Pitavastatin

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Pitavastatin
Systematic (IUPAC) name
(3R,5S,6E)-7-[2-cyclopropyl-4-(4-fluorophenyl)quinolin-3-yl]-3,5-dihydroxyhept-6-enoic acid
Clinical data
Trade namesLivalo
AHFS/Drugs.commonograph
MedlinePlusa610018
Licence dataUS FDA:link
Pregnancy cat.X
Legal status Prescription only
RoutesOral
Pharmacokinetic data
Bioavailability60%
Protein binding96%
Metabolismminimally CYP4502C9
Half-life11 hours
ExcretionFaeces
Identifiers
CAS number147511-69-1 N
ATC codeC10AA08
PubChemCID 5282452
ChemSpider4445604 YesY
UNIIM5681Q5F9P YesY
ChEBICHEBI:32020 YesY
ChEMBLCHEMBL1201753 N
Chemical data
FormulaC25H24FNO4 
Mol. mass421.461
 N (what is this?)  (verify)
 
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Pitavastatin
Systematic (IUPAC) name
(3R,5S,6E)-7-[2-cyclopropyl-4-(4-fluorophenyl)quinolin-3-yl]-3,5-dihydroxyhept-6-enoic acid
Clinical data
Trade namesLivalo
AHFS/Drugs.commonograph
MedlinePlusa610018
Licence dataUS FDA:link
Pregnancy cat.X
Legal status Prescription only
RoutesOral
Pharmacokinetic data
Bioavailability60%
Protein binding96%
Metabolismminimally CYP4502C9
Half-life11 hours
ExcretionFaeces
Identifiers
CAS number147511-69-1 N
ATC codeC10AA08
PubChemCID 5282452
ChemSpider4445604 YesY
UNIIM5681Q5F9P YesY
ChEBICHEBI:32020 YesY
ChEMBLCHEMBL1201753 N
Chemical data
FormulaC25H24FNO4 
Mol. mass421.461
 N (what is this?)  (verify)

Pitavastatin (usually as a calcium salt) is a member of the medication class of statins,[1] marketed in the United States under the trade name Livalo. Like other statins, it is an inhibitor of HMG-CoA reductase, the enzyme that catalyses the first step of cholesterol synthesis. It has been available in Japan since 2003, and is being marketed under licence in South Korea and in India.[2] It is likely that pitavastatin will be approved for use in hypercholesterolaemia (elevated levels of cholesterol in the blood) and for the prevention of cardiovascular disease outside South and Southeast Asia as well.[3] In the US, it received FDA approval in 2009.[4]

Contents

Uses

Like the other statins, pitavastatin is indicated for hypercholesterolaemia (elevated cholesterol) and for the prevention of cardiovascular disease. A 2009 study showed that pitavastatin increased HDL cholesterol (24.6%), especially in patients with HDL lower than 40 mg/dl, in addition to greatly reducing LDL cholesterol (–31.3%).[5] As a consequence, pitavastatin is most likely to be appropriate for patients with metabolic syndrome with high LDL, low HDL and diabetes mellitus.

Side-effects

Common statin-related side-effects (headaches, stomach upset, abnormal liver function tests and muscle cramps) were similar to other statins. However, pitavastatin seems to lead to fewer muscle side effects than other statins, since coenzyme Q10 is not significantly reduced.[3][clarification needed]

Metabolism and interactions

Most statins are metabolised in part by one or more hepatic cytochrome P450 enzymes, leading to an increased potential for drug interactions and problems with certain foods (such as grapefruit juice). Pitavastatin appears to be a substrate of CYP2C9, and not CYP3A4 (which is a common source of interactions in other statins). As a result, pitavastatin is less likely to interact with drugs that are metabolized via CYP3A4, which might be important for elderly patients who need to take multiple medicines.[3]

History

Pitavastatin (previously known as itavastatin, itabavastin, nisvastatin, NK-104 or NKS-104) was discovered in Japan by Nissan Chemical Industries and developed further by Kowa Pharmaceuticals, Tokyo.[3] Pitavastatin was approved for use in the United States by the FDA on 08/03/2009 under the trade name Livalo. Pitavastatin has been also approved by the Medicines and Healthcare products Regulatory Agency (MHRA) in UK on 17 August 2010.

References

  1. ^ Kajinami, K; Takekoshi, N; Saito, Y (2003). "Pitavastatin: efficacy and safety profiles of a novel synthetic HMG-CoA reductase inhibitor". Cardiovascular drug reviews 21 (3): 199–215. PMID 12931254. edit
  2. ^ Zydus Cadila launches pitavastatin in India
  3. ^ a b c d Mukhtar, R. Y. A.; Reid, J.; Reckless, J. P. D. (2005). "Pitavastatin". International Journal of Clinical Practice 59 (2): 239–252. doi:10.1111/j.1742-1241.2005.00461.x. PMID 15854203. edit
  4. ^ The Seventh Statin; Pitavastatin
  5. ^ http://www.ncbi.nlm.nih.gov/pubmed/19907105

External links