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2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults
Update to 2004 NCEP ATP III cholesterol guidelines
- This slide reviews the available statins and doses that fall under the categories of high- or medium- intensity therapy.
- High-intensity stain therapy lowers LDL-C by approximately ≥50%:
- Atorvastatin 40-80 mg qd (if unable to tolerate atorvastatin 80 mg, down titrate to 40 mg)
- Rosuvastatin 20 mg qd (40 mg qd)
- Medium-intensity statin therapy lowers LDL-C by approximately 30% to 50%:
- Atorvastatin 10 mg qd (20 mg qd)
- Rosuvastatin (5 mg qd) 10 mg qd
- Simvastatin 20-40 mg qd*
- Pravastatin 40 mg qd (80 mg qd)
- Lovastatin 40 mg qd
- Fluvastatin XL 80 mg qd
- Fluvastatin 40 mg bid
- Pitavastatin 2-4 mg qd
*Initiation of or titration to simvastatin is not recommended by the FDA due to increased myopathy risk
Italics denotes FDA-approved doses that were not tested in trials reviewed for guideline development
Stone NJ, Robinson J, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults. J Am Coll Cardiol. 2013. doi:10.1016/j.jacc.2013.11.002.
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The pharmacologic agents discussed are approved for use in the United States by the U.S. Food and Drug Administration (FDA) unless otherwise noted. Consult individual package inserts for use outside of the United States.