Livalo (pitavastatin) to Lower Cholesterol (cont.)

How is Livalo (pitavastatin) prescribed?

• The usual dose range of Livalo is 1-4 mg daily administered at any time of the day without regard to meals.
  
  
• Therapy is usually initiated at 2 mg daily and increased after 4 weeks up to a maximum dose of 4 mg daily.
  
  
• Doses greater than 4 mg daily are associated with severe muscle toxicity.
  
  
• The recommended dose for individuals with moderate renal dysfunction or on dialysis is 1-2 mg daily.

With which drugs does Livalo (pitavastatin) interact?

• Sandimmune, Neoral, Restasis, Gengraf Capsules, Gengraf Oral Solution (cyclosporine), erythromycin, Reyataz (atazanavir), Rifadin, Rifamate, Rifater, Priftin (rifampin), and Lopid (gemfibrozil) significantly increase blood levels of Livalo.
  
  
• Because of the effect of cyclosporine or erythromycin on Livalo blood levels, cyclosporine should not be administered with Livalo and a dose of 1 mg daily should not be exceeded when Livalo is used in combination with erythromycin.
  
  
• When combined with Priftin (rifampin) the maximum recommended dose of Livalo is 2 mg daily.
  
  
• Grapefruit juice and Fenofibrate also increase blood levels of Livalo but to a lesser extent.
  
  
• Sporanox, Sporanox Injection, Sporanox Oral Solution (itraconazole) decreases blood levels of Livalo.
  
  
• Since other statins interact with the combination of Kaletra Tablets, Kaletra Capsules (lopinavir and ritonavir), Livalo should not be used with this combination.
  
  
• Fibrates, Niaspan, Advicor, Niacor (niacin), and Lopid (gemfibrozil) are known to increase adverse effects of statins and should be used cautiously with Livalo.

Reference: Livalo (pitavastatin) Prescribing Information, 2009