|
|
| (One intermediate revision by one other user not shown) |
| Line 1: |
Line 1: |
| __NOTOC__
| | #redirect [[Lovastatin#Drug Interactions]] |
| {{Lovastatin}}
| |
| {{CMG}}; {{AE}} {{SS}}
| |
| | |
| ==Drug Interactions==
| |
| Drug interaction studies have not been performed with Altoprev®. The types, frequencies and magnitude of drug interactions that may be encountered when Altoprev® is administered with other drugs may differ from the drug interactions encountered with the lovastatin immediate-release formulation. In addition, as the drug exposure with Altoprev® 60 mg is greater than that with lovastatin immediate-release 80 mg (maximum recommended dose), the severity and magnitude of drug interactions that may be encountered with Altoprev® 60 mg are not known. It is therefore recommended that the following precautions and recommendations for the concomitant administration of lovastatin immediate-release with other drugs be interpreted with caution, and that the monitoring of the pharmacologic effects of Altoprev® and/or other concomitantly administered drugs be undertaken where appropriate. | |
| | |
| ===Strong CYP 3A Inhibitors===
| |
| | |
| Lovastatin is metabolized by CYP3A4 but has no CYP3A inhibitory activity; therefore it is not expected to affect the plasma concentrations of other drugs metabolized by CYP3A. Strong inhibitors of CYP3A (e.g., [[itraconazole]], [[ketoconazole]], [[posaconazole]], [[voriconazole]], [[clarithromycin]], [[telithromycin]], HIV protease inhibitors, [[boceprevir]], [[telaprevir]], and [[nefazodone]]), increase the risk of myopathy by reducing the elimination of lovastatin. The use of lovastatin with strong CYP3A inhibitors is contraindicated [see Contraindications (4), Warnings and Precautions (5.1 ), andClinical Pharmacology (12.3)].
| |
| | |
| ===Erythromycin===
| |
| | |
| Do not use Altoprev concomitantly with [[erythromycin]] [see Contraindications (4) and Warnings and Precautions (5.1)].
| |
| | |
| ===Interactions With Lipid-Lowering Drugs That Can Cause Myopathy When Given Alone===
| |
| | |
| The risk of [[myopathy]] is also increased by the following lipid-lowering drugs that are not strong CYP3A inhibitors, but which can cause [[myopathy]] when given alone. [seeWarnings and Precautions (5.1)].
| |
| | |
| Gemfibrozil – Avoid the concomitant use of Altoprev with [[gemfibrozil]] [see Warnings and Precautions (5.1)].
| |
| | |
| Other [[fibrate]]s - Use caution when prescribing Altoprev with other [[fibrate]]s. [see Warnings and Precautions (5.1)].
| |
| | |
| [[Niacin]] (nicotinic acid) (≥1 g/day) - Use caution when prescribing Altoprev with lipid-modifying (≥1 g/day) doses of [[niacin]]. [see Warnings and Precautions (5.1)].
| |
| | |
| ===Cyclosporine===
| |
| | |
| Avoid the concomitant use of Altoprev with [[cyclosporine]] [see Warnings and Precautions (5.1)].
| |
| | |
| === Danazol, Diltiazem, Dronedarone or Verapamil===
| |
| | |
| Do not exceed 20 mg of Altoprev daily in patients receiving concomitant therapy with [[danazol]], [[diltiazem]], [[dronedarone]], or [[verapamil]]. [see Dosage and Administration (2.3), Warnings and Precautions (5.1), and Clinical Pharmacology (12.3)].
| |
| | |
| ===Amiodarone===
| |
| | |
| Do not exceed 40 mg of Altoprev daily in patients receiving concomitant therapy with [[amiodarone]]. [see Dosage and Administration (2.3), Warnings and Precautions (5.1)].
| |
| | |
| ===Coumarin Anticoagulants===
| |
| | |
| In a small clinical trial in which lovastatin was administered to [[warfarin]] treated patients, no effect on prothrombin time was detected. However, another HMG-CoA reductase inhibitor has been found to produce a less than two second increase in prothrombin time in healthy volunteers receiving low doses of [[warfarin]]. Also, bleeding and/or increased prothrombin time has been reported in a few patients taking coumarin anticoagulants concomitantly with lovastatin. In patients taking anticoagulants, prothrombin time should be determined before starting Altoprev and frequently enough during early therapy to ensure that no significant alteration of prothrombin time occurs. Once a stable prothrombin time has been documented, prothrombin times can be monitored at the intervals usually recommended for patients on coumarin anticoagulants. If the dose of Altoprev is changed, the same procedure should be repeated. Lovastatin therapy has not been associated with bleeding or with changes in prothrombin time in patients not taking anticoagulants.
| |
| ===Colchicine===
| |
| | |
| Cases of [[myopathy]], including rhabdomyolysis have been reported with lovastatin coadministered with [[colchicine]]. Exercise caution when prescribing Altoprev with [[colchicine]].
| |
| | |
| ===Ranolazine===
| |
| | |
| The risk of myopathy, including [[rhabdomyolysis]], may be increased by concomitant administration of [[ranolazine]]. Exercise caution when prescribing Altoprev with [[ranolazine]]. Dose adjustment of Altoprev may be necessary during coadministration with [[ranolazine]].
| |
| | |
| ===Propranolol===
| |
| | |
| In normal volunteers, there was no clinically significant pharmacokinetic or pharmacodynamic interaction with concomitant administration of single doses of lovastatin and [[propranolol]].
| |
| | |
| ===Digoxin===
| |
| | |
| In patients with [[hypercholesterolemia]], concomitant administration of lovastatin and [[digoxin]] resulted in no effect on [[digoxin]] plasma concentrations.
| |
| | |
| ===Oral Hypoglycemic Agents===
| |
| | |
| In pharmacokinetic studies of lovastatin immediate-release in hypercholesterolemic non-insulin dependent diabetic patients, there was no drug interaction with [[glipizide]] or with [[chlorpropamide]].<ref name="dailymed.nlm.nih.gov">{{Cite web | last = | first = | title = ALTOPREV (LOVASTATIN) TABLET, EXTENDED RELEASE [SHIONOGI INC.] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=e8b6ccc2-e6e7-45fd-ab66-c312bcbe2b01 | publisher = | date = | accessdate = 13 February 2014 }}</ref>
| |
| | |
| ==References==
| |
| {{Reflist|2}}
| |
| | |
| {{Statins}}
| |
|
| |
|
| [[Category:Statins]] | | [[Category:Statins]] |
| [[Category:Carboxylate esters]] | | [[Category:Carboxylate esters]] |
| [[Category:Lactones]] | | [[Category:Lactones]] |
| [[Category:Cardiovascular Drug]] | | [[Category:Cardiovascular Drugs]] |
| [[Category:Drug]] | | [[Category:Drug]] |