Lovastatin / Cholesterol Topical Cream Compounded

Lovastatin

By: Karan Modi
PharmD Candidate 2022
CareFirst Specialty Pharmacy

Lovastatin is an antihyperlipidemic agent to treat high blood cholesterol and reduce the risk of cardiovascular disease. Recent studies suggest that statins may have potential as novel treatments for diverse conditions, ranging from sepsis and inflammatory diseases to chronic wounds and bone fractures.

Pronunciation

(LOE va sta tin)

Other Names

Altoprev

Drug Class

HMG-CoA Reductase Inhibitor, Antihyperlipidemic, Cardiovascular agent

Mechanism of Action:

Lovastatin is a cholesterol lowering agent and it is rapidly hydrolyzed to beta-hydroxyacid which is an inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase. It prevents the conversion of HMG-CoA to mevalonate which is rate limiting step in the biosynthesis of cholesterol.

Statins exert their anti-inflammatory effect by inhibiting the release of C-reactive peptide, chemokines, cytokines and adhesion molecules, which may make them a powerful addition to the dermatologic anti-inflammatory medication arsenal. Along with reducing inflammation, statins have the potential to heal chronic wounds by decreasing farnesyl pyrophosphate, facilitating vascular relaxation, promoting neovascularization and reducing bacterial load. A better understanding of their effects at the cellular and molecular level in skin is necessary for their future use.

Drug Interactions:

Do not take it with the following medications: Amprenavir, Atazanavir, Boceprevir, Clarithromycin, Cobicistat, Darunavir, Erythromycin, Fosamprenavir, Idelalisib, Indinavir, Itraconazole, Ketoconazole, Lopinavir, Mibefradil, Mifepristone, Nefazodone, Nelfinavir, Posaconazole, Ritonavir, Saquinavir, Telaprevir, Telithromycin, Tipranavir, Voriconazole

Consider therapy modifications with the following medications: Amiodarone, Bezafibrate, Ceritinib, Ciprofibrate, Clofibrate, Colchicine, Conivaptan, Cyclosporine, Dabigatran, Etexilate, Dalfopristin, Danazol, Daptomycin, Delavirdine, Diltiazem, Dronedarone, Duvelisib, Fenofibrate, Fenofibric Acid, Fluconazole, Fosnetupitant, Gemfibrozil, Glecaprevir, Ivosidenib, Larotrectinib, Lefamulin, Letermovir, Lomitapide, Lorlatinib, Lumacaftor, Netupitant, Niacin, Pibrentasvir, Quinupristin, Ranolazine, Verapamil

Contraindications:

• Hypersensitivity to lovastatin or any component of the formulation
• Active liver disease
• Unexplained persistent elevations of serum transaminases
• Concomitant use of strong CYP3A4 inhibitors (eg, clarithromycin, erythromycin, itraconazole, ketoconazole, nefazodone, posaconazole, voriconazole, protease inhibitors [including boceprevir and telaprevir], telithromycin, cobicistat-containing products)
• Pregnancy
• Breastfeeding

Adverse Effects:

Common side effects you might experience: abdominal pain, constipation, arthralgia, headache, flatulence, skin rash

Administration

Use this drug as ordered by your prescriber.

Dosing

Contact your healthcare provider for specific dosing instructions.

Pregnancy/Breastfeeding:

Lovastatin is contraindicated in pregnant females.

Due to the potential for serious adverse reactions in a breastfed infant, use while breastfeeding is contraindicated by the manufacturer.

Children/Pediatrics:

No data for the use of lovastatin in younger patients <10 years of age.

Veterinary:

There is no data for the use of lovastatin in pets.

References:

• Lovastatin. Dynamed. TJU Library, Philadelphia, PA. Accessed May 26, 2021. https://www.dynamed.com/drug-monograph/lovastatin#GUID-03B19702-96EF-469D-86F8-0488B97BA1F1
• Lovastatin. Lexi-drugs. Lexicomp. TJU Library, Philadelphia, PA. Accessed May 26, 2021. http://online.lexi.com.proxy1.lib.tju.edu/lco/action/doc/retrieve/docid/patch_f/7202?cesid=9OaE1c2g7cz&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3Dlovastatin%26t%3Dname%26va%3Dlovastatin
• Stojadinovic O, Lebrun E, Pastar I, et al. Statins as potential therapeutic agents for healing disorders. Expert Rev Dermatol. 2010;5(6):689-698. https://cardiacos.net/wp-content/uploads/ArticulosMedicos/2010/2010-Statins-as-Potential-Therapeutic-Agents-for-Healing-Disorders-printer-friendly.pdf. Accessed May26, 2021.