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Livalo (pitavastatin) to Lower Cholesterol

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

What is Livalo (pitavastatin)?

Livalo (pitavastatin) is a cholesterol-lowering drug approved by the Food and Drug Administration in August 2009. Livalo is an HMG-CoA reductase inhibitor or "statin."

Other statins include:

Statins reduce cholesterol by reducing the activity of HMG-CoA reductase, an enzyme in the liver that is necessary for the production of cholesterol.

In one study Livalo (pitavastatin), 4 mg daily:

  • reduced total cholesterol by 32%
  • reduced LDL ("bad") cholesterol by 45%,
  • reduced triglycerides by 19%,
  • reduced apolipoprotein B by 35%, and
  • raised HDL ("good") cholesterol by 5%.

The 4 mg dose of Livalo (pitavastatin) is comparable to 20 mg of atorvastatin in reducing cholesterol. However, Livalo increases HDL more than Lipitor (atorvastatin). The 2 mg and 4 mg doses of Livalo are comparable to 20 mg and 40 mg doses of Zocor (simvastatin), respectively.

How is Livalo (pitavastatin) prescribed?

  • The usual dose range of Livalo is 1 to 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 to 2 mg daily.

With which drugs does Livalo (pitavastatin) interact?

What about taking Livalo (pitavastatin) during pregnancy?

Like other statins, Livalo should not be used during pregnancy because statins are harmful to the fetus.

What are the side effects of Livalo (pitavastatin)?

Common side effects of Livalo include back pain, muscle pain, constipation and diarrhea. Livalo, may cause persistent abnormal liver function tests and rarely fatal or non-fatal liver failure. Liver function tests are performed before starting Livalo and if signs or symptoms of liver injury occur.

Like other statins Livalo may cause fatal muscle damage (rhabdomyolysis) at any dose, but most often at higher doses, or when used in combination with other drugs that increase its blood levels. All patients should promptly report unexplained muscle pain, tenderness, or weakness, especially if associated with malaise or fever. Livalo should be discontinued if rhabdomyolysis is diagnosed or suspected.

Livalo may increase HbA1c and fasting serum glucose levels.

Reviewed by:
Robert J. Bryg, MD
Board Certified Internal Medicine with subspecialty in Cardiovascular Disease

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