You are correct...
When is recommended to take the anti-cholesterol
drugs Lipitor, Crestor, and Pravachol
1. In the Morning
2. In the Evening
3. At Bedtime
4. Before Meals
5. After Meals
6. Any time
Lipitor, Crestor, and Pravachol can be taken at any time
of the day...probably because they have a longer half-life. Tell patients
they can take Lipitor, Crestor, or Pravachol whenever
they take their other meds. Recommend evening dosing when possible for
Mevacor, Altocor, Zocor, and Lescol.
According to the manufacturers, pravastatin (Pravachol), atorvastatin
(Lipitor), and rosuvastatin (Crestor) can be taken any
time of the day. The plasma half life of both rosuvastatin (Crestor)
and atorvastatin (Lipitor) is approximately 20 hours. The half-life
of pravastatin (Pravachol) along with its active metabolites
is approximately 77 hours. The long half-lives of these medications
allow them to be dosed anytime of the day since they will still be at
therapeutic levels when cholesterol synthesis is at its peak. 3,5,6
On the contrary, simvastatin (Zocor), lovastatin (Mevacor), fluvastatin
(Lescol), and lovastatin ER (Altocor) have much shorter plasma half-lives.
The plasma half-lives for these products are 4 hours, 5.3 hours, <3
hours, 11.8 hours, respectively. Therefore, these drugs should be dosed
in the evening in order for the medications to be at therapeutic levels
when cholesterol synthesis is at its peak. 1,2,4
New research from the U.K. suggests that only half of patients receiving
statin medications achieve maximum benefit from them. Patient compliance
was cited as one of the major reason for these results.8
Compliance can also be an issue when patients are expected to take
multiple medications multiple times per day. you can only assume that
statin compliance would be improved if patients had the choice of what
time of day to take the medicine. Therefore, tell your patients on pravastatin
(Pravachol), atorvastatin (Lipitor), and rosuvastatin (Crestor) that
they can take these statins at any time in the day. However, remind
your patients on simvastatin (Zocor), lovastatin (Mevacor, Altocor),
and fluvastatin (Lescol) that these medications should be taken in the
evening if possible.
Reference:
-
Product information for Zocor. Merck and Company,
Inc. Whitehouse Station, NJ 08889. September 2003.
-
Product information for Mevacor. Merck and Company,
Inc. Whitehouse Station, NJ 08889. June 2002.
-
Product information for Pravachol. Bristol-Myers
Squibb Company. Princeton, NJ 08543. October 2003.
-
Product information for Lescol. Novartis. East Hanover,
NJ 07936. August 2002
-
Product information for Lipitor. Pfizer Pharmaceuticals.
Dublin, Ireland. 2003.
-
Product information for Crestor. AstraZeneca. Wilmington,
DE 19850. August 2003.
-
Product information for Altocor. Andrx Labs. Weston,
FL 33331. July 2002.
-
Peck P. Only half of patients receiving statins
achieve maximum benefit. Medscape 2003. http://www.medscape.com/viewarticle/460833
| Drugs |
Half-life |
Administration Time* |
| Atorvastatin
(Lipitor) |
20 to 30 hours (includes active metabolites) |
Anytime of the day |
| Fluvastatin
(Lescol and Lescol XL) |
Lescol: <3 hours
Lescol XL: 9 hours |
In the evening |
| Lovastatin
(Mevacor) |
5.3 hours |
With the evening meal |
| Pravastatin
(Pravachol) |
77 hours (includes active metabolites) |
Anytime of the day |
| Simvastatin
(Zocor) |
4 hours |
In the evening |
| Lovastatin ER
(Altocor) |
11.8 hours |
In the evening, at bedtime |
| Rosuvastatin
(Crestor) |
19 hours |
Anytime of the day |
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