A Guide to Most Common Cholesterol Medications

A Guide to Most Common Cholesterol Medications

(Dyslipidemia Drugs)

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The Most Famous 5 drugs most Commonly used in the Treatment of Dyslipidemia “Cholesterol Medications” are:

1- Atorvastatin 💊

2- Lovastatin 💊 

3- Pravastatin 💊

4- Rosuvastatin 💊

5- Simvastatin 💊

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Atorvastatin

• Brand Names: Lipitor
• Therapeutic Category: HMG-CoA Reductase Inhibitor
• Dosage Forms: oral (tablet)
• Use: Cholesterol Medications
• Labeled Indications: Dyslipidemias/ Prevention of cardiovascular disease (CVD)
• Off-Label: Cardiac risk reduction for noncardiac surgery (perioperative therapy)/ Noncardioembolic stroke
• Dosing : Adult: Oral: Initial: 10 or 20 mg once daily; patients requiring >45% reduction in LDL-C may be started at 40 mg once daily; range: 10 to 80 mg once daily
• Pediatric : Children ≥10 years and Adolescents: Oral: 10 mg once daily (maximum: 20 mg/day)
• Dose Adjustments
• Renal Impairment:. No dosage adjustment.
• Hepatic Impairment: Contraindicated in active liver disease or in patients with unexplained persistent elevations of serum transaminases.
• Adverse Drug Interaction:
  Diarrhea/ Arthralgia/ Nasopharyngitis/ Insomnia
• Pharmacodynamics/Kinetics:
• Onset of action: Initial changes: 3 to 5 days; Maximal reduction in plasma cholesterol and triglycerides: 2 to 4 weeks;
• Time to peak, serum: 1 to 2 hours
• Metabolism: Hepatic
• Half-life elimination: Parent drug: 14 hours; Equipotent metabolites: 20 to 30 hours
• Important Notes:
• Diabetes mellitus: Increases in HbA1c and fasting blood glucose have been reported with HMG-CoA reductase inhibitors
• Hepatotoxicity: Persistent elevations in serum transaminases have been reported
• Pregnancy & Lactation: Pregnancy category X/ not known if present in breast milk
• Drug safety issue:

AtorvaSTATin may be confused with atoMOXetine, lovastatin, nystatin, pitavastatin, pravastatin, rosuvastatin, simvastatinMevacor may be confused with Benicar, Lipitor

 

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Lovastatin

 

• Brand Names: Altoprev; Mevacor
• Therapeutic Category: HMG-CoA Reductase Inhibitor
• Dosage Forms: oral (tablet)
• Use: Cholesterol Medications
• Labeled Indications: Adjunct to dietary therapy to decrease elevated serum total and LDL-cholesterol concentrations/Primary prevention of coronary artery disease
• Off-Label: Cardiac risk reduction for noncardiac surgery/ Noncardioembolic stroke
• Dosing Adult: Dyslipidemia and primary prevention of CAD: Oral: Initial: 20 mg once daily with evening meal, then adjust at 4-week intervals; maximum dose: 80 mg daily
• Pediatric10 to 40 mg once daily with evening meal, then adjust dose at 4-week intervals
• Dose Adjustments
• Renal Impairment:. CrCl <30 mL/minute: Use with caution and carefully consider doses >20 mg/day.
• Hepatic Impairment: No dosage adjustment
• Adverse Drug Interaction:
  Increased creatine phosphokinase/ Headache, dizziness
• Pharmacodynamics/Kinetics:
• Onset of action: LDL-cholesterol reductions: 3 days
• Time to peak, serum: Immediate release: 2-4 hours
• Metabolism: Hepatic
• Half-life elimination: 1.1-1.7 hours
• Important Notes:
• Diabetes mellitus: Increases in HbA1c and fasting blood glucose have been reported with HMG-CoA reductase inhibitors
• Reduced cholesterol synthesis as a result of therapy could theoretically lead to reduced adrenal or gonadal steroid hormone production
• Pregnancy & Lactation: Pregnancy category X/ not known if present in breast milk
• Drug safety issue:

Lovastatin may be confused with atorvaSTATin, Leustatin, Livostin, Lotensin, nystatin, pitavastatin

