Pitavastatin (patient information)

# Why is this medication prescribed?
Pitavastatin is used together with diet, weight-loss, exercise to reduce the amount of fatty substances such as low-density lipoprotein (LDL) cholesterol ('bad cholesterol') in the blood and to increase the amount of high-density lipoprotein (HDL) cholesterol ('good cholesterol'). Pitavastatin is in a class of medications called HMG-CoA reductase inhibitors (statins). It works by slowing the production of cholesterol in the body to decrease the amount of cholesterol that may build up on the walls of the arteries and block blood flow to the heart, brain, and other parts of the body.

# How should this medicine be used?
Pitavastatin comes as a tablet to take by mouth. It is usually taken once a day with or without food. Take pitavastatin at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take pitavastatin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Your doctor may start you on a low dose of pitavastatin and gradually increase your dose, not more than once every 4 weeks.
Continue to take pitavastatin even if you feel well. Do not stop taking pitavastatin without talking to your doctor.
Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

# What special precautions should I follow?
Before taking pitavastatin,
tell your doctor and pharmacist if you are allergic to pitavastatin, any other medications, or any of the ingredients in pitavastatin tablets. Ask your pharmacist for a list of the ingredients.
tell your doctor if you are taking cyclosporine (Gengraf, Neoral, Sandimmune). Your doctor will probably tell you not to take pitavastatin if you are taking this medication.
tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: erythromycin (E.E.S., E-Mycin, Erythrocin); other cholesterol-lowering medications such as fenofibrate (Tricor), gemfibrozil (Lopid), and niacin (nicotinic acid, Niacor, Niaspan); rifampin (Rifadin, in Rifamate, in Rifater, Rimactane); ritonavir (Norvir) taken with atazanavir (Reyataz) or darunavir (Prezista); ritonavir and lopinavir (Kaletra);or warfarin (Coumadin, Jantoven). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
tell your doctor if you have liver disease. Your doctor will order laboratory tests to see how well your liver is working even if you do not think you have liver disease. Your doctor will probably tell you not to take pitavastatin if you have liver disease or if the tests show that you may be developing liver disease.
tell your doctor if you drink large amounts of alcohol, if you have ever had liver disease, or if you have or have ever had seizures, low blood pressure, or thyroid or kidney disease.
tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while you are taking pitavastatin. Talk to your doctor about birth control methods that will work for you. If you become pregnant while taking pitavastatin, stop taking pitavastatin and call your doctor immediately. Pitavastatin may harm the fetus.
do not breast-feed while you are taking this medication.
you should know that the risk that you will develop serious muscle problems during your treatment is higher if you are 65 years of age or older. Talk to your doctor about the risks of taking pitavastatin.
if you are having surgery, tell the doctor that you are taking pitavastatin. If you are hospitalized due to serious injury or infection, tell the doctor treating you that you are taking pitavastatin.
ask your doctor about the safe use of alcoholic beverages while you are taking pitavastatin. Alcohol can increase the risk of serious side effects.

# What special dietary instructions should I follow?
Eat a low-fat, low-cholesterol diet. Be sure to follow all exercise and dietary recommendations made by your doctor or dietitian. You can also visit the National Cholesterol Education Program (NCEP) website for additional dietary information at .

# What should I do if I forget a dose?
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

# What side effects can this medication cause?
Pitavastatin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
back pain
constipation
diarrhea
memory loss or forgetfulness
confusion
Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency medical help:
muscle pain, tenderness, or weakness
fever
nausea
extreme tiredness
unusual bleeding or bruising
lack of energy
weakness
loss of appetite
pain in the upper right part of the stomach
yellowing of the skin or eyes
dark urine
flu-like symptoms
rash
itching
hives
Pitavastatin may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online  or by phone .

# What should I know about storage and disposal of this medication?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from light, excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

# What other information should I know?
Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests during your treatment , especially if you develop signs of liver damage.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
Brand names
Livalo