Pravastatin and simvastatin for hypercholesterolemia
Article Abstract:
Pravastatin and simvastatin are new drugs that prevent the production of cholesterol, and may soon be available in the US for treating hypercholesterolemia (abnormally high blood levels of cholesterol). These drugs act by inhibiting the enzyme, 3-hydroxy-3-methyl-glutaryl-coenzyme A, which sets the rate of cholesterol production. A decrease in production of cholesterol causes increased activity of low density lipoprotein (LDL) cholesterol receptors in the liver, which are cell membrane proteins that specifically bind LDL cholesterol. These LDL cholesterol receptors remove LDL cholesterol from the blood and thereby decrease levels of both total and LDL cholesterol. Pravastatin and simvastatin are not completely absorbed from the gastrointestinal tract and simvastatin must be metabolized to become active. Both drugs are metabolized by the liver, and elimination of 50 percent of the administered dose from the body requires about two hours. The drugs are eliminated in the bile and urine. Clinical trials have shown that pravastatin and simvastatin result in decreases in LDL cholesterol, total cholesterol, and triglycerides, and increases in high density lipoprotein (HDL) cholesterol levels in patients with hypercholesterolemia. Results of studies comparing the effects of the new agents to those of cholestyramine, probucol, and gemfibrozil are discussed. The combination of cholestyramine with either pravastatin or simvastatin was shown to cause more of a decrease in LDL cholesterol than when pravastatin or simvastatin were used alone. Both new drugs are well-tolerated and cause mild and transient side effects. Potential toxic effects on the liver, muscle, and eye, along with dosage and cost, are described. Although pravastatin and simvastatin appear to be more effective than conventional cholesterol-lowering agents, the long-term safety of these new agents have yet to be established. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Medical Letter on Drugs and Therapeutics
Subject: Health
ISSN: 0025-732X
Year: 1991
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Choice of lipid-lowering drugs
Article Abstract:
HMG-CoA reductase inhibitors (statins) may be more effective and better tolerated than other cholesterol-lowering drugs, such as bile acid-binding resins, niacin, and fibric acid derivatives. Statins, including lovastatin, pravastatin, simvastatin, and fluvastatin, reduce low-density lipoproteins at a rate of 20% to 40% and prevent premature death from heart disease.
Publication Name: Medical Letter on Drugs and Therapeutics
Subject: Health
ISSN: 0025-732X
Year: 1996
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Choice of lipid-regulating drugs
Article Abstract:
Statins are probably the drug of choice for lowering cholesterol levels. Other lipid-lowering treatments include bile-acid sequestrants, fibrates, niacin, and fish oil.
Publication Name: Medical Letter on Drugs and Therapeutics
Subject: Health
ISSN: 0025-732X
Year: 2001
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