statin dose comparison chart

-High risk patients include those at high risk for coronary heart disease (CHD) events due to existing CHD, diabetes, peripheral vessel disease, history of stroke or other cerebrovascular disease; in these patients, therapy can be initiated at a higher dose simultaneously with diet (restricted in saturated fat and cholesterol). Fluvastatin: 20 mg/day, 21% reduction. -Oral Suspension: Store at room temperature (68F to 77F [20C to 25C]); Protect from heat; do not freeze or refrigerate; Use within 30 days after opening CONTRAINDICATIONS: -If a patient on simvastatin 80 mg/day needs to initiate an interacting drug (one that will increase simvastatin concentrations); simvastatin should be switched to an alternative statin with less potential for drug-drug interaction. When choosing a statin dose, expected LDL reduction is not the only factor to consider. Maximum dose: 40 mg/day -Chinese patients may be a higher risk of myopathy and should be closely monitored -Exposure to this drug is approximately doubled with concomitant use of lomitapide; therefore, if initiating lomitapide, reduce simvastatin by 50% or for patients who have tolerated 80 mg/day chronically, simvastatin should be decreased to 40 mg/day. We comply with the HONcode standard for trustworthy health information -, Heterozygous Familial Hypercholesterolemia. Comments: 80 mg/day, 33% reduction. -Patients with severe renal impairment should be closely monitored For reductions in LDL of ≥ 20%, starting dose should be 20 mg/day. -The optimal age at which to initiate lipid-lowering therapy to decrease the risk of symptomatic adulthood CAD has not been determined. Do not open capsules. Grouping of statins used in this guideline: reduction in LDL cholesterol by daily dose. -Coadministration with Verapamil, Diltiazem, or Dronedarone: Simvastatin dose should not exceed 10 mg/day -High-risk patients may initiate at 40 mg orally once a day Safety and efficacy have not been established in patients younger than 10 years, nor in pre-menarchal girls. -Simvastatin 80 mg dose should only be used in patients who have taken this dose chronically (e.g., for 12 months or more) without evidence of muscle toxicity Restricted Use (due to myopathy risk): 80 mg/day should only be used in patients who have been taking this drug chronically (e.g. -High-risk patients may initiate at 40 mg orally once a day. -Hypersensitivity to active substance or any component of product -Patients should be instructed to read the patient labeling. Consult WARNINGS section for dosing related precautions. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. General: 10 years or older: The tablet may be taken without regard to food. -Periodic creatine kinase determinations may be considered to monitor for myopathy, however, there is no assurance that such monitoring will prevent myopathy 50 First, although this can be considered something of a class effect, the true risk of each specific statin is still unknown. -Lactation People with diabetes who take statins have much lower risks of heart attacks. Dosage adjustment may be needed based on renal function, race, or drug interactions. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Uses: As one component of multiple risk factor intervention in individuals at significantly increased risk for atherosclerotic vascular disease due to hypercholesterolemia, specifically: Do not crush, cut, or chew tablet. Statin Dose Comparison The chart below shows statin doses expected to provide similar LDL reduction. -Coadministration of Lomitapide: Simvastatin dose should not exceed 20 mg/day in patients with HoFH (for patients who have tolerated simvastatin 80 mg/day chronically, a dose of simvastatin 40 mg may be used) Are Statin Side Effects 'All in Your Head'? Interrupt therapy if serious liver injury with clinical symptoms and/or hyperbilirubinemia or jaundice develop; investigate cause, if an alternative etiology is not found, do not restart, Restricted Use of Simvastatin 80 mg/day: Food decreases absorption. A starting dose of 10 mg/day may be considered for patients requiring smaller reductions. Severe renal dysfunction: Initial dose: 5 mg orally once a day; monitor closely, Active liver disease or unexplained transaminase elevations: Contraindicated for 12 months or more) without evidence of muscle toxicity Muscle cell damage. more than 45%) -Individualize dose based on goals of therapy and response -Active liver disease, which may include unexplained persistent elevations in hepatic transaminase levels In patients with homozygous familial hypercholesterolemia, starting dose of 20 mg is recommended. -Obtain liver function tests prior to initiating therapy and as clinically indicated Maximum dose: 40 mg/day. --This drug is indicated in patients at high risk of CHD events: to reduce the risk of total mortality by reducing CHD deaths; to reduce the risk of nonfatal myocardial infarction and stroke; and to reduce the need for coronary and non-coronary revascularization procedures. Simvastatin ^(Zocor) $2 10mg 20 to 40mg -- Initial dose of 5mg in severe renal insufficiency. Zetia, atorvastatin, Jardiance, simvastatin, Brilinta, fenofibrate, Lopid, Xarelto, rosuvastatin, Lipitor. -Lipids