Pitavastatin (Livalo) for Hyperlipidemia and Mixed Dyslipidemia

Vol. 35 No. 4 • April 2010 • P&T® 197 INTRODUCTION Hyperlipidemia is extremely prevalent in both men and women today. Total cholesterol (TC) levels, as well as lowdensity lipoprotein-cholesterol (LDL-C) levels, usually increase throughout our lives. Nearly half of all Americans older than 20 years of age have TC levels exceeding 200 mg/dL. Only 50% of adults who qualify for lipid-lowering therapy receive it, and only one-third of treated patients are at their cholesterol goals. In addition to a high prevalence, hyper lipidemia has a significant impact on public health, as this condition is a risk factor for many types of cardiovascular disease (CVD), including coronary heart disease (CHD).1 The National Cholesterol Education Program’s Expert Panel on Detection, Evaluation, and Treatment of High Cholesterol in Adults (ATP III) describes the approach to the management of hyperlipidemia. These guidelines recommend that LDL-C be the initial target of lipidlowering therapy, because it is most often associated with the risk for developing CHD. Other secondary targets of lipidlowering therapy include serum trigly cerides (TGs) and non–high density lipoprotein-cholesterol (non–HDL-C). Although the goal is to decrease most lipid markers, HDL-C levels should be with a high-fat meal decreases the drug’s Cmax by 43%, whereas the area-under-thecurve (AUC) concentration remains relatively unchanged. Neither the Cmax nor the AUC concentration differed when pitavastatin was taken in the morning or evening. Pitavastatin is more than 99% protein-bound in human plasma, mainly to albumin and alpha1-acid glycoprotein.