Table 3.12-1. Selected lipid-lowering agents

Agent

Dosage

Statins

Atorvastatin

10-80 mg once daily

Fluvastatin

20-80 mg once daily

Lovastatin

20-80 mg once daily

Rosuvastatin

5-40 mg once daily

Simvastatin

5-80 mga once daily

Pitavastatin (not used in Canada)

1-4 mg once daily

Cholesterol absorption inhibitor

Ezetimibe

10 mg once daily

Fibrates

Bezafibrate

400 mg once daily

Gemfibrozil

600 mg bid

Fenofibrate

Nonmicronized

48 mg, 145 mg, 54 mg, 160 mg, or 67 mg once daily with main meal

Micronized

200 mg, 134 mg, 40 mg, 120 mg, 43 mg, 130 mg, 30 mg, 90 mg, 50 mg, or 150 mg once daily with main meal

PCSK9 inhibitors

Alirocumab

75 mg SC every other week, 150 mg SC every 2 weeks, or 300 mg every 4 weeks

Inclisiran

– Initial dose: 284 mg SC once, and repeat in 3 months

– Maintenance dose (after initial dose): 284 mg SC every 6 months

Evolocumab (no longer used in Canada)

140 mg SC every 2 weeks or 420 mg once monthly

Omega-3 acid

Icosapent ethyl

2 g bid

Bile acid sequestrants (resins)

Cholestyramine

Start from 4 g once daily to bid, then titrate up to 4 g/d (max, 24 g/d in divided doses)

Colesevelam

1.875 g bid or 3.75 g once daily

a Note: The US Food and Drug Administration does not recommend the use of simvastatin at a dose of 80 mg/d because of increased incidence of myopathy.

Bid, twice a day; PCSK9, proprotein convertase subtilisin/kexin type 9; SC, subcutaneous.