Alternate-day dosing of HMG-CoA reductase inhibitors for cholesterol reduction

OBJECTIVE: Assess efficacy, safety, and cost of alternate-day dosing with 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (HRIs). DATA: International Pharmaceutical Abstracts and MEDLINE (English-language clinical trials, 1966–April 2000) were searched. DATA SYNTHESIS: Established efficacy of HRIs is based on daily administration. Many patients who could benefit from these agents are unable to afford them; therefore, alternate-day dosing may be a solution for reducing expense without decreasing therapy benefits. Studies addressing alternate-day HRI therapy are evaluated to determine the usefulness of this option for cholesterol reduction. CONCLUSIONS: Although limited studies imply a trend toward benefit with alternate-day HRI therapy, large, controlled, randomized trials are needed before making this a standard recommendation.