Lovastatin

Registered South African indications:

• Primary hypercholesterolemia (Types IIa and IIb)
  - As an adjunct to diet for the reduction of elevated total and Low Density Lipoprotein Cholesterol (LDL-C) levels, when the
  response to diet and other measures alone has been inadequate

Contraindication

• Hypersensitivity to the active ingredient or any of its excipients
• Pregnancy
• Breastfeeding
• Active liver disease or unexplained persistent elevations of serum-aminotransaminases and creatine-phosphokinase. If such a condition develops during therapy, the medicine should be discontinued
• Safe use of lovastatin in children have not been established and is thus not recommended

Caution

• Moderate to severe renal impairment
• Alcohol abuse
• Risk factors for renal failure
• Risk factors for rhabdomyolysis
• Diabetes mellitus
• Homozygous familial hypercholestrolaemia

Forms avail. in SA and covered in this monograph: tab

South African registered indications and dosages

Primary hypercholesterolemia (Types IIa and IIb)
- As an adjunct to diet for the reduction of elevated total and Low Density Lipoprotein Cholesterol (LDL-C) levels, when the
response to diet and other measures alone has been inadequate

• Oral (tab): Initial: 20mg, as a single dly dose with the evening meal; Titrate at intervals of not less than 4 weeks; Maintenance: 20-80mg/day, in 1-2 divided doses with the morning and evening meal; Max: 80mg/24hrs

The patient should be placed on a standard cholesterol-lowering diet before receiving lovastatin and should continue on this diet during treatment. If appropriate, a program of weight control and physical exercise should be implemented

• Contraindicated

Pregnancy

• Contraindicated

Breastfeeding

• Contraindicated

Renal Impairment

• Moderate to severe: Caution; dose adjustment recommended

Hepatic Impairment

• Contraindicated

Elderly

• No dose adjustment recommended

Central Nervous System Disorders

• Headache
• Dizzyness

Gastrointestinal Disorders

• Nausea
• Diarrhoea
• Dysgeusia
• Dyspepsia
• Constipation
• Flatulance
• Abdominal pain

Genitourinary System Disorders

• Acute renal failure

Endocrine and Metabolic Disorders

• Elevated serum aminotransferase 
• Increased creatine phosphokinase concentrations

Musculoskeletal Disorders

• Myopathy
• Myalgia
• Muscle weakness
• Rhabdomyolysis

Skin and Subcutaneous Tissue Disorders

• Skin rashes

Sensory Disorder

• Blurred vision 
• Lens opacities

• CYP3A4 inhibitors
• Propranolol
• Immunosuppresive agents
• Lipid lowering agents
• Warfarin

• Hepatic function

Specific cases may require

• Blood glucose
• Ophthalmic examination
• Creatine phosphokinase

Lovastatin is a cholesterol lowering agent that acts by inhibiting the HMG-CoA reductase enzyme. This enzyme catalyzes the conversion of HMG-CoA to mevalonate, which is an early and rate-limiting step in the biosynthesis of cholesterol. Lovastatin reduces cholesterol production by the liver and induces some changes in cholesterol transport and disposition in the blood and tissues. The mechanism(s) of this effect is believed to involve both reduction in the synthesis of low-density lipoprotein (LDL) and an increase in LDL catabolism as a result of induction of the hepatic LDL receptors.

Tablet 20mg

• Lovachol (Pharmacare)

Tablet 40mg

• Lovachol (Pharmacare)