The patient should be placed on a standard cholesterol-lowering diet before receiving Corstat and should continue on this diet during treatment with Corstat.
Coronary Heart Disease: Patients with coronary heart disease can be treated with a starting dose of 20 mg/day given as a single dose in the evening. Adjustment of dosage, if required, should be made at intervals of not less than 4 weeks, to a maximum of 80 mg/day given as a single dose in the evening, depending on the patient's individual response.
If LDL-cholesterol levels fall <1.94 mmol/L or total serum cholesterol levels fall <3.6 mmol/L consideration should be given to reducing the dose of Corstat.
Hyperlipidaemia: Recommended Dose: 10 mg once daily taken in the evening. The dose range is 10-80 mg a day in single doses taken in the evening. A marked response to Corstat is seen within 2 weeks and the maximum therapeutic response occurs within 4-6 weeks. The response is maintained during continuation of therapy. When therapy with Corstat is stopped, total cholesterol has been shown to return to pretreatment levels. Adjustment of dosage, if required, should be made as previously specified.
Homozygous Familial Hypercholesterolaemia: Based on the results of a controlled clinical study, the recommended dosage for patients with homozygous familial hypercholesterolaemia is 40 mg/day taken as a single dose in the evening, or 80 mg/day in 3 divided doses of 20-, 20- and 40-mg dose taken in the evening. Corstat should be used as an adjunct to other lipid-lowering treatments (eg, LDL apheresis) in these patients or if such treatments are unavailable. Concomitant Therapy: Corstat is effective alone or in combination with bile acid sequestrants. In patients taking cyclosporin, fibrates or niacin concomitantly with Corstat, the maximum recommended dosage is 10 mg/day.
Renal Insufficiency: Because Corstat does not undergo significant renal excretion, modification of dosage should not be necessary in patients with moderate renal insufficiency. In patients with severe renal insufficiency (creatinine clearance <30 mL/min), dosages >10 mg/day should be carefully considered and, if deemed necessary, implemented cautiously.
Elderly: Although experience in elderly patients is limited, efficacy using standard doses appears similar to that seen in the population as a whole. There is no apparent increase in the frequency of clinical or laboratory adverse findings.
Children: Studies to show safety and effectiveness in children have not been carried out.