Statins (HMG-CoA Reductase Inhibitors)
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' -- ' Signifies that equivalent tablet size is not available (comparable
dose is either too high or too low) |
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Equivalent Dosages -1
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Atorvastatin (Lipitor ®):
-- (see tablet strengths) |
Fluvastatin (Lescol ®):
20 mg |
Lovastatin (Mevacor ®):
10 mg |
Pravastatin (Pravachol ®):
10 mg |
Rosuvastatin (Crestor ®):
-- |
Simvastatin (Zocor ®):
5 mg |
Equivalent Dosages - 2
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Atorvastatin (Lipitor ®):
-- |
Fluvastatin (Lescol ®):
40 mg |
Lovastatin (Mevacor ®):
20 mg |
Pravastatin (Pravachol ®):
20 mg |
Rosuvastatin (Crestor ®):
-- |
Simvastatin (Zocor ®):
10 mg |
Equivalent Dosages - 3
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Atorvastatin (Lipitor ®):
10 mg |
Fluvastatin (Lescol ®):
80 mg |
Lovastatin (Mevacor ®):
40 mg |
Pravastatin (Pravachol ®):
40 mg |
Rosuvastatin (Crestor ®):
5 mg |
Simvastatin (Zocor ®):
20 mg |
Equivalent Dosages - 4
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Atorvastatin (Lipitor ®):
20 mg |
Fluvastatin (Lescol ®):
-- |
Lovastatin (Mevacor ®):
80 mg |
Pravastatin (Pravachol ®):
80 mg |
Rosuvastatin (Crestor ®):
5 - 10 mg |
Simvastatin (Zocor ®):
40 mg |
Equivalent Dosages - 5
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Atorvastatin (Lipitor ®):
40 mg |
Fluvastatin (Lescol ®):
-- |
Lovastatin (Mevacor ®):
-- |
Pravastatin (Pravachol ®):
-- |
Rosuvastatin (Crestor ®):
10 - 20 mg |
Simvastatin (Zocor ®):
80 mg |
Atorvastatin (Lipitor ®)
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Supplied: 10 mg, 20 mg, 40 mg, 80 mg
Dosing: Hyperlipidemias:
Adults: Oral: Initial: 10-20 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.
Adjustments
should be made at intervals of 2-4 weeks.
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Fluvastatin (Lescol ®)
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Supplied: Capsule: 20 mg, 40 mg.
Tablet, extended release (Lescol® XL): 80 mg
Dosing:
Dyslipidemia: Oral: (Adults):
Patients requiring >/= 25% decrease in LDL-C: 40 mg capsule once daily in the
evening, 80 mg XL tablet once daily (anytime), or 40 mg capsule
twice daily. Patients requiring <25% decrease in LDL-C: Initial: 20 mg
capsule once daily in the evening; may increase based on tolerability and
response to a maximum recommended dose of 80 mg/day, given in 2 divided doses
(capsule) or as a single daily dose (XL tablet).
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Lovastatin (Mevacor ®)
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Supplied: Tablet: 10 mg, 20 mg, 40 mg. Tablet, extended release: 20 mg, 40 mg, 60 mg
Dosing: Dyslipidemia: Oral:
(Adults): Initial: 20 mg with evening
meal, then adjust at 4-week intervals; maximum: 80 mg/day immediate release
tablet or 60 mg/day extended release tablet.
Dosage modification/limits based on concurrent therapy:
Cyclosporine and other immunosuppressant drugs: Initial dose: 10 mg/day with a
maximum recommended dose of 20 mg/day.
Concurrent therapy with fibrates, danazol, and/or lipid-lowering doses of niacin
(>1 g/day): Maximum recommended dose: 20 mg/day. Concurrent use with fibrates
should be avoided unless risk to benefit favors use.
Concurrent therapy with amiodarone or verapamil: Maximum recommended dose: 40
mg/day of regular release or 20 mg/day with extended release.
