What are the current doses of statins (HMG-CoA reductase inhibitors) available in the market?

Current Statin Doses Available in the Market

The currently available statins and their dose ranges are: atorvastatin 10-80 mg, lovastatin 10-80 mg, pravastatin 10-80 mg, simvastatin 10-80 mg, fluvastatin 40-80 mg, and rosuvastatin 5-40 mg daily. 1, 2

Specific Dose Ranges by Statin

Rosuvastatin

• Available doses: 5 mg, 10 mg, 20 mg, and 40 mg tablets 2
• The 5-40 mg range provides LDL-C reductions from 39% (at 5 mg) to 55% (at 40 mg) 3
• High-intensity therapy is defined as 20-40 mg daily, achieving ≥50% LDL-C reduction 4, 5

Atorvastatin

• Available doses: 10 mg, 20 mg, 40 mg, and 80 mg 1
• High-intensity therapy consists of 40-80 mg daily, lowering LDL-C by 50-63% 5
• The 10 mg dose achieves approximately 39% LDL-C reduction 1

Simvastatin

• Available doses: 10 mg, 20 mg, 40 mg, and 80 mg 1
• Standard doses of 20-40 mg achieve 35-41% LDL-C reduction 1
• The 80 mg dose should not be used due to increased myopathy risk 5

Lovastatin

• Available doses up to 80 mg 1
• Standard dose of 40 mg achieves approximately 31% LDL-C reduction 1

Pravastatin

• Available doses up to 80 mg 1
• Standard dose of 40 mg achieves approximately 34% LDL-C reduction 1

Fluvastatin

• Available doses: 40 mg and 80 mg 1
• This dose range achieves 25-35% LDL-C reduction 1

Dose-Response Relationship

• For every doubling of statin dose above the standard dose, an approximate 6% additional decrease in LDL-C can be obtained 1
• This relationship applies to atorvastatin, lovastatin, pravastatin, and simvastatin when escalating beyond their standard doses 1

Relative Potency Considerations

• Rosuvastatin is the most potent statin per milligram: rosuvastatin 5 mg is approximately equivalent to atorvastatin 15 mg or simvastatin 39 mg for LDL-C reduction 3
• Each rosuvastatin dose is equivalent to doses 3-3.5 times higher for atorvastatin and 7-8 times higher for simvastatin 3
• Rosuvastatin 40 mg achieves LDL-C reductions not attainable with maximum doses (80 mg) of atorvastatin or simvastatin 3

Important Dosing Caveats

• Asian patients should initiate rosuvastatin at 5 mg once daily due to increased plasma concentrations, with careful consideration of risks and benefits when exceeding 20 mg daily 2
• Patients with severe renal impairment (CrCl <30 mL/min/1.73 m²) not on hemodialysis should start rosuvastatin at 5 mg once daily and not exceed 10 mg daily 2
• Multiple drug interactions require dose modifications, particularly with cyclosporine (rosuvastatin maximum 5 mg daily), gemfibrozil (avoid or maximum 10 mg daily), and various antiviral medications 2