Pectin Lovastatin

Lovastatin (Mevacor/ Altocor) [Antilipemic/HMG-CoA Reductase Inhibitor] Uses Hypercholesterolemia Action HMG-CoA reductase inhibitor Dose 20 mg/d PO w/ PM meal may T at 4-wk intervals to 80 mg/d max or 60 mg ER tab take w/ meals Caution [X, -] Avoid w/ grapefruit juice, gemfibrozil. Contra Active liver Dz Disp Tabs SE HA GI intolerance common promptly report any unexplained muscle pain, tenderness, or weakness (myopathy) Interactions T Effects W/ grapefruit juice T risk of severe myopathy W/ azole antifungals, cyclosporine, erythromycin, gemfibrozil, HMG-CoA inhibitors, niacin T effects OF warfarin >1 effects W/ isradipine, pectin EMS t Risk of photosensitivity Rxns T effects of warfarin concurrent EtOH use t risk of liver tox diltiazem and verapamil can T risk of lovastatin tox OD Unlikely to cause life-threatening Sxs... 

Pectin and oat bran can reduce the cholesterol-lowering effects of lovastatin. 

The serum LDL-cholesterol levels of 3 patients taking lovastatin 80 mg daily showed a marked rise from 4.48 to 6.36 mmol/L when they were also given pectin 15 g daily. One patient had a 59% rise in LDL-cholesterol. Two other patients taking lovastatin had a rise in LDL-cholesterol from 5.03 to 6.54 mmol/L when they were also given 50 to 100 g of oat bran daily. One patient had a 41% rise in LDL-cholesterol. When the pectin and oat bran were stopped, the serum levels of the LDL-cholesterol fell. It is presumed that both pectin and oat bran reduced the absorption of lovastatin from the gut. Evidence is still very limited but if patients are adding these fibres to their diets it would seem prudent to separate the ingestion of lovastatin by as much as possible. 

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