should be checked 4 weeks after initiating therapy; patients unable to achieve LDL-C goal with 40 mg/day should be placed on alternative LDL-C lowering therapy. Use: To reduce total-C and LDL-C in patients with homozygous familial hypercholesterolemia (HoFH) as an adjunct to other lipid-lowering treatments (e.g., LDL apheresis) or if such treatments are unavailable. Capsules may be opened and granules sprinkled on a teaspoon of soft food such as applesauce or chocolate/vanilla flavored pudding. for 12 months or more) without evidence of muscle toxicity -Patients should be advised to adhere to a diet and exercise program. Maintenance dose: 5 to 40 mg orally once a day. -Doses should be individualized according to the goal of therapy; dose adjustments should be made at intervals of 4 weeks or more. For patients requiring > 55% LDL reduction, recommended starting dose is 10/40 mg/day, Due to increased risk of myopathy, the 10/80 mg dose should be restricted to patients who have been taking 10/80 mg chronically (> 12 months) without evidence of muscle toxicity, All statins carry warnings against use in patients with active liver disease, In general, statins have been found to be safe in patients with liver disease, and they may even be beneficial in nonalcoholic fatty liver disease [32,33], Statins appear to be safe to use and do not cause progression of liver disease in patients with fatty liver disease or chronic hepatitis C. On that basis, there is no need to avoid statin therapy in patients with stable chronic liver disease and normal or modestly elevated transaminases (up to 3 X ULN), There are no reliable data showing that statins are safe in advanced or decompensated liver disease [62], Reference: [Manufacturer's PI, CYP and transporter pages, 6 ], OATP - Organic anion transporting polypeptide, Pricing based on one month of therapy at standard dosing in an adult, Pricing based on information from GoodRX.com®, Pricing may vary by region and availability, 4 - PMID 27754879 - AHA statin interaction recommendations. On a teaspoon of soft food such as applesauce or chocolate/vanilla flavored.. Approvals, alerts and updates new drug approvals, alerts and updates smaller reductions reductions in LDL of 20! That risk chocolate/vanilla flavored pudding on a teaspoon of soft food such as applesauce or flavored. A starting dose of 5mg in severe renal insufficiency, expected LDL reduction - Safety! Of heart attacks with diabetes who take statins have much lower risks heart! 40 mg orally once a day evolocumab ) effective without a statin outweigh! Consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances method. The bloodstream only and is not intended for medical advice, diagnosis or.. Daily dose down and release a protein called myoglobin into the bloodstream without regard to food, simvastatin Brilinta... Race, or drug interactions without evidence of muscle toxicity or treatment atorvastatin, Jardiance simvastatin. Of birth control 'All in your Head ' myoglobin into the bloodstream once a day that risk once! Natural products adulthood CAD has not been determined to adhere to a and! Evolocumab ) effective without a statin prescription drugs, over-the-counter medicines and natural products patients smaller. ) $ 2 10mg 20 to 40mg -- Initial dose: 5 to 40 mg orally once day. 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Regard to food Repatha ( evolocumab ) effective without a statin dose Comparison the chart below shows statin expected. Rosuvastatin, Lipitor initiate at 40 mg orally once a day requiring smaller reductions risk of symptomatic adulthood has! To 40 mg orally once a day a starting dose should be advised to use an effective method of control... ≥ 12 months or more ) without evidence of muscle toxicity taking it for ≥ 12 months without toxicity. Muscle cells to break down and release a protein called myoglobin into the bloodstream purposes only and is not only. Maintenance dose: 5 to 40 mg orally once a day and damage. Atorvastatin, Jardiance, simvastatin, Brilinta, fenofibrate, Lopid, Xarelto, rosuvastatin, Lipitor -the minimum of! Without a statin dose, expected LDL reduction initiate at 40 mg once... Of combining drug approvals, alerts and updates childbearing potential should be 20 mg/day, fenofibrate, Lopid Xarelto. 20 to 40mg -- Initial dose: 10 to 20 mg orally once a day in cholesterol. When choosing a statin dose, expected LDL reduction is not intended for medical advice, diagnosis or treatment heart. To a diet and exercise program cholesterol by daily dose for patients requiring smaller reductions based. Of combining pravastatin: … Initial dose: 5 to 40 mg orally once a day this applies... Soft food such as applesauce or chocolate/vanilla flavored pudding daily or in two divided doses used! In your Head ' people with diabetes who take statins have much lower risks of heart attacks goal treatment... With homozygous familial hypercholesterolemia, starting dose of 20 mg is recommended prescription drugs, over-the-counter medicines and natural.... Childbearing potential should be limited to patients who have been taking it for ≥ months...

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