Endocrine Society GUIDELINES Bundle (free trial)

17 Table 4. Statins: LDL-C Reduction by Dose, and Major Drug Interactions Pitavastatin ----- 1 mg, 2 mg, 4 mg ----- Erythromycin, rifampin, colchicine, niacin Lovastatin ----- 40 mg, 80 mg 20 mg Verapamil, diltiazem, amiodarone, dronedarone, macrolide antibiotics, antifungal azoles, nefazodone, danazol, ranolazine, colchicine, cyclosporine, niacin Fluvastatin ----- 40 mg BID 20 mg, 40 mg Fluconazole, colchicine, cyclosporine, niacin, glyburide, phenytoin Red Italics represent drugs and doses specifically studied in CVD outcomes trials that demonstrated significant reduction in vascular events (Cholesterol Treatment Trialists Collaboration, Baigent C, Blackwell L, et al. Efficacy and safety of more intensive lowering of ldl cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet. 2010;376(9753):1670–1681; Yusuf S, Bosch J, Dagenais G, et al.; HOPE-3 Investigators. Cholesterol lowering in intermediate-risk persons without cardiovascular disease. N Engl J Med. 2016;374(21):2021–2031.) * Some of the drugs listed require a reduction in statin dose with some statins and should be avoided in others. Macrolide antibiotics include clarithromycin, erythromycin and telithromycin. Azole antifungals include itraconazole, ketoconazole, posaconazole, voriconazole. All statins have varying interactions with HIV protease inhibitors and other antiretroviral medications, and hepatitis C protease inhibitors (Newman CB, Preiss D, Tobert JA, et al.; American Heart Association Clinical Lipidolog y, Lipoprotein, Metabolism and rombosis Committee, a Joint Committee of the Council on Atherosclerosis, rombosis and Vascular Biolog y and Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular Disease in the Young ; Council on Clinical Cardiolog y; and Stroke Council. Statin safety and associated adverse events: a scientific statement from the American Heart Association. Arterioscler romb Vasc Biol. 2019;39(2):e38–e81.). For more information on interactions and dose limitations, see product labeling and Newman et al. 2019 "Statin Safety and Associated Adverse Events: A Scientific Statement from the American Heart Association" (Newman CB, Preiss D, Tobert JA, et al.; American Heart Association Clinical Lipidolog y, Lipoprotein, Metabolism and rombosis Committee, a Joint Committee of the Council on Atherosclerosis, rombosis and Vascular Biolog y and Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular Disease in the Young ; Council on Clinical Cardiolog y; and Stroke Council. Statin safety and associated adverse events: a scientific statement from the American Heart Association. Arterioscler romb Vasc Biol. 2019;39(2):e38–e81.). † Due to increased rosuvastatin plasma concentrations in Asian patients, initiation with the 5 mg dose is suggested. From prescribing information for Parke-Davis Div of Pfizer Inc. Prescribing information for Lipitor (atorvastatin calcium) 2020. ScicGen Pharmaceuticals. Prescribing information for rosuvastatin 2020. NuCare Pharmaceuticals, Inc. Prescribing information for simvastatin 2020. PD-Rx Pharmaceuticals, Inc. Prescribing information for pravastatin 2020. Kowa Pharmaceuticals America, Inc. Prescribing information for LIVALO (Pitavastatin calcium) 2009. Teva Pharmaceuticals USA, Inc. Prescribing information for Lovastatin 2020. Mylan Pharmaceuticals Inc. Prescribing information for Fluvastatin 2020.

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