Zypitamag

Generic name: pitavastatin

Drug class: Statins (HMG-CoA reductase inhibitors)

Dosage form: Tablets (2 mg and 4 mg)

Route of administration: Oral

Dose: 2 mg to 4 mg once daily; maximum recommended dose is 4 mg once daily

Mechanism of action: Pitavastatin inhibits HMG-CoA reductase, the enzyme responsible for converting HMG-CoA to mevalonate, a precursor of cholesterol, thereby reducing cholesterol synthesis in the liver and lowering blood cholesterol levels.

Drug usage cases:

• Primary hyperlipidemia
• Mixed dyslipidemia

Drug contraindications:

• Active liver disease, including unexplained persistent elevations of hepatic transaminases
• Hypersensitivity to pitavastatin or any component of the formulation
• Concomitant use with cyclosporine

Side effects:

• Muscle pain, tenderness, or weakness
• Elevated creatine kinase (CK) levels
• Abnormal liver function tests
• Increased blood sugar levels
• Headache
• Diarrhea
• Constipation
• Back pain
• Pain in extremities
• Joint pain
• Influenza-like symptoms
• Runny or stuffy nose

Warnings:

• Myopathy and rhabdomyolysis: Risk factors include age ≥65 years, uncontrolled hypothyroidism, renal impairment, concomitant use with certain other drugs (e.g., fibrates, niacin), and higher pitavastatin dosages. Discontinue pitavastatin if markedly elevated CK levels occur or if myopathy is diagnosed or suspected. Temporarily discontinue in patients experiencing an acute or serious condition at high risk of developing renal failure secondary to rhabdomyolysis.
• Hepatic dysfunction: Monitor liver enzymes before and during treatment. Discontinue if persistent elevations occur.
• Increased blood sugar levels: Monitor blood glucose levels; consider dose adjustment in patients with diabetes or at risk for diabetes.
• Renal impairment: In patients with moderate to severe renal impairment or end-stage renal disease on hemodialysis, the recommended starting dose is 1 mg once daily, with a maximum dose of 2 mg once daily. Zypitamag is not available in a 1 mg dose; use an alternative formulation of pitavastatin for the 1 mg dose.
• Drug interactions: Use caution when co-administering with erythromycin (maximum dose of 1 mg once daily) and rifampin (maximum dose of 2 mg once daily). Zypitamag is not available in a 1 mg dose; use an alternative formulation of pitavastatin for the 1 mg dose.

Use during pregnancy or breastfeeding: Pitavastatin is contraindicated during pregnancy and lactation due to potential risks to the fetus or nursing infant. Women of childbearing potential should use effective contraception during treatment. If pregnancy occurs, discontinue pitavastatin and consult a healthcare provider.