Pitavastatin

Mechanism :

Pitavastatin belongs to class of medications called HMG-CoA reductase inhibitors (statins).

Livalo is calcium salt of pitavastatin

Zypitamag is magnesium salt of pitavastatin

It inhibits rate limiting step in cholesterol biosynthesis by completly inhibiting HMG-CoA reductase

Indication :

• Heterozygous Familial Hypercholesterolemia - Livalo only

Contraindications :

• drug or excipient-related hypersensitivity

• Hepatic transaminases that are persistently elevated without apparent cause or active liver disease

• concurrent cyclosporine usage

• coadministration with gemfibrozil is not recommended

Dosing :

Adverse Effect :

common adverse effects are Back pain , constipation, diarrhoea , pain in extremity, myalgia.

Post marketing adverse effects - indigestion, nausea, dyspepsia, and pain in the abdomen, angioedema and immune-mediated necrotizing myopathy linked to statin use, Elevations in HbA1c and fasting serum glucose levels , rhabdomyolysis, myopathy, and muscle spasms, hypoesthesia, peripheral neuropathy

Insomnia, depression; infrequent reports of cognitive impairment (such as memory loss, forgetfulness, amnesia, and confusion) associated with statin use; cognitive impairment was typically non-serious and reversible upon discontinuation, with variable times to symptom onset (1 day to years) and symptom resolution (median of 3 weeks)

Breast diseases and the reproductive system: erectile dysfunction

Interstitial lung disease: respiratory, thoracic, and mediastinal problems

Interaction :

Pitavastatin shouldn't be administered with erythromycin in excess of 1 mg per day.

Pitavastatin should not be used with rifampin in excess of 2 mg per day.

Usage is Contraindicated when used with the following drugs – atazanavir, cyclosporine, gemfibrozil, letermovir, lopinavir, red yeast rice

Lactation :

There is no information available regarding how the medicine would affect a breastfed baby or milk production. Although it was demonstrated that medications in this class transfer into human milk and atorvastatin is present in rat milk, it is unclear whether is present in human milk.

not advised while undergoing treatment

The FDA MedWatch - The FDA requested to remove the warning against using HMG-CoA reductase inhibitors in pregnant women on July 20, 2021.

Breastfeeding is still not advised if taking statins because the medicine may still enter via milk and harm nursing infants.

Temporarily discontinue statin treatment for people at lower risk till breastfeeding is over.

Patients who need statins after delivery and are at high risk of heart attack or stroke shouldn't breastfeed; instead, they should use alternatives like infant formula.

Hepatic Dose :

Not to be used if there is active liver disease or unexplained transaminase elevations.

Pregnanacy :

HMG-CoA reductase inhibitors may harm a foetus when given to pregnant women because they reduce the production of cholesterol and perhaps other biologically active molecules derived from cholesterol; stop therapy as soon pregnancy is confirmed

; Insufficient information has been provided to evaluate whether there is a drug-related risk of serious congenital abnormalities or miscarriage.

Contraception - Encourage women who are sexually active to utilise effective contraception while receiving treatment

The FDA MedWatch - The FDA requested to remove the warning against using HMG-CoA reductase inhibitors in pregnant women on July 20, 2021.

Despite the adjustments, the majority of women who are discovered to be pregnant should cease therapy.