Mevacor may be confused with Benicar, Lipitor

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Pravastatin

• Brand Names: Pravachol
• Therapeutic Category: HMG-CoA Reductase Inhibitor
• Dosage Forms: oral (tablet)
• Use: Cholesterol Medications
• Labeled Indications: Hyperlipidemia/ Prevention of cardiovascular disease
• Off-Label: Cardiac risk reduction for noncardiac surgery (perioperative therapy)/ Noncardioembolic stroke/Transient ischemic attack (secondary prevention)
• Dosing : Adult: Oral: Initial: 40 mg once daily; titrate dosage to response (maximum dose: 80 mg/day)
• Pediatric : Children and Adolescents 8 to 13 years: 20 mg once daily
• Adolescents 14 to 18 years: 40 mg once daily
• Dose Adjustments
• Renal Impairment:. no dosage adjustments
• Hepatic Impairment: Use is contraindicated.
• Adverse Drug Interaction:
  Chest pain/ Headache/ fatigue/ Nausea
• Pharmacodynamics/Kinetics:
• Onset of action: Several days
• Peak effect: 4 weeks
• Bioavailability: 17%
• Half-life elimination: 77 hours (including all metabolites)
• Important Notes:
• Diabetes mellitus: Increases in HbA1c and fasting blood glucose have been reported with HMG-CoA reductase inhibitors
• Reduced cholesterol synthesis as a result of therapy could theoretically lead to reduced adrenal or gonadal steroid hormone production
• Pregnancy & Lactation: Pregnancy category X/ excreted in breast milk
• Drug safety issue:

Pravachol may be confused with atorvaSTATin, Prevacid, Prinivil, propranolol

Pravastatin may be confused with nystatin, pitavastatin, prasugrel

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Rosuvastatin

• Brand Names: Crestor
• Therapeutic Category: HMG-CoA Reductase Inhibitor
• Dosage Forms: oral (tablet)
• Use: Cholesterol Medications
• Labeled Indications: Familial hypercholesterolemia/ Hyperlipidemia and mixed dyslipidemia/ Hypertriglyceridemia
• Off-Label: Cardiac risk reduction for noncardiac surgery (perioperative therapy)/ Noncardioembolic stroke/Transient ischemic attack (secondary prevention)
• Dosing : Adult: usual dosage range: 5 to 40 mg once daily (maximum dose: 40 mg/day)
• Pediatric : Children 8 to <10 years: 5 to 10 mg once daily (maximum: 10 mg/day)
• Children ≥10 years and Adolescents: 5 to 20 mg once daily (maximum: 20 mg/day)
• Dose Adjustments
• Renal Impairment:. CrCl <30 mL/minute/1.73 m2: Initial: 5 mg once daily (maximum: 10 mg/day).
• Hepatic Impairment: no dosage adjustments
• Adverse Drug Interaction:
  Myalgia/ Headache/ dizziness/ Nausea
• Pharmacodynamics/Kinetics:
• Onset of action: Within 1 week; maximal at 4 weeks
• Time to peak, plasma: 3 to 5 hours
• Metabolism: Hepatic
• Half-life elimination: 19 hours
• Important Notes:
• Diabetes mellitus: Increases in HbA1c and fasting blood glucose have been reported with HMG-CoA reductase inhibitors
• Hematuria/proteinuria: Hematuria (microscopic) and proteinuria have been observed; more commonly reported in adults receiving rosuvastatin 40 mg daily
• Pregnancy & Lactation: Pregnancy category X/ present in breast milk
• Drug safety issue:

Rosuvastatin may be confused with atorvaSTATin, nystatin, pitavastatin

 

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Simvastatin

• Brand Names: Zocor
• Therapeutic Category: HMG-CoA Reductase Inhibitor
• Dosage Forms: oral (tablet/suspension)
• Use:
• Labeled Indications: Dysbetalipoproteinemia/ Heterozygous familial and nonfamilial hypercholesterolemia and mixed dyslipidemia/ Prevention of cardiovascular events
• Off-Label: Cardiac risk reduction for noncardiac surgery (perioperative therapy)
• Dosing : Adult: Oral: 40 mg once daily in the evening
• If patient is unable to achieve low-density lipoprotein-cholesterol (LDL-C) goal using the 40 mg dose of simvastatin, increasing to 80 mg dose is not recommended. Instead, switch patient to an alternative LDL-C-lowering treatment
• Pediatric : Initial: 10 mg once daily in the evening; range: 10 to 40 mg/day (maximum: 40 mg/day))
• Dose Adjustments
• Renal Impairment:. No dosage adjustment.
• Hepatic Impairment: Contraindicated in active liver disease or in patients with unexplained persistent elevations of serum transaminases.
• Adverse Drug Interaction:
  Atrial fibrillation/ Eczema/ Abdominal pain/ constipation
• Pharmacodynamics/Kinetics:
• Onset of action: >3 days
• Peak effect: 2 weeks
• Metabolism: Hepatic
• Time to peak: 1.3 to 2.4 hours
• Important Notes:
• Diabetes mellitus: Increases in HbA1c and fasting blood glucose have been reported with HMG-CoA reductase inhibitors
• Hepatotoxicity: Persistent elevations in serum transaminases have been reported
• Pregnancy & Lactation: Pregnancy category X/ not known if present in breast milk
• Drug safety issue:

Simvastatin confused with atorvaSTATin, nystatin, pitavastatin

Zocor may confused with Cozaar, Lipitor, Zoloft, ZyrTEC

 

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