Lipid-Lowering Drug Therapies, Usual Starting Dosages and Dosage Ranges
Agent
Usual recommended
starting daily dosage Dosage range
Statins
Lovastatin 20 mg 10-80 mg
Pravastatin 40 mg 10-80 mg
Simvastatin 20-40 mg 5-80 mga
Fluvastatin 40 mg 20-80 mg
Atorvastatin 10-20 mg 10-80 mg
Rosuvastatin 10 mg 5-40 mg
Pitavastatin 2 mg 2-4 mg
Cholesterol absorption inhibitors
Ezetimibe 10 mg 10 mg
PCSK9 Inhibitors
Alirocumab 75 mg every 2 weeks 75-150 mg every 2 weeks
Evolocumab 140 mg every 2 weeks or
420 mg once monthly Not applicable
Fibrates
Fenofibrate 48-145 mg 48-145 mg
Gemfibrozil 1,200 mg 1,200 mg
Fenofibric acid 45-135 mg 45-135 mg
Niacin
Immediate-release 250 mg 250-3,000 mg
Extended-release 500 mg 500-2,000 mg
Bile acid sequestrants
Cholestyramine 8-16 g 4-24 g
Colestipol 2 g 2-16 g
Colesevelam 3.8 g 3.8-4.5 g
Combination therapies (single pill)
Ezetimibe/simvastatin 10/20 mg 10/10-10/80 mg
Extended-release
niacin/simvastatin 500/20 mg 500/20-1,000/20 mg
MTP inhibitor
Lomitapide 5 mg, with
subsequent titration 5-60 mg
Antisense apolipoprotein B oligonucleotide
Mipomersen (SubQ injection) 200 mg once weekly 200 mg once weekly
Omega-3 fatty acids
Omega-3-acid ethyl esters
(Lovaza) 4 g per day 4 g per day
Icosapent ethyl (Vascepa®) 4 g per day 4 g per day
Abbreviations: MTP = microsomal transfer protein; PCSK9 = proprotein convertase subtilisin/kexin
type 9; SubQ = subcutaneous
a Simvastatin, 80 mg, not approved for therapy unless individual has been on treatment for more than 1 year without myopathy
CPG for Managing Dyslidemia and Prevention of CVD, Endocr Pract. 2017;23(Suppl 2)
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