DRUG CLASS AND MECHANISM: Lovastatin is a cholesterol- lowering medicine. It inhibits the production of cholesterol by the liver. It lowers overall blood cholesterol as well as blood LDL cholesterol levels. LDL cholesterol is believed to be the "bad" cholesterol that is primarily responsible for the development of coronary artery disease. Lowering LDL cholesterol levels retards progression and may even reverse coronary artery disease.

PREPARATIONS: Tablets: 10, 20, and 40 mg. Extended release tablets: 10, 20, 40, and 60 mg.

STORAGE: Tablets should be stored at room temperature in a tightly closed container.

PRESCRIBED FOR: High LDL cholesterol is usually first treated with exercise, weight loss in obese individuals, and a diet low in cholesterol and saturated fats. When these measures fail, cholesterol-lowering medications such as lovastatin can be added. The National Cholesterol Education Program (NCEP) has published treatment guidelines for use of these medications. These treatment guidelines take into account the level of LDL cholesterol as well as the presence of other risk factors such as diabetes, hypertension, cigarette smoking, low HDL cholesterol level, and family history of early coronary heart disease. The effectiveness of the medication in lowering cholesterol is dose- related. Blood cholesterol determinations are performed in regular intervals during treatment so that dosage adjustments can be made. A reduction in LDL cholesterol level can be seen two weeks after starting therapy.

DOSING: May be taken on an empty or full stomach. The medication seems to be most effective when given with the evening meal.

DRUG INTERACTIONS: Lovastatin is generally well- tolerated by most patients. The medication should be used with caution in patients with alcohol or other liver diseases. Persistent abnormal liver tests during treatment are rare, but may lead to the discontinuation of the medication. Rare cases of muscle inflammation (myositis) and breakdown have been reported with lovastatin. Muscle breakdown causes release of muscle protein (myoglobin) into the blood and kidney tubules, resulting in kidney failure. Severe muscle breakdown and kidney failure have been reported when lovastatin is used together with gemfibrozil (Lopid). Therefore their concomitant use is discouraged. The risk of muscle breakdown is also increased when lovastatin is given together with other medications, such as cyclosporine (Sandimmune), erythromycin and nicotinic acid. Therefore, lovastatin should be used with caution and in lower doses when medications, such as cyclosporine are also needed. Lovastatin should not be used by children. It is not habit forming.

PREGNANCY: Lovastatin may cause fetal harm, and should not be given to pregnant women.

NURSING MOTHERS: Lovastatin should not be used by nursing mothers because of potential adverse side effects to the nursing infant.

SIDE EFFECTS: Side effects are rare. Minor side effects include constipation, diarrhea, gas, heartburn, headache, insomnia. Major side effects include abdominal pain or cramps, blurred vision, dizziness, itching, muscle pain or cramps, rash, yellowing of the skin or eyes.

Caution! Before starting to take this medicine, it is vital that you should consult your doctor! Do not use it on your own initiative, without medical advice.