Comment
Author: Admin | 2025-04-28
Once daily and titrate to 80 mg once daily if LDL-C remains above target (Pignone 2019).Patients with diabetes:Age 40 to 75 years without additional ASCVD risk factors: Moderate-intensity therapy: Oral: 10 to 20 mg once daily to reduce LDL-C by 30% to 49% (ACC/AHA [Grundy 2019]; ACC/AHA [Stone 2014]).ASCVD risk >20% or multiple ASCVD risk factors: High-intensity therapy: Oral: 80 mg once daily to reduce LDL-C by ≥50%; if unable to tolerate due to adverse effects, may reduce dose to 40 mg once daily (ACC/AHA [Grundy 2019]; ACC/AHA [Stone 2014]).LDL-C ≥190 mg/dL and age 20 to 75 years: High-intensity therapy: Oral: 80 mg once daily to reduce LDL-C by ≥50%; if unable to tolerate due to adverse effects, may reduce dose to 40 mg once daily. Note: Consider familial hypercholesterolemia, which is preferably managed by an experienced lipid specialist (ACC/AHA [Grundy 2019]; ACC/AHA [Stone 2014]).Secondary prevention in patients with established atherosclerotic cardiovascular disease (eg, coronary heart disease, cerebrovascular disease [ischemic stroke or transient ischemic attack], peripheral arterial disease):Note: Patients with high-risk ASCVD may require additional therapies to achieve LDL-C goal (eg, High-intensity therapy: Oral: 80 mg once daily to reduce LDL-C by ≥50%; if unable to tolerate 80 mg once daily, may reduce dose to 40 mg once daily; if unable to tolerate 40 mg once daily, may reduce dose to 10 to 20 mg once daily (ACC/AHA [Grundy 2019]; ACC/AHA [Stone 2014]).Transplantation, post heart or post kidney (off-label use):Note: Initiate after transplant regardless of baseline cholesterol levels. Certain immunosuppressive drugs can induce or exacerbate hypercholesterolemia; significant drug interactions between statins and immunosuppressant drugs are frequent; many interactions can increase statin serum concentrations and risk of toxicity (eg, myopathy) (Brennan 2019; Costanzo 2010; KDIGO 2013; Wiggins 2016). Consult drug interactions database for more detailed information.Oral: Initial: 10 mg once daily starting 1 to 2 weeks after transplant; increase dose based on response and tolerability up to 20 mg once daily (Brennan 2019; Costanzo 2010; Wiggins 2016).Dosing: GeriatricPrevention of atherosclerotic cardiovascular disease:Note: If LDL cholesterol (LDL-C) goal (eg, percent reduction or absolute goal) is not met with the initial dose, may
Add Comment