DHMGCoA reductase inhibitors

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1. Lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor), fluvastatin (Lescol), atorvastatin (Lipitor) and cerivastatin (Baycol) are HMG-CoA reductase inhibitors, or statins, that inhibit cholesterol synthesis. These agents lower total, LDL and triglyceride cholesterol and slightly raise the HDL fraction. While these agents are generally well tolerated, 1% may develop elevated hepatic transaminase levels, which may necessitate discontinuation of the drug. Other adverse effects include myopathy (0.1%) and gastrointestinal complaints.

2. Atorvastatin (Lipitor) may exert a greater effect on lowering LDL cholesterol, total cholesterol and triglycerides. Statins should generally be taken in a single dose with the evening meal or at bedtime.

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