HMG-CoA Reductase Inhibitors (Systemic)
Before Using This MedicineIn deciding to use a medicine, the risks of taking the medicine must be
weighed against the good it will do. This is a decision you and your doctor
will make. For HMG-CoA reductase inhibitors, the following should be considered:
Allergies - Tell your doctor if you have ever had any unusual or
allergic reaction to HMG-CoA reductase inhibitors. Also tell your health care
professional if you are allergic to any other substances, such as foods, preservatives,
or dyes.
Diet - Before prescribing medicines to lower your
cholesterol, your doctor will probably try to control your condition by prescribing
a personal diet for you. Such a diet will be lower in total fat, particularly
saturated fat, and dietary cholesterol. Many people are able to control their
condition by carefully following their doctor's orders for proper diet and
exercise. Medicine is prescribed only when additional
help is needed
and is effective only when a schedule of diet and exercise
is properly followed. Also, this medicine is less effective if you are greatly overweight. It
may be very important for you to go on a reducing diet. However, check with
your doctor before going on any diet.
Pregnancy - HMG-CoA reductase inhibitors should not be used during
pregnancy or by women who plan to become pregnant in the near future. These
medicines block formation of cholesterol, which is necessary for the fetus
to develop properly. HMG-CoA reductase inhibitors may cause birth defects
or other problems in the baby if taken during pregnancy. An effective form
of birth control should be used during treatment with these medicines. Check with your doctor immediately if you think you have become
pregnant while taking this medicine
. Be sure you have discussed this
with your doctor.
Breast-feeding - These medicines are not recommended for use during
breast-feeding because they may cause unwanted effects in nursing babies.
Children - Studies on this medicine have been done only in adult
patients, and there is no specific information comparing use of HMG-CoA reductase
inhibitors in children with use in other age groups. However, atorvastatin,
lovastatin, and simvastatin have been used in a limited number of children
under 18 years of age. Early information seems to show that these medicines
may be effective in children, but their long-term safety has not been studied.
Older adults - This medicine has been tested in a limited number
of patients 65 years of age or older and has not been shown to cause different
side effects or problems in older people than it does in younger adults.
Other medicines - Although certain medicines should not be used
together at all, in other cases two different medicines may be used together
even if an interaction might occur. In these cases, your doctor may want to
change the dose, or other precautions may be necessary. When you are taking
HMG-CoA reductase inhibitors, it is especially important that your health
care professional know if you are taking any of the following:
-
Cyclosporine (e.g., Sandimmune) or
-
Gemfibrozil (e.g., Lopid) or
-
Clofibrate (e.g., Atromid-S) or
-
Fenofibrate (e.g., Tricor) or
-
Niacin - Use of these medicines with an HMG-CoA reductase inhibitor
may increase the risk of developing muscle problems and kidney failure
-
Digoxin (e.g., Lanoxin) - Use with atorvastatin, fluvastatin,
or simvastatin may increase blood levels of digoxin, increasing the risk of
side effects
-
Oral contraceptives, (birth control tablets) - Atorvastatin may
increase the blood levels of the birth control hormones, increasing the risk
of side effects
-
HIV protease inhibitors (Amprenavir [e.g., Agenerase], Indinavir
[e.g., Crixivan], Nelfinavir [e.g., Viracept], Ritonavir [e.g., Norvir], Saquinavir
[e.g., Fortovase, Invirase]) or
-
Nefazodone (e.g. Serzone) - Use with simvastatin may increase
the risk of developing muscle problems and kidney failure
-
Verapamil (e.g. Calan, Isoptin) - Use with simvastatin may increase
the risk of muscle problems
Other medical problems - The presence of other medical
problems may affect the use of HMG-CoA reductase inhibitors. Make sure you
tell your doctor if you have any other medical problems, especially:
-
Alcohol abuse (or history of) or
-
Liver disease - Use of this medicine may make liver problems
worse
-
Convulsions (seizures), not well-controlled, or
-
Organ transplant with therapy to prevent transplant rejection or
-
If you have recently had major surgery - Patients with these
conditions may be at risk of developing problems that may lead to kidney failure
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