DISTINCTLY DIFFERENT helping patients avoid certain drug interactions
LIVALO® is only minimally metabolized via the CYP450* system1
- Based on its metabolism, LIVALO may have reduced potential for clinically significant drug
interactions mediated by the CYP450 system1,7,8
- The principal route of LIVALO metabolism is conjugation with glucuronic acid via liver UGTs† with subsequent formation of pitavastatin lactone
- No dose adjustment necessary when taken with calcium channel blockers, HIV protease inhibitors, the anticoagulant warfarin, or the antifungal itraconazole1
†UGT=uridine 5'-diphosphate (UDP) glucuronosyltransferase.
- Cyclosporine. Co-administration is contraindicated
- Erythromycin. Do not exceed a 1-mg dose of LIVALO once daily
- Rifampin. Do not exceed a 2-mg dose of LIVALO once daily
- Use with gemfibrozil should be avoided
- Other fibrates. Co-administration with fenofibrate did not result in a significant increase in AUC‡ or Cmax§ of LIVALO, however, HMG-CoA reductase inhibitors like LIVALO should be used with caution with fibrates due to the increased risk of myopathy
- Niacin (≥1 g/day). A reduction in LIVALO dosage should be considered due to potential risk of skeletal muscle effects
- Colchicine. Cases of myopathy, including rhabdomyolysis, have been reported with HMG-CoA reductase inhibitors coadministered with colchicine, and caution should be exercised when prescribing LIVALO with colchicine
§Cmax = maximum concentration observed.
- 1. LIVALO [prescribing information]. Montgomery, AL: Kowa Pharmaceuticals America, Inc; October 2013.
- 2. Atorvastatin (Lipitor) [prescribing information], New York, NY, Pfizer, Inc. 2012.
- 3. Simvastatin (Zocor) [prescribing information], Whitehouse Station, NJ, Merck & Co., Inc. 2012.
- 4. Statin Market TRx by Year. Symphony Health Solutions data as of the end of October, 2015.
- 5. Guengerich FP. Cytochrome P450 and chemical toxicology. Chem Res Toxicol. 2008;21(1):70-83.
- 6. Huang SM, Temple R, Throckmorton DC, Lesko LJ. Drug interaction studies: study design, data analysis, and implications for dosing and labeling. Clin Pharmacol Ther. 2007;81(2):298-304.
- 7. Neuvonen PJ. Drug interactions with HMG-CoA reductase inhibitors (statins): the importance of CYP enzymes, transporters and pharmacogenetics. Curr Opin Investig Drugs. 2010;11(3):323-332.
- 8. Corsini A, Ceska R. Drug-drug interactions with statins: will pitavastatin overcome the statins’ Achilles’ heel? Curr Med Res Opin. 2011;27(8):1551-1562.