Anticholesterol Drug/Lipid Lowering Drug /Statins Groups Drug

Anticholesterol drug, Anticholesterol Drug/Lipid Lowering Drug /Statins Groups Drug, Rx Harun
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Anticholesterol drug is also known as HMG-CoA reductase inhibitors, are a class of lipid-lowering medications. Statins have been found to reduce cardiovascular disease (CVD) and mortality in those who are at high risk of cardiovascular disease. The evidence is strong that statins are effective for treating CVD in the early stages of the disease (secondary prevention) and in those at elevated risk but without CVD (primary prevention)

The statins are divided into two groups: fermentation-derived and synthetic. They include, along with brand names, which may vary between countries:

StatinImageBrand nameDerivationMetabolism
Atorvastatin
Anticholesterol drug, Anticholesterol Drug/Lipid Lowering Drug /Statins Groups Drug, Rx Harun
Lipitor, AtorSyntheticCYP3A4
Cerivastatin
Anticholesterol drug, Anticholesterol Drug/Lipid Lowering Drug /Statins Groups Drug, Rx Harun
Lipobay, Baycol (withdrawn from the market in August, 2001 due to risk of serious rhabdomyolysis)Syntheticvarious CYP3Aisoforms
Fluvastatin
Anticholesterol drug, Anticholesterol Drug/Lipid Lowering Drug /Statins Groups Drug, Rx Harun
Lescol, Lescol XLSyntheticCYP2C9
Lovastatin
Anticholesterol drug, Anticholesterol Drug/Lipid Lowering Drug /Statins Groups Drug, Rx Harun
Mevacor, Altocor, AltoprevNaturally occurring, fermentation-derived compound. It is found in oyster mushroomsand red yeast riceCYP3A4
Mevastatin
Anticholesterol drug, Anticholesterol Drug/Lipid Lowering Drug /Statins Groups Drug, Rx Harun
CompactinNaturally occurring compound found in red yeast riceCYP3A4
Pitavastatin
Anticholesterol drug, Anticholesterol Drug/Lipid Lowering Drug /Statins Groups Drug, Rx Harun
Livalo, Livazo, PitavaSyntheticCYP2C9 and CYP2C8(minimally)
Pravastatin
Anticholesterol drug, Anticholesterol Drug/Lipid Lowering Drug /Statins Groups Drug, Rx Harun
Pravachol, Selektine, LipostatFermentation-derived (a fermentation product of bacterium Nocardia autotrophica)Non-CYP
Rosuvastatin
Anticholesterol drug, Anticholesterol Drug/Lipid Lowering Drug /Statins Groups Drug, Rx Harun
CrestorSyntheticCYP2C9 and CYP2C19
Simvastatin
Anticholesterol drug, Anticholesterol Drug/Lipid Lowering Drug /Statins Groups Drug, Rx Harun
Zocor, LipexFermentation-derived (simvastatin is a synthetic derivate of a fermentation product of Aspergillus terreus)CYP3A4
Simvastatin + ezetimibeVytorin, InegyCombination therapy: statin + cholesterol absorption inhibitor
Lovastatin + niacin extended-releaseAdvicor, MevacorCombination therapy
Atorvastatin + amlodipineCaduet, EnvacarCombination therapy: statin + calcium antagonist
Simvastatin + niacin extended-releaseSimcorCombination therapy
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LDL-lowering potency varies between agents. Cerivastatin is the most potent, (withdrawn from the market in August 2001 due to the risk of serious rhabdomyolysis) followed by (in order of decreasing potency), rosuvastatin, atorvastatin, simvastatin, lovastatin, pravastatin, and fluvastatin. The relative potency of pitavastatin has not yet been fully established.

The oyster mushroom, a culinary mushroom, naturally contains lovastatin.

Some types of statins are naturally occurring and can be found in such foods as oyster mushrooms and red yeast rice. Randomized controlled trials have found these foodstuffs to reduce circulating cholesterol, but the quality of the trials has been judged to be low. Due to patent expiration, most of the block-buster branded statins have been generic since 2012, including atorvastatin, the largest-selling branded drug.

Statin equivalent dosages
% LDL reduction (approx.)AtorvastatinFluvastatinLovastatinPravastatinRosuvastatinSimvastatin
10–20%20 mg10 mg10 mg5 mg
20–30%40 mg20 mg20 mg10 mg
30–40%10 mg80 mg40 mg40 mg5 mg20 mg
40–45%20 mg80 mg80 mg5–10 mg40 mg
46–50%40 mg10–20 mg80 mg*
50–55%80 mg20 mg
56–60%40 mg
* 80-mg dose no longer recommended due to increased risk of rhabdomyolysis
Starting dose
Starting dose10–20 mg20 mg10–20 mg40 mg10 mg; 5 mg if hypothyroid, >65 yo, Asian20 mg
If higher LDL reduction goal40 mg if >45%40 mg if >25%20 mg if >20%20 mg if LDL >190 mg/dL (4.87 mmol/L)40 mg if >45%
Optimal timingAnytimeEveningWith evening mealsAnytimeAnytime 

Evening

References

Anticholesterol drug, Anticholesterol Drug/Lipid Lowering Drug /Statins Groups Drug, Rx Harun

Anticholesterol drug, Anticholesterol Drug/Lipid Lowering Drug /Statins Groups Drug, Rx Harun

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