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Livalo

Livalo

SIDE EFFECTS

The following serious adverse reactions are discussed in greater detail in other sections of the label:

Of 4,798 patients enrolled in 10 controlled clinical studies and 4 subsequent open-label extension studies, 3,291 patients were administered pitavastatin 1 mg to 4 mg daily. The mean continuous exposure of pitavastatin (1 mg to 4 mg) was 36.7 weeks (median 51.1 weeks). The mean age of the patients was 60.9 years (range; 18 years – 89 years) and the gender distribution was 48% males and 52% females. Approximately 93% of the patients were Caucasian, 7% were Asian/Indian, 0.2% were African American and 0.3% were Hispanic and other.

Clinical Studies Experience

Because clinical studies on LIVALO are conducted in varying study populations and study designs, the frequency of adverse reactions observed in the clinical studies of LIVALO cannot be directly compared with that in the clinical studies of other HMG-CoA reductase inhibitors and may not reflect the frequency of adverse reactions observed in clinical practice.

Adverse reactions reported in > 2% of patients in controlled clinical studies and at a rate greater than or equal to placebo are shown in Table 1. These studies had treatment duration of up to 12 weeks.

Table 1: Adverse Reactions* Reported by ≥ 2.0% of Patients Treated with LIVALO and > Placebo in Short-Term Controlled Studies

Adverse Reactions* Placebo
N= 208
LIVALO 1 mg
N=309
LIVALO 2 mg
N=951
LIVALO 4 mg
N=1540
Back Pain 2.90% 3.90% 1.80% 1.40%
Constipation 1.90% 3.60% 1.50% 2.20%
Diarrhea 1.90% 2.60% 1.50% 1.90%
Myalgia 1.40% 1.90% 2.80% 3.10%
Pain in extremity 1.90% 2.30% 0.60% 0.90%
* Adverse reactions by MedDRA preferred term.

Other adverse reactions reported from clinical studies were arthralgia, headache, influenza, and nasopharyngitis.

The following laboratory abnormalities have also been reported: elevated creatine phosphokinase, transaminases, alkaline phosphatase, bilirubin, and glucose.

In controlled clinical studies and their open-label extensions, 3.9% (1 mg), 3.3% (2 mg), and 3.7% (4 mg) of pitavastatin-treated patients were discontinued due to adverse reactions. The most common adverse reactions that led to treatment discontinuation were: elevated creatine phosphokinase (0.6% on 4 mg) and myalgia (0.5% on 4 mg).

Hypersensitivity reactions including rash, pruritus, and urticaria have been reported with LIVALO.

Postmarketing Experience:

The following adverse reactions have been identified during postapproval use of LIVALO. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Adverse reactions associated with LIVALO therapy reported since market introduction, regardless of causality assessment, include the following: abdominal discomfort, abdominal pain, dyspepsia, nausea, asthenia, fatigue, malaise, hepatitis, jaundice, fatal and non-fatal hepatic failure, dizziness, hypoesthesia, insomnia, depression, interstitial lung disease, erectile dysfunction and muscle spasms.

There have been rare postmarketing reports of cognitive impairment (e.g., memory loss, forgetfulness, amnesia, memory impairment, confusion) associated with statin use. These cognitive issues have been reported for all statins. The reports are generally nonserious, and reversible upon statin discontinuation, with variable times to symptom onset (1 day to years) and symptom resolution (median of 3 weeks).

Read the Livalo (pitavastatin) Side Effects Center for a complete guide to possible side effects

DRUG INTERACTIONS

Cyclosporine

Cyclosporine significantly increased pitavastatin exposure. Co-administration of cyclosporine with LIVALO is contraindicated [see CONTRAINDICATIONS, and CLINICAL PHARMACOLOGY].

Erythromycin

Erythromycin significantly increased pitavastatin exposure. In patients taking erythromycin, a dose of LIVALO 1 mg once daily should not be exceeded [see DOSAGE AND ADMINISTRATION and CLINICAL PHARMACOLOGY].

Rifampin

Rifampin significantly increased pitavastatin exposure. In patients taking rifampin, a dose of LIVALO 2 mg once daily should not be exceeded [see DOSAGE AND ADMINISTRATION and CLINICAL PHARMACOLOGY].

Gemfibrozil

Due to an increased risk of myopathy/rhabdomyolysis when HMG-CoA reductase inhibitors are coadministered with gemfibrozil, concomitant administration of LIVALO with gemfibrozil should be avoided.

Other Fibrates

Because it is known that the risk of myopathy during treatment with HMG-CoA reductase inhibitors is increased with concurrent administration of other fibrates, LIVALO should be administered with caution when used concomitantly with other fibrates [see WARNINGS AND PRECAUTIONS, and CLINICAL PHARMACOLOGY].

Niacin

The risk of skeletal muscle effects may be enhanced when LIVALO is used in combination with niacin; a reduction in LIVALO dosage should be considered in this setting [see WARNINGS AND PRECAUTIONS].

Warfarin

LIVALO had no significant pharmacokinetic interaction with R-and S-warfarin. LIVALO had no significant effect on prothrombin time (PT) and international normalized ratio (INR) when administered to patients receiving chronic warfarin treatment [see CLINICAL PHARMACOLOGY]. However, patients receiving warfarin should have their PT and INR monitored when pitavastatin is added to their therapy.

Read the Livalo Drug Interactions Center for a complete guide to possible interactions

Last reviewed on RxList: 3/13/2012
This monograph has been modified to include the generic and brand name in many instances.

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