The patient should be placed on a standard cholesterol-lowering diet before receiving ALTOCOR and should continue on this diet during treatment with ALTOCOR (see NCEP Treatment Guidelines for details on dietary therapy).
The usual recommended starting dose is 20, 40 or 60 mg once a day given in the evening at bedtime. The recommended dosing range is 10-60 mg/day, in single doses. Doses should be individualized according to the recommended goal of therapy (see NCEP Guidelines and CLINICAL PHARMACOLOGY). A starting dose of 10 mg may be considered for patients requiring smaller reductions. Adjustments should be made at intervals of 4 weeks or more. In patients taking cyclosporine concomitantly with ALTOCOR (see WARNINGS, Skeletal Muscle), therapy should begin with 10 mg of ALTOCOR and should not exceed 20 mg/day. Cholesterol levels should be monitored periodically and consideration should be given to reducing the dosage of ALTOCOR if cholesterol levels fall significantly below the targeted range. Concomitant Lipid-Lowering Therapy Use of ALTOCOR with fibrates or niacin should generally be avoided. However, if ALTOCOR is used in combination with fibrates or niacin, the dose of ALTOCOR should generally not exceed 20 mg (see WARNINGS, Skeletal Muscle and PRECAUTIONS, Drug Interactions). In patients with severe renal insufficiency (creatinine clearance <30 mL/min), dosage increases above 20 mg/day should be carefully considered and, if deemed necessary, implemented cautiously.