Lovastatin belongs to the family of medications known as lipid metabolism regulators. It is used in addition to diet and exercise to lower high cholesterol. It is also used to slow the progression of coronary atherosclerosis (hardening of the arteries in the heart). It works by blocking an enzyme that is needed to make cholesterol in the body. Less cholesterol is made, and cholesterol levels in the blood decrease.

The medication usually takes about 2 to 6 weeks to have a significant effect on the cholesterol level in your blood. After this time, your doctor will likely send you for a blood test to check for changes in your cholesterol levels.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

Before starting lovastatin, you should follow a cholesterol-lowering diet. If appropriate, a weight control and physical exercise program should also be followed.

The usual starting dose for adults is 20 mg taken daily as a single dose, with the evening meal. At 4-week intervals, depending on how well the medication has worked for you, your doctor may increase your dose to a maximum of 80 mg taken daily. The higher doses may be taken in 2 divided doses (morning and evening meals).

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones given here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not take lovastatin if you:

• are allergic to lovastatin or any ingredients of the medication
• are pregnant or breast-feeding
• have active liver disease or unexplained increases in liver function tests
• are taking any of the following medications:
  • "azole" antifungal medications (e.g., itraconazole, ketoconazole, voriconazole)
  • protease inhibitors such as atazanavir, ritonavir, boceprevir, or telaprevir
  • erythromycin or clarithromycin
  • nefazodone
  • cobicistat
  • cyclosporine

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• abdominal pain
• confusion
• constipation
• cough
• diarrhea
• dizziness
• gas
• headache
• nausea
• nightmares
• poor memory
• trouble sleeping
• upset stomach

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• blurred vision
• fever
• shortness of breath
• signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
• signs of liver damage (e.g., yellow skin or eyes, abdominal pain, dark urine, clay-coloured stools, loss of appetite, nausea and vomiting, or itching)
• signs of muscle damage (e.g., muscle pain, tenderness or weakness, or brown or discoloured urine) - especially if you also have a fever or a general feeling of being unwell
• signs of nerve damage (e.g., muscle weakness, decreased sensation in the hands or feet, loss of balance, numbness, tingling or prickling sensations)
• skin rash
• symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• severe skin rash, including skin blistering and peeling (possibly with headache, fever, coughing, or aching before the rash begins)
• signs of a serious allergic reaction (e.g., swelling of the face or throat, hives, or difficulty breathing)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Alcohol: The combination of alcohol use while taking lovastatin can increase the risk of harm to the liver. People who drink large quantities of alcohol should be closely monitored by their doctor while they are taking this medication.

Diabetes: Lovastatin may cause an increase in blood sugar levels (may cause a loss of blood glucose control) and glucose tolerance may change. People with diabetes may find it necessary to monitor their blood sugar more frequently while using this medication.

If you have diabetes or are at risk for developing diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Kidney function: People with severely reduced kidney function should be closely monitored by their doctors if they take this medication

Liver effects: If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking this medication.

If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Muscle effects: In rare cases, serious muscle damage has been associated with the use of statin medications (i.e., cholesterol-lowering medications whose names end in "statin," such as atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin, or simvastatin), especially at higher doses. Before taking this medication, tell your doctor or pharmacist if you:

• are over 70 years of age
• are taking other cholesterol-lowering medications, such as fibrates (e.g., gemfibrozil, fenofibrate) or niacin
• are taking other medications, including prescription, non-prescription, and natural health products, as drug interactions are possible
• do excessive physical exercise
• drink 3 or more alcoholic beverages daily
• have a family history of muscular disorders
• have diabetes
• have had any past problems with the muscles (e.g., pain, tenderness) after using a statin
• have kidney or liver problems
• have thyroid problems
• have undergone surgery or other tissue injury

Report any unexplained muscle pain, tenderness, weakness or cramps, or any brown or discoloured urine to your doctor immediately, particularly if you are also experiencing malaise (a general feeling of being unwell) or fever.

Pregnancy: This medication should not be used during pregnancy. If you become pregnant while taking this medication, stop taking it immediately and call your doctor.

Breast-feeding: It is not known if lovastatin passes into breast milk.

If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children.

Seniors:  Seniors may be at an increased risk of muscle-related side effects from lovastatin.

There may be an interaction between lovastatin and any of the following:

• abiraterone acetate
• amiodarone
• aprepitant
•  "azole" antifungals (e.g., itraconazole, ketoconazole, voriconazole)
• bezafibrate
• calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine, verapamil)
• cholestyramine
• cobicistat
• colchicine
• colestipol
• conivaptan
• cyclosporine
• cyproterone
• dabigatran
• danazol
• dronedarone
• eltrombopag
• fenofibrate
• gemfibrozil
• grapefruit juice
• HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., efavirenz, etravirine, nevirapine)
• HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
• lanthanum
• letermovir
• lomitapide
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• mifepristone
• niacin
• niacinamide
• phenytoin
• protein kinase inhibitors (e.g., bosutinib, dasatinib, imatinib, nilotinib)
• quinine
• raltegravir
• rifampin
• rupatadine
• St. John's wort
• sitagliptin
• ticagrelor
• trabectedin
• warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.