What are the FDA approved statin doses for the treatment of familial hypercholesterolemia (FH)?

Updated: Oct 04, 2021
  • Author: Mose July, MD, CCD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

An extended follow-up of the Heart Protection Study examined the long-term efficacy and safety of LDLc-lowering with simvastatin treatment. In-trial cardiovascular benefits began after the first year and increased with each subsequent year of statin therapy and persisted 6 years beyond the end of the study. No difference in nonvascular morbidity or mortality was observed either during 5 years of statin therapy or in 6-year follow-up. The investigators recommend prompt initiation and long-term statin treatment in patients who are at increased risk for vascular events. [58]

Table 3. Statin and Statin Combination Approved Doses, Expected LDLc Decrease, and Dose Required for 30-40% LDLc Reduction (Open Table in a new window)

 

Statin

 

FDA-Approved Dose

 

Expected LDLc Decrease

 

Dose Required for 30-40% LDLc Reduction

Atorvastatin

10-80 mg daily

35-60%

10 mg

Fluvastatin

20-40 mg at bedtime

20-30%

40 mg qd/bid

40 mg bid

35%

40 mg bid

Extended-release fluvastatin

(Lescol XL)

80 mg at bedtime

35-38%

80 mg at bedtime

Lovastatin

20-80 mg at supper

25-48%

40 mg at dinner

Extended-release lovastatin

(Altoprev)

20-60 mg at bedtime

25-45%

60 mg at bedtime

Pravastatin

40-80 mg at bedtime

30-40%

40 mg at bedtime

Rosuvastatin

10-40 mg daily

40-60%

5 mg daily

Simvastatin

20-80 mg daily at bedtime

35-50%

20 mg at bedtime

Simvastatin + ezetimibe

(Vytorin)

10/20 mg

10/40 mg

10/80 mg

at bedtime

50-60%

10/20 mg at bedtime


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