Lovastatin
MEVACOR
Pronunciation: LOE-va-sta-tin
“Lover’s Mega coronary”
What it isHMG-CoA reductase inhibitor; hyperlipidemia.
Why this oneFood-dependent absorption and modest potency have pushed it behind atorvastatin and rosuvastatin.
What limits itCYP3A4 inhibitors and grapefruit increase myopathy risk; the immediate-release product must be taken with food.
FDA-approved for
- hyperlipidemia (1987)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Hypercholesterolemia / hyperlipidemia | Adults | 20 mg QD with evening meal (10 mg if smaller LDL reduction needed) | 10–80 mg/day, QD or divided BID | 80 mg/day |
| Heterozygous familial hypercholesterolemia | Adolescents 10–17 yr | 20 mg/day (10 mg if smaller reduction) | 10–40 mg/day | 40 mg/day |
Titration Adjust at intervals of 4 weeks or more
Renal Severe (CLcr <30 mL/min): carefully consider before exceeding 20 mg/day
Hepatic Contraindicated in active liver disease or unexplained persistent transaminase elevations
With danazol/diltiazem/dronedarone/verapamil: start 10 mg, max 20 mg/day; with amiodarone: max 40 mg/day
Instructions
- Take with meals (evening meal for once-daily dosing)
- Place patient on a standard cholesterol-lowering diet before and during treatment
Available strengths
- tab 10, 20, 40 mg
Contraindications
- Active liver disease or unexplained persistent serum transaminase elevations
- Concomitant strong CYP3A4 inhibitors (e.g., itraconazole, ketoconazole, HIV protease inhibitors, clarithromycin, erythromycin, telithromycin, nefazodone, cobicistat-containing products)
- Pregnancy and lactation
Cautions
- Myopathy / rhabdomyolysis (higher risk with CYP3A4 inhibitors, cyclosporine, gemfibrozil, niacin)
- Immune-mediated necrotizing myopathy (rare)
- Liver dysfunction / persistent transaminase elevations
Adverse reactions
- Flatulence
- Abdominal pain
- Constipation
- Diarrhea
- Myalgia
- Headache
- Elevated transaminases and CK
Pregnancy Contraindicated (Category X) — may harm the fetus; discontinue immediately if pregnancy is recognized
Lactation Contraindicated in nursing mothers
Cost
Generic entry2001
NO BOXED WARNINGS
Principal riskMyopathy; the most CYP3A4-dependent statin
Classes and tags
Clinical profile
Legacy pregnancy categoryX
Defining liabilityMyopathy/rhabdomyolysis and hepatotoxicity; interaction burden varies by agent.
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