In CHD: Reduce risk of mortality; reduce risk of coronary death & non-fatal MI; reduce risk for undergoing myocardial revascularization procedures (CABG & percutaneous transluminal coronary angioplasty); slow the progression of coronary atherosclerosis. In hyperlipidaemia: Adjunct to diet to reduce elevated total-cholesterol, LDL-cholesterol, apolipoprotein B & triglycerides in patients w/ primary hypercholesterolaemia, heterozygous familial hypercholesterolaemia or combined (mixed) hyperlipidaemia when response to diet & other nonpharmacological measures is inadequate. Also increases HDL-cholesterol. In homozygous familial hypercholesterolaemia: Adjunct to diet & other non-dietary measure to reduce elevated total-cholesterol, LDL-cholesterol & apolipoprotein B in patients w/ homozygous familial hypercholesterolaemia when response to these measures is inadequate.
Dosage/Direction for Use
CHD Initially 20 mg/day as a single evening dose. Adjust at 4-wk intervals to max 80 mg/day as a single evening dose. Hyperlipidaemia Initially 10-20 mg/day as a single evening dose. Homozygous familial hypercholesterolaemia 40 mg/day in the evening or 80 mg/day in 3 divided doses of 20 mg, 20 mg & 40-mg evening dose. Concomitant therapy w/ cyclosporine, fibrates or niacin Max dose: 10 mg/day. Severe renal insufficiency(CrCl <30 mL/min) 10 mg/day.
May be taken with or without food: Avoid excessive consumption (>1 L/day) of grapefruit juice.
Active liver disease or unexplained persistent elevations of serum transaminases; porphyria. Pregnancy & lactation.
Myopathy/rhabdomyolysis. Perform liver function tests before treatment begins & periodically thereafter. Patients who consume substantial quantities of alcohol &/or have a history of liver disease.