"The U.S. Food and Drug Administration today approved Kynamro (mipomersen sodium) injection as an addition to lipid-lowering medications and diet to treat patients with a rare type of high cholesterol called homozygous familial hypercholesterolemi"...
Therapy with lipid-altering agents should be only one component of multiple risk factor intervention in individuals at significantly increased risk for atherosclerotic vascular disease due to hypercholesterolemia. Drug therapy is indicated as an adjunct to diet when the response to a diet restricted in saturated fat and cholesterol and other non-pharmacologic measures alone has been inadequate.
Hypercholesterolemia (Heterozygous Familial and Nonfamilial) and Mixed Dyslipidemia
LESCOL and LESCOL XL are indicated
- as an adjunct to diet to reduce elevated total cholesterol (Total-C), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG) and apolipoprotein B (Apo B) levels, and to increase high-density lipoprotein cholesterol (HDL-C) in patients with primary hypercholesterolemia and mixed dyslipidemia (Fredrickson Type IIa and IIb).
- as an adjunct to diet to reduce Total-C, LDL-C, and Apo B levels in adolescent boys and adolescent girls who are at least one year post-menarche, 10-16 years of age, with heterozygous familial hypercholesterolemia and the following findings are present:
The NCEP classification of cholesterol levels in pediatric patients with a familial history of hypercholesterolemia or premature CVD is summarized below.
|Category||Total-C (mg/dL)||LDL-C (mg/dL)|
|Acceptable||< 170||< 110|
|High||≥ 200||≥ 130|
Children treated with fluvastatin in adolescence should be re-evaluated in adulthood and appropriate changes made to their cholesterol-lowering regimen to achieve adult treatment goals.
Secondary Prevention of Cardiovascular Disease
In patients with clinically evident CHD, LESCOL and LESCOL XL are indicated to:
- reduce the risk of undergoing coronary revascularization procedures
- slow the progression of coronary atherosclerosis
Limitations of Use
Neither LESCOL nor LESCOL XL have been studied in conditions where the major abnormality is elevation of chylomicrons, VLDL, or IDL (i.e., hyperlipoproteinemia Types I, III, IV, or V).
DOSAGE AND ADMINISTRATION
General Dosing Information
Dose range: 20 mg to 80 mg/ day.
LESCOL/LESCOL XL can be administered orally as a single dose, with or without food.
Do not break, crush or chew LESCOL XL tablets or open LESCOL capsules prior to administration.
Do not take two LESCOL 40 mg capsules at one time.
Since the maximal effect of a given dose is seen within 4 weeks, periodic lipid determinations should be performed at this time and dosage adjusted according to the patient's response to therapy and established treatment guidelines.
For patients requiring LDL-C reduction to a goal of ≥ 25%, the recommended starting dose is 40 mg as one capsule in the evening, 80 mg as one LESCOL XL tablet administered as a single dose at any time of the day or 80 mg in divided doses of the 40 mg capsule given twice daily. For patients requiring LDL-C reduction to a goal of < 25% a starting dose of 20 mg may be used.
Adult Patients with Hypercholesterolemia (Heterozygous Familial and Nonfamilial) and Mixed Dyslipidemia
Adult patients can be started on either LESCOL or LESCOL XL. The recommended starting dose for LESCOL is one 40 mg capsule in the evening, or one LESCOL 40 mg capsule twice daily. Do not take two LESCOL 40 mg capsules at one time.
The recommended starting dose for LESCOL XL is one 80 mg tablet administered as a single dose at any time of the day.
Pediatric Patients (10-16 years of age) with Heterozygous Familial Hypercholesterolemia
The recommended starting dose is one 20 mg LESCOL capsule. Dose adjustments, up to a maximum daily dose administered either as LESCOL capsules 40 mg twice daily or one LESCOL XL 80 mg tablet once daily should be made at 6 week intervals. Doses should be individualized according to the goal of therapy [see NCEP Pediatric Panel Guidelines and Clinical Studies]1.
Use with Cyclosporine
Do not exceed a dose of 20 mg b.i.d. LESCOL in patients taking cyclosporine [see DRUG INTERACTIONS].
Use with Fluconazole
Do not exceed a dose of 20 mg b.i.d. LESCOL in patients taking fluconazole [see DRUG INTERACTIONS].
Dosage Forms And Strengths
- LESCOL 20 mg capsules are brown and light brown imprinted twice with “ ” and “20” on one half and “LESCOL” and the LESCOL® (fluvastatin sodium) logo twice on the other half of the capsule.
- LESCOL 40 mg capsules are brown and gold imprinted twice with “ ” and “40” on one half and “LESCOL” and the LESCOL® (fluvastatin sodium) logo twice on the other half of the capsule.
- LESCOL XL 80 mg tablets are yellow, round, slightly biconvex film-coated tablet with beveled edges debossed with “LESCOL XL” on one side and “80” on the other.
Storage And Handling
LESCOL ® (fluvastatin sodium) Capsules
Brown and light brown imprinted twice with “Logo” and “20” on one half and “LESCOL” and the LESCOL® (fluvastatin sodium) logo twice on the other half of the capsule.
Bottles of 30
Bottles of 100 capsules………………………...NDC 0078-0176-05
Brown and gold imprinted twice with “Logo ” and “40” on one half and “LESCOL” and the LESCOL® (fluvastatin sodium) logo twice on the other half of the capsule.
Bottles of 30 capsules………………………...NDC
Bottles of 100 capsules………………………...NDC 0078-0234-05
LESCOL® XL (fluvastatin sodium) Extended-Release Tablets
Yellow, round, slightly biconvex film-coated tablet with beveled edges debossed with “LESCOL XL” on one side and “80” on the other.
Bottles of 30 tablets
Bottle of 100 tablets………………………...NDC 0078-0354-05
Store and Dispense
Store at 25°C (77°F); excursions permitted to 15 -30°C (59 -86°F) [see USP Controlled Room Temperature]. Dispense in a tight container. Protect from light.
1National Cholesterol Education Program (NCEP): Highlights of the Report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents. Pediatrics. 89(3):495-501. 1992.
Distributed by: Novartis Pharmaceuticals Corporation., East Hanover, New Jersey 07936. Revised February 2012
Last reviewed on RxList: 3/12/2012
This monograph has been modified to include the generic and brand name in many instances.
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