What are the characteristics of statin drugs?

Updated: Dec 19, 2019
  • Author: Mary Ellen T Sweeney, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

Table 5. Statin Drug Characteristics [88] (Open Table in a new window)

Drug

Potency (average LDL decrease)

Renal Considerations

Liver Function Monitoring

Atorvastatin

10 mg: 35-39%

20 mg: 43%

40 mg: 50%

80 mg: 55-60%

No dose adjustment necessary for reduced renal function

Check liver function tests at baseline and when clinically indicated

Fluvastatin

20 mg: 22%

40 mg: 25%

80 mg: 35%

(as XL product)

In severe renal impairment, use daily doses >40 mg with caution

Check liver function tests at baseline and when clinically indicated

Lovastatin

10 mg: 21%

20 mg: 24-27%

40 mg: 30-31%

80 mg: 40-42%

(as 40 mg BID)

If CrCl < 30 mL/min, use daily doses over 20 mg with caution

Check liver function tests at baseline and when clinically indicated

Pitavastatin

1 mg: 31-32%

2 mg: 36-39%

4 mg: 41-45%

For glomerular filtration rate 15-59 mL/min/1.73 m2, including hemodialysis, initial daily dose is 1 mg, not to exceed 2 mg/day

Check liver function tests at baseline and when clinically indicated

Pravastatin

10 mg: 22%

20 mg: 32%

40 mg: 34%

80 mg: 37%

In significant renal impairment, start with 10 mg/day

Check liver function tests at baseline and when clinically indicated

Rosuvastatin

5 mg: 45%

10 mg: 46-52%

20 mg: 47-55%

40 mg: 55-63%

If CrCl < 30 mL/min/1.73 m2 (but not on hemodialysis), starting dose is 5 mg/day, not exceed 10 mg/day

Rosuvastatin levels in hemodialysis patients are about 50% higher than levels in normal renal function

Check liver function tests at baseline and when clinically indicated

Simvastatin

5 mg: 26%

10 mg: 30%

20 mg: 38%

40 mg: 29-41%

80 mg: 36-47%

In severe renal impairment, starting dose is 5 mg daily with close monitoring

Check liver function tests at baseline and when clinically indicated