The Current Status of Altoprev and Its Manufacturer
Altoprev, an extended-release form of the statin medication lovastatin, was manufactured and marketed by Covis Pharma US, Inc.. However, according to recent updates from Drugs.com and the DailyMed database, all formulations of the brand-name drug Altoprev have been discontinued. This means the extended-release version of lovastatin under the brand name Altoprev is no longer commercially available from its manufacturer. Generic, immediate-release versions of lovastatin still exist, but they are not bioequivalent and have different dosing schedules than the extended-release Altoprev.
The discontinuation of a brand-name drug can happen for many reasons, such as business decisions, the availability of more effective treatments, or safety concerns. In the case of Altoprev, the market for cholesterol-lowering medications is highly competitive, with many generic statins and other lipid-lowering agents available. The extended-release formulation of Altoprev was less popular and often not covered by insurance, which likely contributed to its decreased market viability. For patients who previously used Altoprev, a healthcare provider will need to prescribe an appropriate alternative.
A Shift in Ownership: The Journey of Altoprev
Before landing with Covis Pharma, the rights to Altoprev passed through several pharmaceutical companies. This kind of movement is common in the pharmaceutical industry, where products are bought and sold based on corporate strategy. The drug's history includes:
- Andrx Corporation: Originally, the product was developed and marketed by Andrx Corporation under the name Altocor.
- Name Change to Altoprev: In 2004, following litigation with another company regarding a trademark dispute, Andrx changed the name of its extended-release lovastatin product from Altocor to Altoprev.
- Acquisition by First Horizon: In 2005, First Horizon Pharmaceutical Corporation acquired the rights to Altoprev from Andrx Corporation.
- Acquisition by Covis Pharma: At a later date, the rights were transferred to Covis Pharma, the last known manufacturer of the product.
This history of acquisitions shows how a single medication can be produced and sold by different companies over its lifetime, which can sometimes lead to confusion about its origin and current status. For a product like Altoprev, which has been discontinued, knowing the final manufacturer is crucial for tracking its availability and official information, even if it's no longer sold.
Altoprev vs. Other Statin Medications
All statins, including lovastatin (the active ingredient in Altoprev), work by inhibiting HMG-CoA reductase, an enzyme in the liver that is a crucial step in cholesterol synthesis. However, different statins vary in potency, side effect profile, and pharmacokinetics. For patients who were previously taking Altoprev, a switch to an alternative statin is necessary. Potential substitutes and their characteristics are compared below.
| Feature | Altoprev (discontinued) | Immediate-Release Lovastatin | Atorvastatin (Lipitor) | Rosuvastatin (Crestor) |
|---|---|---|---|---|
| Manufacturer | Covis Pharma | Various generic companies | Pfizer | AstraZeneca |
| Formulation | Extended-release tablet | Immediate-release tablet | Immediate-release tablet | Immediate-release tablet |
| Generic Available? | No | Yes | Yes | Yes |
| Popularity | Less popular | Common | Very popular | Very popular |
| Dosing Schedule | Once daily, at bedtime | Once or twice daily, with meals | Once daily, any time of day | Once daily, any time of day |
| Potency | Moderate | Moderate | High | Very high |
Alternatives to Altoprev
Since Altoprev is no longer available, individuals who were prescribed this medication must consult their doctor for a suitable alternative. A healthcare provider will consider factors like the patient's cholesterol levels, co-existing conditions, and potential drug interactions before recommending a new treatment. The alternatives generally fall into the following categories:
- Other statins: These are the most common alternative and include other HMG-CoA reductase inhibitors. Examples include:
- Atorvastatin (Lipitor)
- Rosuvastatin (Crestor)
- Simvastatin (Zocor)
- Pravastatin (Pravachol)
- Fluvastatin (Lescol XL)
- Cholesterol Absorption Inhibitors: These drugs work by blocking the absorption of cholesterol in the intestines. Ezetimibe (Zetia) is a prominent example and is often used in combination with a statin. Ezetimibe/simvastatin (Vytorin) is also an option.
- PCSK9 Inhibitors: These are injectable medications, such as alirocumab (Praluent) and evolocumab (Repatha), that are typically reserved for patients with very high LDL levels or those who cannot tolerate statins.
- Other Lipid-Lowering Agents: Depending on the specific lipid abnormality, other drugs may be considered. These include fibrates (e.g., fenofibrate), niacin, or omega-3 fatty acid products.
The Role of Lovastatin in Pharmacology
The discovery of lovastatin, and statins in general, represents a major milestone in modern pharmacology and cardiovascular medicine. The first statin, mevastatin, was discovered in 1976 by Akira Endo, but it was Merck's discovery of lovastatin (originally mevinolin) in 1979 that led to the first FDA-approved statin drug, Mevacor, in 1987. Lovastatin's mechanism of action paved the way for the development of more potent statins and revolutionized the treatment of high cholesterol, significantly reducing the risk of heart attack and stroke. While Altoprev specifically is no longer available, the underlying pharmacology of its active ingredient, lovastatin, remains an important part of medical history and continues to be used in its generic and immediate-release forms.
Conclusion
Altoprev, the extended-release formulation of lovastatin, was manufactured by Covis Pharma US, Inc., but has since been discontinued. Its journey through the pharmaceutical world involved a name change and multiple company acquisitions before its eventual discontinuation. While the brand-name Altoprev is no longer available, the generic drug lovastatin (immediate-release) is still on the market. Patients previously on Altoprev have several alternative treatment options, including other statins like atorvastatin and rosuvastatin, as well as different classes of lipid-lowering medications. The decision on which alternative is best must be made in consultation with a healthcare professional to ensure safe and effective management of cholesterol levels.
For more detailed information on the history of statin discovery and their impact, read the article "A historical perspective on the discovery of statins" from the National Institutes of Health.
