Lovastatin

DEA Class; Rx

Common Brand Names; Mevacor, Altoprev

Hypersensitivity to lovastatin or other components

Active liver disease, or unexplained elevated transaminases

Concomitant administration with strong CYP3A4 inhibitors (eg, itraconazole, ketoconazole, posaconazole, voriconazole, HIV protease inhibitors, cobicistat, boceprevir, telaprevir, erythromycin, clarithromycin, telithromycin, and nefazodone)

Nonserious and reversible cognitive side effects may occur

Avoid coadministration with cyclosporine or gemfibrozil; caution with other fibrates or lipid-lowering doses of niacin (≥1 g/day) because of increased risk for myopathy

Use caution in heavy alcohol use, history of liver disease, or renal failure

Obtain baseline liver enzyme tests before initiating and then periodically thereafter

Increases in HbA1c and fasting serum glucose levels reported

HMG-CoA reductase inhibitor shown to reduce plasma testosterone response to HCG; effects of HMG-CoA reductase inhibitors on male fertility not studied in adequate numbers of male patients

Effects of therapy, if any, on pituitary-gonadal axis in premenopausal women are unknown; patients who develop clinical evidence of endocrine dysfunction should be evaluated appropriately

Use caution if an HMG-CoA reductase inhibitor or other agent used to lower cholesterol levels is administered to patients also receiving other drugs (e.g., spironolactone, cimetidine) that may decrease levels or activity of endogenous steroid hormones

Risk of myopathy increased by coadministration of CYP3A4 inhibitors or other drugs that cause myopathy

Owing to HMG-CoA reductase inhibitors decrease cholesterol synthesis and possibly the synthesis of other biologically active substances derived from cholesterol, fetal harm may occur when administered to pregnant females

There is no available information on effects of drug on breastfed infant or on milk production

Unknown whether is present in human milk; it has been shown that drugs in this class pass into human milk and atorvastatin is present in rat milk

Not recommended during treatment