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Thu, 21 Sep 1995 16:30:07 -0500 |
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Re the question on lovastatin(Mevacor). Mevacor lowers cholesterol
synthesis by inhibiting a special enzyme(HMG CoA reductase for the budding
pharmacologists) in the liver that blocks cholesterol synthesis. Therapy
of hyperlipoproteinemia is a life-long process, and I can see no good
justification for using this product in a lactating woman just to cover a
few months or even a year of elevated plasma cholesterol, unless her
cholesterol was incredibly high > 400. Mevacor is an unusual product that
is largely sequestered in the liver by first-pass removal and in general
less than 5% of the ingested product ever reaches the general circulation.
Although it has not been reported, I would expect that the milk levels in
humans would be minimal. It is detected in the milk of rats. Nevertheless,
the oral bioavailability in humans is extremely poor, with most of the drug
remaining in the gut. From this I would assume that the oral
bioavailability in the infant would likewise be minimal. If the mom's
cholesterol is not that high, don't use it, it's not even worth the risk.
TWHale
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