Lovastatin is a pharmaceutical agent in the statin class of medications. It helps to lower blood cholesterol by inhibiting an enzyme that assists the body in producing cholesterol. Decreasing blood cholesterol levels is important because it can reduce the risk for heart attack and stroke. Lovastatin can cause side effects such as headache, joint pain, and dizziness. Patients with abnormal liver function or those who are pregnant should avoid taking this medication, as they could experience more significant side effects.
The mechanism of action of lovastatin is to inhibit an enzyme called 3-hydroxy-3-methyl-glutaryl-Coenzyme A (HMG-CoA) reductase. Normally this enzyme facilitates a reaction important in the production of cholesterol. As a result of inhibition of this enzyme, patients taking the medication experience a reduction in their blood levels of cholesterol, low-density lipoprotein (LDL), and very-low density lipoprotein (VLDL).
The most common use of lovastatin is to treat patients with high levels of cholesterol in their blood. Patients with this condition, often called hypercholesterolemia or hyperlipidemia, are at an increased risk for developing heart attacks or strokes. Often the dose of the medication is adjusted up or down until a target LDL blood value is reached. Patients with risk factors for having a heart attack, such as diabetes mellitus or hypertension, should aim for an LDL level of less than 100.
Lovastatin is typically given as a pill taken at night, and is sold under the brand names Altoprev® and Mevacor®. Like all other drugs in the statin class, it inhibits HMG-CoA reductase. Other examples of statins include the medications atorvastatin, simvastatin, pravastatin, and rosuvastatin. Many of these medications have similar efficacies in lowering LDL levels, but they vary in their prices and adverse reactions.
Common side effects of lovastatin include headache, muscle pain, joint pain, diarrhea, and dizziness. The medication commonly causes elevations of results in laboratory tests such as the creatinine kinase (CK) and the liver function tests. Some people can have more severe reactions, including a condition caused rhabdomyolysis, which causes a widespread destruction of muscles and can result in kidney failure. Patients on this medication who have a sudden onset of severe muscle pain should go to the emergency room to be checked for this condition. Other rare but serious side effects include pancreatitis, liver toxicity, and low platelet counts.
Although lovastatin is typically well-tolerated, not all people are considered good candidates for treatment with the medication. Patients with known liver disease, or who have unexplained abnormalities in their liver function tests, should not take the drug. Women who are either pregnant or breastfeeding should avoid lovastatin, as it can cause abnormalities in growth and development of both fetuses and babies. Caution should be used in giving the medication to patients with dehydration, a history of seizures, or low blood pressure.