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Pravastatin (Pravachol ®)
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Supplied: 10 mg, 20 mg, 40 mg, 80 mg
Dosing: Hyperlipidemias: Oral:
(Adults): Initial: 40 mg once daily; titrate dosage to
response (usual range: 10-80 mg) (maximum dose: 80 mg once daily).
Dosage adjustment based on concomitant cyclosporine: Oral: Initial: 10 mg/day,
titrate with caution (maximum dose: 20 mg/day). |
Rosuvastatin (Crestor ®)
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Supplied: 5 mg, 10 mg, 20 mg, 40 mg
Dosing: Hypercholesterolemia;
mixed
dyslipidemia:
Oral: (Adults):
Initial dose: 10 mg once daily (20 mg in patients with severe
hypercholesterolemia).
Conservative dosing: Patients requiring less aggressive treatment or predisposed
to myopathy (including patients of Asian descent): 5 mg once daily.
Titration: After 2 weeks, may be increased by 5-10 mg once daily; dosing range:
5 to 40 mg/day (maximum dose: 40 mg once daily).
Dosage adjustment with concomitant medications: Oral:
Cyclosporine: Rosuvastatin dose should not exceed 5 mg/day.
Gemfibrozil: Rosuvastatin dose should not exceed 10 mg/day.
Dosage adjustment for persistent, unexplained proteinuria while on 40 mg/day:
Reduce dose and evaluate causes.
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Simvastatin (Zocor ®)
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Supplied: 5 mg, 10 mg, 20 mg, 40 mg, 80 mg
Dosing: Oral: (Adults):
Prevention of cardiovascular events, hyperlipidemias: Oral: 20-40 mg once daily
in the evening; range: 5 to 80 mg/day.
Homozygous familial hypercholesterolemia: Oral: 40 mg once daily in the evening
or 80 mg/day (given as 20 mg, 20 mg, and 40 mg evening dose).
Patients requiring only moderate reduction of LDL-cholesterol: May be started at
10 mg once daily
Patients requiring reduction of >45% in low-density lipoprotein (LDL)
cholesterol: May be started at 40 mg once daily in the evening.
Patients with CHD or at high risk for CHD: Dosing should be started at 40 mg
once daily in the evening; simvastatin may be started simultaneously with diet.
Dosage adjustment for simvastatin with concomitant medications:
Cyclosporine or danazol: Patient must first demonstrate tolerance to simvastatin
>/= 5 mg once daily: Initial: 5 mg, should not exceed 10 mg/day.
Fibrates or niacin: Dose should not exceed 10 mg/day.
Amiodarone or verapamil: Dose should not exceed 20 mg/day. |
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References
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| Crestor (rosuvastatin) package insert.
Wilmington, DE: AstraZeneca Pharmaceuticals LP; Aug 2003. |
| Drug Facts & Comparisons. St. Louis, MO. Facts &
Comparisons. 2005. |
| Helfand, Mark, Carson, Susan, Kelley, Cathy. Drug
Class Review on HMG-CoA Reductase Inhibitors (Statins). 2006.
http://www.ohsu.edu/drugeffectiveness/reports/final.cfm
Accessed: Sept 2007. |
| Lescol (fluvastatin) package insert. East
Hanover, NJ: Novartis Pharmaceuticals Corporation; October 2001. |
| Mevacor (lovastatin) package insert. West Point,
PA: Merck & Co., Inc.; June 2002. |
| Lipitor (atorvastatin) package insert. Morris
Plains, NJ: Parke-Davis; April 2002. |
| Pravachol (pravastatin) package insert.
Princeton, NJ: Bristol-Myers Squibb; December 2001. |
| Zocor (simvastatin) package insert. Whitehouse
Station, NJ: Merck & Co., Inc; May 2002. |
| The authors make no claims of the accuracy of the
information contained herein; and these suggested doses are not a
substitute for clinical judgement. Neither GlobalRPh Inc. nor any other
party involved in the preparation of this program shall be liable for
any special, consequential, or exemplary damages resulting in whole or
part from any user's use of or reliance upon this material.PLEASE READ
THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY
ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND
CONDITIONS SET FORTH IN THE DISCLAIMER. |
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