Pharmacy and Therapeutics Committee-approved
Therapeutic Interchanges
Therapeutic Interchange
Alpha Blockers
ACE Inhibitors
Angiotensin Receptor Blockers
Buprenorphine
Calcium Channel Blockers (DHP)
Carbapenems
Cardioselective Beta Blockers
Cephalosporins
Corticosteroids, Inhaled
Corticosteroids, Intranasal
Fluoroquinolones
Glitazones
Histamine Receptor Antagonists (H2RAs)
Ipratropium Metered Dose Inhalers
IV to PO conversions
Leukotriene Receptor Antagonists
Levalbuterol
Long-acting Insulin Analogs
Miscellaneous Antidepressants
Non-benzodiazepine Hypnotics
Non-sedating Antihistamines
Ophthalmic Preparations
Phosphate Binders
Proton Pump Inhbitors
Statins
Revision Date
08/11
08/11
08/11
09/11
08/11
07/11
08/11
09/11
01/13
08/11
01/13
08/11
08/11
01/14
07/11
08/11
12/13
04/13
08/11
08/11
08/11
08/11
01/13
08/11
08/11
All conversions unless noted otherwise are for adult patients with normal renal and/or hepatic
function. Please consult additional references when these clinical situations do not apply.
Marquette General Health System
Pharmacy and Therapeutics Committee-approved
Therapeutic Interchange: Alpha Blockers
Generic Name
Terazosin
Doxazosin
Brand Name
Hytrin®
Cardura®
Tamsulosin
Alfuzosin
Flomax®
UroXatral®
1
1
0.4
10
Dose Equivalents (mg/day)
2
5
10
2
4
8
0.8
10
N/A
N/A
N/A
N/A
20
16
N/A
N/A
*Formulary agents in bold.
Notes:
Prazosin is not included in this therapeutic interchange.
Doxazosin and terazosin are therapeutically equivalent for the treatment of hypertension and benign
prostatic hypertrophy (BPH).
Alfuzosin and tamsulosin are therapeutically equivalent for the treatment of BPH and are the preferred
agents in patients who are unable to tolerate the cardiovascular adverse effects from other alpha blockers.
Document created: 08/11.
Revised: None
Marquette General Health System
Pharmacy and Therapeutics Committee-approved
Therapeutic Interchange: ACE Inhibitors
Generic Name
Short-acting
Captopril
Brand Name
Dose Equivalents (mg/day)
Capoten®
75
150
300
450
Intermediate-acting
Benazepril
Enalapril
Moexipril
Quinapril
Ramipril
Lotensin®
Vasotec®
Univasc®
Accupril®
Altace®
5
5
7.5
5
2.5
10
10
15
10
5
20
20
22.5
20
10
40
40
30
40
20
Long-acting
Lisinopril
Fosinopril
Perindopril
Trandolapril
Prinivil®
Monopril®
Aceon®
Mavik®
5
5
4
1
10
10
8
2
20
20
12
4
40
40
16
8
*Formulary agents in bold.
Notes:
Captopril is short-acting and should be dosed 2-3 times daily.
Enalapril and benazepril are intermediate-acting and should be dosed 1-2 times daily. Enalapril is the
preferred intermediate-acting ACE inhibitor. Benazepril is available for continuation of outpatient therapy.
Lisinopril is long-acting and should be dosed once daily.
Document created: 12/03.
Revised: 08/11.
Marquette General Health System
Pharmacy and Therapeutics Committee-approved
Therapeutic Interchange: Angiotensin Receptor Blockers
Generic Name
Losartan
Candesartan
Eprosartan
Irbesartan
Olmesartan
Telmisartan
Valsartan
Brand Name
Cozaar®
Atacand®
Teveten®
Avapro®
Benicar®
Micardis®
Diovan®
Dose Equivalents (mg/day)
25
50
100
4
8
16
200
400
600
75
150
300
5
10
20
20
40
80
40
80
160
*Formulary agent in bold.
Document created: 08/11.
Revised: None
100
32
800
300
40
80
320
Marquette General Health System
Pharmacy and Therapeutics Committee-approved
Therapeutic Interchange: Buprenorphine Sublingual
Generic Name
Buprenorphine
Buprenorphine/naloxone
Brand Name
Subutex®
Suboxone®
Dose Equivalents (mg/day)
8
16
24
8/2
16/4
24/6
*Formulary agent in bold.
Notes:
Suboxone® strength expressed as buprenorphine/naloxone which are available as 2 mg/0.5 mg and 8 mg/2
mg sublingual tablets and film.
Document created: 09/11.
