Reduce LDL-C, apo B & triglycerides. Increase HDL-C in the treatment of hyperlipidemia including hypercholesterolemia & combined (mixed) hyperlipidemia (type IIa & IIb hyperlipoproteinemia), hypertriglyceridemia (type IV) & dysbetalipoproteinemia (type III). Adjunctive therapy in patients w/ HoFH who have LDL-receptor function.
Primary hypercholesterolemia & combined (mixed) dyslipidemia including familial combined hyperlipidemia Starting dose: 10 or 20 mg. Patients requiring large reduction in LDL-C (>45%) Start at 40 mg. Dose range: 10-80 mg. Adjust dose at intervals of 2-4 wk up to a max of 80 mg/day. Severe dyslipidemia including homozygous & heterozygous familial hypercholesterolemia & dysbetalipoproteinemia (type III) Up to 80 mg/day. Heterozygous familial hypercholesterolemiaChildn 10-17 yr Starting dose: 10 mg. Max: 20 mg/day. Adjust dose at intervals of ≥4 wk. Primary prevention of MI 10 mg. Secondary prevention of MI 10-80 mg. All doses to be taken once daily.
Monitor lipid levels periodically. Discontinue use if markedly elevated creatine kinase levels & hypersensitivity occurs, if myopathy is diagnosed or suspected, during fusidic acid therapy & having risk factor predisposing to development of renal failure secondary to rhabdomyolysis. Patients w/ predisposing factors for myopathy/rhabdomyolysis. Concomitant use w/ CYP3A4 inhibitors; digoxin; drugs that may decrease endogenous steroid hormone levels (eg, ketoconazole, spironolactone, cimetidine). Consider risk of hemorrhagic stroke prior to treatment in patients w/ recent (1-6 mth) stroke or transient ischemic attack. Decrease in myocardial ubiquinone (CoQ10) levels may lead to impaired cardiac function in CHF patients. Severe renal impairment. Perform LFT prior to treatment & periodically thereafter. Ped patients except childn 10-17 yr w/ heterozygous familial hypercholesterolemia. Elderly ≥70 yr.
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