Lipid Medications

Question 1

What is the function of statin medications?

Answer 1

HMG- CoA Reductase Inhibitors
Inhibits enzyme that converts HMG-CoA to mevalonate - limits cholesterol production.

Question 2

What are examples of statins?

Answer 2

Atorvastatin / Lipitor*

Fluvastatin / Lescol*
Lescol XL

Lovastatin*
Mevacor
Altoprev XL

Pravastatin / Pravachol*

Rosuvastatin / Crestor

Simvistatin / Zocor*

Pitavastatin / Livalo

Question 3

What is the usual dose range of statins?

Answer 3

Atorvastatin / Lipitor: 10 – 80 mg

Fluvastatin / Lescol: 20 – 80 mg
Lescol XL: 80 mg

Lovastatin*
Mevacor: 20 - 80 mg
Altoprev XL: 10 - 60 mg

Pravastatin / Pravachol: 10 - 80 mg

Rosuvastatin / Crestor: 5 – 40 mg

Simvistatin / Zocor: 20 – 80 mg

Pitavastatin / Livalo: 2 – 4 mg

Question 4

Which statins are moderate intensity?

Answer 4

Moderate intensity - (lowers LDL 30-50%)
atorvastatin (Lipitor) 10-20mg
rosuvastatin (Crestor) 5-10mg
simvastatin (Zocor) 20-40mg
pravastatin (Pravachol) 40 – 80mg
lovastatin (Mevacor) 40 mg
fluvastatin (Lescol) XL 80mg
pitavastatin (Livalo) 1-4mg

Question 5

Which statins are high intensity?

Answer 5

atorvastatin (Lipitor) 40-80mg
rosuvastatin (Crestor) 20-40mg

Question 6

What are considerations for statins?

Answer 6

Lowers TGs 7-30%
Raise HDL 5-15%
Take at night
Don’t take with grapefruit juice

Question 7

What are side effects of statins?

Answer 7

weakness, muscle pain, elevated glucose levels.

Question 8

What is the action of bile acid sequestrants?

Answer 8

Bind to bile acids in intestine, decreasing cholesterol production. Secondary action – raise HDL

Question 9

What are examples of bile acid sequestrants?

Answer 9

Cholestyramine/ Questran*
Colesevelam / Welchol (Lowers A1c 0.5%)
Colestipol / Colestid

Question 10

What are doses of bile acid sequestrants?

Answer 10

Cholestyramine/ Questran: 4 to 16 g per day powder – 1 scoop 4 g
Colesevelam / Welchol: 3.75 x 1 daily
1.875 x 2 daily (625mg tablets)
Colestipol / Colestid: 2 - 16 gms per day tabs
Powder – 1 scoop = 5g
5 to 20 gm per day
Mix w/ fluid

Question 11

How much do bile acid sequestrants lower LDL?

Answer 11

15-30%

Question 12

What are other benefits of bile acid sequestrants?

Answer 12

May raise TG levels.
Raise HDL 3-5%.

Question 13

What are side effects and considerations for bile acid sequestrants?

Answer 13

Avoid taking in same time frame w/ other meds – may affect
absorption (see package insert). Side effects: GI in nature