Medication Pearl of the Day: Pitavastatin (Livalo)
Indication: Livalo is an HMG-CoA reductase inhibitor indicated as an adjunctive therapy to diet in adults with primary hyperlipidemia or mixed dyslipidemia to reduce elevated total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (Apo B), triglycerides (TG), and to increase high-density lipoprotein cholesterol (HDL-C).
- Dosing:The recommended starting dosage for pitavastatin is 2 mg once daily.
- Dosage forms: 1 mg, 2 mg, and 4 mg tablets
- Adverse events:The most frequent adverse reactions (≥ 2%) were myalgia, back pain, diarrhea, constipation, and pain in extremity.
- Mechanism of action:Pitavastatin is an inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, the enzyme that catalyzes the conversion of HMG-CoA to mevalonate, a rate-limiting step in the biosynthetic pathway for cholesterol. As a result, the expression of LDL receptors followed by the uptake of LDL from blood to liver is accelerated, and the plasma TC decreases. Sustained inhibition of cholesterol synthesis in the liver also decreases levels of very low-density lipoproteins.