DrugindexOnline^{2nd edition}

Generic name: Lovastatin
Brand names: Altocor

Why is Altocor prescribed?

Altocor is an extended-release form of the cholesterol-lowering drug lovastatin. By releasing small amounts of the drug throughout the day, Altocor maintains a relatively steady level of lovastatin in the bloodstream.

In many people, high cholesterol levels contribute to the development of clogged arteries and heart disease. Altocor is prescribed to slow the clogging process in people who already have heart disease, and to fend off clogged arteries in people at risk of developing the disease.

Like other drugs in its class, Altocor reduces the level of "bad" LDL cholesterol and raises the level of "good" HDL cholesterol. For people at high risk of heart disease, current guidelines suggest drug therapy when the LDL level reaches 130. For people at lower risk, the cut-off is 160. For those at little or no risk, it's 190.

Most important fact about Altocor

Altocor is usually prescribed only if diet, exercise, and weight loss fail to bring your cholesterol level under control. It is important to remember that Altocor is a supplement--not a substitute--for those other measures. To get the full benefit of the medication, you need to stick to the diet and exercise program prescribed by your doctor.

How should you take Altocor?

Altocor is taken once a day at bedtime. Swallow Altocor whole. Do not break, chew, crush, or cut the tablets.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the dose you missed and go back to your regular schedule. Never take 2 doses at once.

--Storage instructions...

Store at room temperature. Protect from heat and humidity.

What side effects may occur?

The side effects of Altocor generally are mild and temporary. Nevertheless, if any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine whether it is safe for you to continue taking Altocor.

• More common side effects may include:
  Back pain, diarrhea, flu-like symptoms, headache, infection, injury, joint pain, muscle pain, sinus inflammation, unspecified pain, weakness

Why should Altocor not be prescribed?

Cholesterol is essential for developing babies, so Altocor must never be taken during pregnancy or when nursing an infant. You'll also need to avoid Altocor if you have active liver disease or the drug gives you an allergic reaction.

Special warnings about Altocor

In rare cases, drugs such as Altocor cause rhabdomyolysis, a potentially fatal condition that destroys muscle cells and sometimes causes kidney failure. Alert your doctor immediately if you experience any unexplained muscle tenderness, weakness, or pain, especially if you also have a fever or feel sick. You'll probably need to give up Altocor therapy.

Because Altocor may affect the liver, your doctor may order blood tests to check liver function. Blood tests will probably be done before you start taking Altocor, at 6 weeks and 12 weeks after you start taking the drug, when your dosage is increased, and periodically after that (semi-annually). If the tests detect a significant problem, Altocor therapy will have to be stopped. You'll be monitored especially closely if you have a history of liver disease or drink substantial quantities of alcohol

If you have surgery or a major illness, you'll be told to stop taking Altocor until you get better.

Altocor is not recommended for individuals below age 20.

Possible food and drug interactions when taking Altocor

If you take Altocor with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Altocor with any of the following:

Antipyrine
Blood-thinning drugs such as Coumadin and Dicumarol
Cimetidine (Tagamet)
Clarithromycin (Biaxin)
Cyclosporine (Sandimmune, Neoral)
Erythromycin (E.E.S., PCE, and others)
Gemfibrozil (Lopid)
HIV protease inhibitors such as Agenerase, Norvir, and Viracept
Itraconazole (Sporanox)
Ketoconazole (Nizoral)
Spironolactone (Aldactone)
Nefazodone (Serzone)
Nicotinic acid or niacin (Niaspan, Niacor)
Verapamil (Calan, Verelan)

Do not take Altocor with large amounts of grapefruit juice.

Special information if you are pregnant or breastfeeding

Because of potential harm to the developing baby, Altocor should never be taken during pregnancy, or by anyone who may become pregnant. If you become pregnant while taking Altocor, stop taking Altocor immediately and notify your doctor.

Because of the potential for harm to the nursing infant, do not breastfeed while taking Altocor.

Recommended dosage

You will have to follow a standard cholesterol-lowering diet before starting treatment with Altocor, and continue this diet while using Altocor. Your dose may be adjusted to meet your individual needs.

ADULTS

The usual starting dose is 20 to 60 milligrams, taken once a day at bedtime. Dosage adjustments may be made every 4 weeks, and dose levels may be reduced as cholesterol levels come down.

The usual starting dose is 10 milligrams for people who are taking cyclosporine and Altocor. The dosage should not be increased to more than 20 milligrams a day.

The usual starting dose is 20 milligrams or less for people with kidney disease or people who are taking gemfibrozil, niacin, or other cholesterol-lowering drugs.

Overdosage

Although there is no specific information available about Altocor overdose, any medication taken in excess can have serious consequences. If you suspect an overdose of Altocor, seek medical attention immediately.