The incidence of myalgia in patients taking simvastatin every day was significantly higher as compared to those taking it every alternate day (p = 0.02).  |  Sixty patients with hypercholesterolemia despite diet therapy were enrolled into the study. COVID-19 is an emerging, rapidly evolving situation. © 2020 American College of Cardiology Foundation. J Med Assoc Thai. And there’s no proof that an LDL cholesterol of 70 mg/dL is better than 80 or 90 mg/dL. A total of 28 (7%) patients from the entire study group complained of myalgia, amongst which more than half of the patients … The efficacy of intermittent dosing of statins relates to the fact that the duration of the cholesterol-lowering effect of the statins is not related to the pharmacokinetics of the individual drug. The cholesterol-lowering action of alternate-day statins is as effective as daily dosing in many individuals. 2. NIH They received atorvastatin 10 mg every other day before bedtime. Epub 2003 Apr 28. Achieving lipoprotein goals in patients at high risk with severe hypercholesterolemia: efficacy and safety of ezetimibe co-administered with atorvastatin. The effect of alternate-day statins on its many pleiotropic effects is unknown; thus, the efficacy for reducing cardiovascular events is not established. A lipid profile was determined as baseline, at 4 weeks and again at 8 weeks. The following are 10 points to remember about alternate-day dosing with statins: Objectives: Alternate-day statin administration seems to decrease the incidence of its adverse effects, particularly myopathy. Alternate day treatment will be less expensive, and non-daily dose of certain statins may reduce the already-low but concerning incidence of musculoskeletal pain and weakness that can be a side effect of statin use. Increase in HDL-c level was not statistically significant. While the decrease in mg/dl per mg of statin varies, the linear incremental dose response is similar with each of the statins. Most of studies reviewed demonstrated that when compared with baseline, every-other-day dosing of statins significantly lowered low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), and triglyceride (TG) levels. Clin Interv Aging. To maintain the same degree of decrease in LDL-C when giving the statins on alternate days, the dose of the statins frequently needs to be increased. Clinical Topics: Dyslipidemia, Prevention, Homozygous Familial Hypercholesterolemia, Lipid Metabolism, Nonstatins, Novel Agents, Statins, Keywords: Follow-Up Studies, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Coronary Disease, Lipoproteins, Heptanoic Acids, Hypercholesterolemia, Primary Prevention, Pyrroles, Cholesterol, C-Reactive Protein, Cardiovascular Diseases, Muscular Diseases. 5. Duration of treatment was 8 weeks. 2008;3(2):299-314. doi: 10.2147/cia.s2442. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Circulation. Atorvastatin and cardiovascular risk in the elderly--patient considerations. To maintain the same degree of decrease in LDL-C when giving the statins on alternate days, the dose of the statins frequently needs to be increased. In small cohorts of patients, atorvastatin 20 mg daily decreases the high-sensitivity C-reactive protein (hs-CRP) by 35% compared to 22% with 20 mg atorvastatin every other day (p = 0.08), and there is no difference when baseline hs-CRP is <1 mg/dl. Comparison of the dose-response relationships of 2 lipid-lowering agents: a Bayesian meta-analysis. Three patients had drug side effects. Am Heart J. 6. One patient had increased serum transaminase and one patient had increased serum muscle enzyme. 8. But ultimately, in order to make definitive conclusions, more large-scale … Randomised study to compare the efficacy and safety of isapgol plus atorvastatin versus atorvastatin alone in subjects with hypercholesterolaemia. Epub 2009 May 2. Statins have efficacy in lowering cholesterol and reducing cardiovascular events but their cost is a major disadvantage. Atorvastatin prevents hippocampal cell death due to quinolinic acid-induced seizures in mice by increasing Akt phosphorylation and glutamate uptake. HHS Large-scale studies with outcome endpoints and prolonged follow-up are needed to substantiate the hypothesis that alternate-day statins are an equivalent strategy for reducing cardiovascular events. Epub 2011 Apr 28. Stein E, Stender S, Mata P, Sager P, Ponsonnet D, Melani L, Lipka L, Suresh R, Maccubbin D, Veltri E; Ezetimibe Study Group. All rights reserved. The other one had somnolence. Dosing a statin (rosuvastatin) every other day (EOD) may provide significant lipoprotein changes while avoiding common adverse effects in this statin-intolerant population. 7. Twenty (10%) patients who were on a daily dosage developed myalgia, compared to 8 patients on alternate day therapy. Congenital Heart Disease and Pediatric Cardiology, Invasive Cardiovascular Angiography and Intervention, Pulmonary Hypertension and Venous Thromboembolism, CardioSource Plus for Institutions and Practices, Nuclear Cardiology and Cardiac CT Meeting on Demand, Annual Scientific Session and Related Events, ACC Quality Improvement for Institutions Program, National Cardiovascular Data Registry (NCDR). Clipboard, Search History, and several other advanced features are temporarily unavailable. Ghia CJ, Panda AS, Khobragade LR, Jha RK, Rambhad GS. Ballantyne CM, Houri J, Notarbartolo A, Melani L, Lipka LJ, Suresh R, Sun S, LeBeaut AP, Sager PT, Veltri EP; Ezetimibe Study Group. 2009 Aug;16(2):106-15. doi: 10.1007/s12640-009-9057-6. J Clin Diagn Res. Background: Alternate-day dosing of statins provides cost savings. Epub 2014 Mar 15. There is evidence favoring primary prevention with statins for high-risk patients. Neurotox Res. It doesn’t matter so much what his or her actual cholesterol level is to begin with. Piermartiri TC, Vandresen-Filho S, de Araújo Herculano B, Martins WC, Dal'agnolo D, Stroeh E, Carqueja CL, Boeck CR, Tasca CI. 9. 3. Steady-state statin drug levels may be achieved in a few days, but steady-state LDL-C reductions take several weeks to achieve, and after discontinuation, it takes several weeks before the cholesterol level returns to baseline. The cholesterol-lowering action of alternate-day statins is as effective as daily dosing in many individuals. A shift in the routine prescribing of statin therapy to every-other-day would have important implications. 2014 Mar;8(3):27-31. doi: 10.7860/JCDR/2014/7359.4096. Method and result: 7. Alternate Day versus Once Daily Atorvastatin for Primary Prevention of (CHD) in Naïve Patients of Dyslipidemia. 10. The percentage of patients who obtain the target LDL-C level of <100 mg/dl is 70% with 10 mg of atorvastatin, 82% with 20 mg of atorvastatin, and 89% with 40 mg of atorvastatin. This site needs JavaScript to work properly. 2003 Jun;145(6):1036-45. doi: 10.1016/S0002-8703(03)00106-6. 2004 Sep;148(3):447-55. doi: 10.1016/j.ahj.2004.03.052. Please enable it to take advantage of the complete set of features! Diabetes Metab Syndr Obes. The TC, TG, and LDL-c levels were lower by 23 per cent, 8 per cent, and 30 per cent. J Indian Med Assoc. The authors sought to evaluate the safety and efficacy of atorvastatin administered every other day in patients with hypercholesterolemia. 6. Homozygous Familial Hypercholesterolemia, Congenital Heart Disease and     Pediatric Cardiology, Invasive Cardiovascular Angiography    and Intervention, Pulmonary Hypertension and Venous     Thromboembolism. Get the latest research from NIH: Jayaram S, Prasad HB, Sovani VB, Langade DG, Mane PR. In hypercholesterolemia patients, atorvastatin 10 mg every other day is safe and effective in lowering TC, TG, with LDL-c and a slight increase in HDL-c. NLM
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