The patient should be placed on a standard cholesterol lowering diet before receiving lovastatin tablets and should continue on this diet during treatment with lovastatin tablets (see NCEP Treatment Guidelines for details on dietary therapy). Lovastatin tablets should be given with meals.
Adult Patients
The usual recommended starting dose is 20 mg once a day given with the evening meal. The recommended dosing range of lovastatin tablets is 10 to 80 mg/day in single or two divided doses; the maximum recommended dose is 80 mg/day. Doses should be individualized according to the recommended goal of therapy (see NCEP Guidelines and CLINICAL PHARMACOLOGY). Patients requiring reductions in LDL-C of 20% or more to achieve their goal (see INDICATIONS AND USAGE) should be started on 20 mg/day of lovastatin. A starting dose of 10 mg of lovastatin tablets is may be considered for patients requiring smaller reductions. Adjustments should be made at intervals of 4 weeks or more.
Cholesterol levels should be monitored periodically and consideration should be given to reducing the dosage of lovastatin tablets if cholesterol levels fall significantly below the targeted range.
Dosage in Patients taking Danazol, Diltiazem, Dronedarone or Verapamil:
In patients taking danazol, diltiazem, dronedarone or verapamil concomitantly with lovastatin tablets, therapy should begin with 10 mg of lovastatin tablets and should not exceed 20 mg/day (see CLINICAL PHARMACOLOGY: Pharmacokinetics, WARNINGS: Myopathy/Rhabdomyolysis, PRECAUTIONS: Drug Interactions: Other Drug Interactions).
Dosage in Patients taking Amiodarone
In patients taking amiodarone concomitantly with lovastatin tablets, the dose should not exceed 40 mg/day (see WARNINGS: Myopathy/Rhabdomyolysis and PRECAUTIONS: Drug Interactions: Other Drug Interactions).
Adolescent Patients (10 to 17 years of age) with Heterozygous Familial Hypercholesterolemia
The recommended dosing range is 10 to 40 mg/day; the maximum recommended dose is 40 mg/day. Doses should be individualized according to the recommended goal of therapy (see NCEP Pediatric Panel Guidelines3, CLINICAL PHARMACOLOGY and INDICATIONS AND USAGE). Patients requiring reductions in LDL-C of 20% or more to achieve their goal should be started on 20 mg/day of lovastatin tablets. A starting dose of 10 mg of lovastatin tablets may be considered for patients requiring smaller reductions. Adjustments should be made at intervals of 4 weeks or more.
3
National Cholesterol Education Program (NCEP): Highlights of the Report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents.
Pediatrics. 89(3):495–501. 1992.
Concomitant Lipid-Lowering Therapy
Lovastatin is effective alone or when used concomitantly with bile-acid sequestrants (see WARNINGS: Myopathy/Rhabdomyolysis and PRECAUTIONS: Drug Interactions).
Dosage in Patients with Renal Insufficiency
In patients with severe renal insufficiency (creatinine clearance < 30 mL/min), dosage increases above 20 mg/day should be carefully considered and, if deemed necessary, implemented cautiously (see CLINICAL PHARMACOLOGY and WARNINGS: Myopathy/Rhabdomyolysis).