/day); may increase toxicity.
HERBAL INTERACTIONS
St. John’s wort
PREGNANCY AND BREAST-FEEDING CAUTIONS
FDA Pregnancy Risk Category X. Lovastatin should not be used during breast-feeding.
SPECIAL INFORMATION
Before initiation of therapy, patients should be placed on a standard cholesterol-lowering diet for six weeks and the diet should be continued during drug therapy. Take as directed, with food at evening meal. Report any signs of muscle pain, tenderness, or weakness to doctor. Extended release tablets (Altoprev) should be swallowed whole; do not chew, crush, or cut.
