CLINICAL USE


HMG CoA reductase inhibitor:Hypercholesterolaemia

DOSE IN NORMAL RENAL FUNCTION

10–40 mg daily at night

PHARMACOKINETICS

  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :446.5
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Approx 50
  • %Excreted unchanged in urine &nbsp &nbsp : 20

  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp :0.5

  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :1.5–2/Unchanged

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Unlikely to be dialysed. Dose as in normal renal function

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in normal renal function
  • HDF/high flux &nbsp :Unknown dialysability. Dose as in normal renal function
  • CAV/VVHD &nbsp &nbsp &nbsp:Unlikely to be dialysed. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs
  • Antibacterials: increased risk of myopathy with daptomycin
  • Antivirals: concentration reduced by efavirenz
  • Ciclosporin: increased risk of myopathy Lipid lowering agents: increased risk of myopathy with fibrates, gemfibrozil (avoid) and nicotinic acid

    ADMINISTRATION

    Reconstition

    –

    Route

    Oral

    Rate of Administration

    –

    Comments

    –

    OTHER INFORMATION

    Rhabdomyolysis with acute renal failure, secondary to statin-induced myoglobinaemia, has been reportedInactive polar metabolite accumulates but is readily removed by haemodialysis
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