Lovastatin / Niacin Dosage

Usual Adult Dose for Hyperlipoproteinemia

Initial: 20 mg-500 mg orally once daily at bedtime

Maintenance: 20 mg-500 mg to 40 mg-1000 mg orally once daily at bedtime.

Usual Adult Dose for Hyperlipoproteinemia Type IIa (Elevated LDL)

Initial: 20 mg-500 mg orally once daily at bedtime

Maintenance: 20 mg-500 mg to 40 mg-1000 mg orally once daily at bedtime.

Usual Adult Dose for Hyperlipoproteinemia Type IIb (Elevated LDL + VLDL)

Initial: 20 mg-500 mg orally once daily at bedtime

Maintenance: 20 mg-500 mg to 40 mg-1000 mg orally once daily at bedtime.

Renal Dose Adjustments

CrCl less than 30 mL/min: 20 mg-500 mg orally once a day (caution is advised)

Liver Dose Adjustments

Lovastatin-niacin is contraindicated in patients with active hepatic dysfunction.

Dose Adjustments

Lovastatin-niacin should not be increased by more than 500 mg daily (based on the niacin component) every 4 weeks.

In general, in patients receiving lovastatin-niacin and drugs such as cyclosporine, danazol or gemfibrozil, the dose of lovastatin-niacin should not exceed 1000 mg/20 mg.

In patients receiving a course of treatment with a systemic antifungal azole, macrolide antibiotic, or ketolide antibiotic, interruption of lovastatin-niacin therapy should be considered.

Precautions

Lovastatin-niacin should be used with caution in patients who consume substantial quantities of alcohol and/or have a past history of liver disease. Active liver disease of unexplained transaminase elevations are contraindications to the use of lovastatin-niacin.

Lovastatin-niacin is contraindicated in patients with active peptic ulcer disease or arterial bleeding.

The incidence and severity of myopathy may be increased by concomitant administration of lovastatin-niacin with drugs that can cause myopathy when given alone, such as gemfibrozil and other fibrates and potent inhibitors of CYP450 3A4 (i.e., cyclosporine, antifungal azoles, macrolide antibiotics, HIV protease inhibitors, large amounts of grapefruit juice).

Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).

Dialysis

Data not available

Other Comments

Lovastatin-niacin should be taken at bedtime with a low fat snack.

Lovastatin-niacin should be taken whole and should not be broken, crushed, or chewed before swallowing.

Coadministration of food, particularly high fat content foods, increases the bioavailability of lovastatin-niacin.

Liver function tests should be performed on all patients during therapy with lovastatin-niacin.

Flushing of the skin may be reduced by pretreatment with aspirin up to the recommended dose of 325 mg (taken up to approximately 30 minutes prior to the lovastatin-niacin dose). Flushing, pruritus, and gastrointestinal distress are also greatly reduced by slowly increasing the dose of niacin and avoiding administration on an empty stomach.

If lovastatin-niacin therapy is discontinued for an extended period (7 days or longer), reinstitution of therapy should begin with the lowest dose.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer