英文药名: Altocor(Lovastatin Extended Release Tablets)

中文药名: 洛伐他汀缓释片

生产厂家: Andrx Pharmaceuticals Inc.
药品介绍：
[通　用名]　洛伐他汀烟酸缓释片
英文名：Compound　Lovastatin　and　Niacin　Extended-release　Tablets
[剂　　型]　缓释片
[药理分类]　抗动脉粥样硬化药
[新药类别]　药品注册分类3类；监护期待定
[适　应　症]　具有异常脂蛋白血症的血管动脉粥样硬化等
[药理特点]　　　
目前，正当大多数降胆固醇药都在努力降低坏的低密度脂蛋白(LDL)胆固醇时，人们又认识到增加好的高密度脂蛋白(HDL)胆固醇也是很重要的。他汀类药物对降低LDL具有显著效果，但对增加HDL仅有轻微的作用。烟酸却正相反，有很强的增加HDL作用和轻微的降低LDL作用。两者都能降低甘油三酯。

在美国心脏病学会近期会议上发表的Ⅱ期试验结果显示，联合使用时烟酸和洛伐他汀的作用是相加的。治疗一年后，增加HDL　41%，降低LDL　45%，减少甘油三酯42%。
　
自1987年全球第一个他汀类药物洛伐他汀获美国FDA批准上市以　来，辛伐他汀、阿伐他汀等他汀类新药不断被推出。2000年，调脂药的全年销售额达159亿美元，成为全球第二大治疗药物类别，其中他汀类药物的全球销售额达到120多亿美元，是调脂药的主力军。十多　年来，几个举世瞩目的国际大规模冠心病防治试验的完成，证实他汀　类药物可以降低冠心病的发病率和死亡率，而且能使已经形成的动脉　粥样硬化斑块发展减缓，甚至减退，从而打破了冠心病不可逆转的传　统观念，由“他汀”引发的一场血脂革命在全球兴起。美国心脏病学　会主席Faxon说，他汀类药可明显降低心脏病发作及卒中的危险。许　多大型研究已证实他汀类药可降低心脏病患者死亡危险达30％。
欧洲心脏病学会主席、荷兰Simoons教授和挪威Pedersen教授在第23届欧洲心脏病学会学术大会上（2001年9月）就拜耳公司的西立伐他汀撤出市场一事发表评论指出：.已有充分临床试验证据表明，他汀类药物通过有效降低血清胆固醇水平，预防冠心病和延长寿命。如果应用适当，目前临床应用的西立伐他汀以外的其它他汀类药物产生横纹肌溶解症和其它并发症的危险很小。如认真注意禁忌证和谨慎用药，从他汀类药物获益远大于风险。
　　
洛伐他汀和烟酸缓释片已于２００１年１２月获ＦＤＡ批准，在安全性和使用方便性方面均优于现有降脂药。将缓释烟酸和速释洛伐他汀两种药物联合应用，对改变低密度脂蛋白（ＬＤＬ）、高密度脂蛋白（ＨＤＬ）和甘油三酯的作用要比这二种药物单独应用时大，因此，此药特别适用于混合性高脂血症病人。

AltocorGeneric name: LovastatinBrand names: Altocor

Why is Altocor prescribed?
Altocor is an extended-release form of the cholesterol-lowering drug lovastatin. By releasing small amounts of the drug throughout the day, Altocor maintains a relatively steady level of lovastatin in the bloodstream.

In many people, high cholesterol levels contribute to the development of clogged arteries and heart disease. Altocor is prescribed to slow the clogging process in people who already have heart disease, and to fend off clogged arteries in people at risk of developing the disease.

Like other drugs in its class, Altocor reduces the level of "bad" LDL cholesterol and raises the level of "good" HDL cholesterol. For people at high risk of heart disease, current guidelines suggest drug therapy when the LDL level reaches 130. For people at lower risk, the cut-off is 160. For those at little or no risk, it's 190.

Most important fact about Altocor
Altocor is usually prescribed only if diet, exercise, and weight loss fail to bring your cholesterol level under control. It is important to remember that Altocor is a supplement—not a substitute—for those other measures. To get the full benefit of the medication, you need to stick to the diet and exercise program prescribed by your doctor.

How should you take Altocor?
Altocor is taken once a day at bedtime. Swallow Altocor whole. Do not break, chew, crush, or cut the tablets.

If you miss a dose...Take it as soon as you remember. If it is almost time for your next dose, skip the dose you missed and go back to your regular schedule. Never take 2 doses at once.
Storage instructions...Store at room temperature. Protect from heat and humidity.
What side effects may occur?
The side effects of Altocor generally are mild and temporary. Nevertheless, if any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine whether it is safe for you to continue taking Altocor.

Side effects may include:Back pain, diarrhea, flu-like symptoms, headache, infection, injury, joint pain, muscle pain, sinus inflammation, unspecified pain, weakness
Why should Altocor not be prescribed?
Cholesterol is essential for developing babies, so Altocor must never be taken during pregnancy or when nursing an infant. You'll also need to avoid Altocor if you have active liver disease or the drug gives you an allergic reaction.

Special warnings about Altocor
In rare cases, drugs such as Altocor cause rhabdomyolysis, a potentially fatal condition that destroys muscle cells and sometimes causes kidney failure. Alert your doctor immediately if you experience any unexplained muscle tenderness, weakness, or pain, especially if you also have a fever or feel sick. You'll probably need to give up Altocor therapy.

Because Altocor may affect the liver, your doctor may order blood tests to check liver function. Blood tests will probably be done before you start taking Altocor, at 6 weeks and 12 weeks after you start taking the drug, when your dosage is increased, and periodically after that (semi-annually). If the tests detect a significant problem, Altocor therapy will have to be stopped. You'll be monitored especially closely if you have a history of liver disease or drink substantial quantities of alcohol

If you have surgery or a major illness, you'll be told to stop taking Altocor until you get better.

Altocor is not recommended for individuals below age 20.

Possible food and drug interactions when taking Altocor
If you take Altocor with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Altocor with any of the following:

AntipyrineBlood-thinning drugs such as warfarin sodiumCimetidineClarithromycinCyclosporineErythromycinGemfibrozilHIV protease inhibitors such as amprenavir, nelfinavir mesylate, and ritonavirItraconazoleKetoconazoleSpironolactoneNefazodoneNicotinic acid or niacinVerapamil
Do not take Altocor with large amounts of grapefruit juice.

Special information if you are pregnant or breastfeeding
Because of potential harm to the developing baby, Altocor should never be taken during pregnancy, or by anyone who may become pregnant. If you become pregnant while taking Altocor, stop taking Altocor immediately and notify your doctor.

Because of the potential for harm to the nursing infant, do not breastfeed while taking Altocor.

Recommended dosage for Altocor
You will have to follow a standard cholesterol-lowering diet before starting treatment with Altocor, and continue this diet while using Altocor. Your dose may be adjusted to meet your individual needs.

ADULTS

The usual starting dose is 20 to 60 milligrams, taken once a day at bedtime. Dosage adjustments may be made every 4 weeks, and dose levels may be reduced as cholesterol levels come down.

The usual starting dose is 10 milligrams for people who are taking cyclosporine and Altocor. The dosage should not be increased to more than 20 milligrams a day.

The usual starting dose is 20 milligrams or less for people with kidney disease or people who are taking gemfibrozil, niacin, or other cholesterol-lowering drugs.