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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:

  1. Product information for Zocor. Merck and Company, Inc. Whitehouse Station, NJ 08889. September 2003.

  2. Product information for Mevacor. Merck and Company, Inc. Whitehouse Station, NJ 08889. June 2002.

  3. Product information for Pravachol. Bristol-Myers Squibb Company. Princeton, NJ 08543. October 2003.

  4. Product information for Lescol. Novartis. East Hanover, NJ 07936. August 2002

  5. Product information for Lipitor. Pfizer Pharmaceuticals. Dublin, Ireland. 2003.

  6. Product information for Crestor. AstraZeneca. Wilmington, DE 19850. August 2003.

  7. Product information for Altocor. Andrx Labs. Weston, FL 33331. July 2002.

  8. 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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