Revised: None
Marquette General Health System
Pharmacy and Therapeutics Committee-approved
Therapeutic Interchange: Calcium Channel Blockers (Dihydropyridines)
Generic Name
Amlodipine
Nifedipine, extended release
Felodipine, extended release
Isradipine, immediate release
Isradipine, controlled release
Nicardipine, immediate release
Nicardipine, controlled release
Nisoldipine, extended release
Brand Name
Norvasc®
Procardia XL®
Plendil®
DynaCirc®
DynaCirc CR®
Cardene®
Cardene CR®
Sular®
Dose Equivalents (mg/day)
2.5
5
10
30
60
90
2.5
5
10
5
10
20
5
10
20
60
90
120
60
90
120
17
25.5
34
*Formulary agents in bold.
Notes:
Nimodipine (Nimotop®) is not subject to therapeutic interchange.
Amlodipine is the preferred dihydropyridine CCB. Nifedipine, extended release is available for continuation
of outpatient therapy.
Document created: 08/11.
Revised: None
Marquette General Health System
Pharmacy and Therapeutics Committee-approved
Therapeutic Interchange: Carbapenems
Generic Name
Meropenem
Doripenem
Imipenem/cilastatin
Brand Name
Merrem®
Doribax®
Primaxin®
Dose Equivalents (mg/day)
2000
1500
2000
3000
3000
3000
*Formulary agents in bold.
Notes:
The preferred dosing for the treatment of infections caused by multi-resistant gram negative bacilli or
empiric therapy is meropenem 500 mg every 6 hours. Please refer to the Carbapenem Guidelines for Use
for further details.
Document created: 07/11.
Revised: None
Marquette General Health System
Pharmacy and Therapeutics Committee-approved
Therapeutic Interchange: Cardioselective Beta Blockers
Generic Name
Atenolol
Metoprolol
Betaxolol
Bisoprolol
Nebivolol
Brand Name
Tenormin®
Toprol®
Kerlone®
Zebeta®
Bystolic®
Dose Equivalents (mg/day)
25
50
100
50
100
200
10
20
N/A
5
10
20
5
10
20
N/A
400
N/A
N/A
40
*Formulary agents in bold.
Notes:
Metoprolol is the preferred cardioselective beta blocker. Atenolol is available for continuation of outpatient
therapy.
Document created: 08/11.
Revised: None
Marquette General Health System
Pharmacy and Therapeutics Committee-approved
Therapeutic Interchange: Cephalosporins
Generic Name
Ceftriaxone
Cefotaxime
Brand Name
Rocephin®
Claforan®
Dose Equivalents (mg/day)
1000
2000
3000
3000
6000
9000
4000
12000
*Formulary agent in bold.
Notes:
Ceftriaxone is the preferred third generation cephalosporin in adult patients. Cefotaxime is available for use
in neonates and for orders written by Infectious Diseases faculty.
Usual adult dosing for ceftriaxone is 1-2 gm every 12-24 hours (max: 4 gm/day), usual adult dosing for
cefotaxime is 1-2 gm every 6-8 hours (max: 12 gm/day).
Document created: 09/11.
Revised: None
Marquette General Health System
Pharmacy and Therapeutics Committee-approved
Therapeutic Interchange: Corticosteroids, Inhaled
Generic Name
Beclomethasone
dipropionate
Budesonide
Ciclesonide
Flunisolide
Fluticasone
Fluticasone
Fluticasone
Fluticasone
Fluticasone
Fluticasone
Mometasone
Triamcinolone
Brand Name
Dose Equivalents (puffs per day)
QVAR® 80 mcg
Pulmicort® 180 mcg
Alesco® 80 mcg
AeroBID® 250 mcg
Flovent® HFA 44 mcg
Flovent® HFA 110 mcg
Flovent® HFA 220 mcg
Flovent® Diskus 50 mcg
Flovent® Diskus 100 mcg
Flovent® Diskus 250 mcg
Asmanex® 220 mcg
Azmacort® 100 mcg
1
1
1 to 3
1
N/A
1 to 3
1
N/A
N/A
2
4
6
2 to 3
4 to 5
6
Comparative data not available.
No longer available.
4 to 6
7 to 8
9 to 10
2
3
4
1
N/A
2
4 to 6
7 to 8
9 to 10
2 to 3
4
5
1
N/A
2
1
2
3
No longer available.
8
7+
11+
5+
3+
11+
6+
3+
4+
*Formulary agent in bold.
Generic Name
Budesonide/formoterol
Budesonide/formoterol
Mometasone/formoterol
Mometasone/formoterol
Fluticasone/salmeterol
Fluticasone/salmeterol
Fluticasone/salmeterol
Fluticasone/salmeterol
Fluticasone/salmeterol
Fluticasone/salmeterol
Brand Name
Symbicort® 80/4.5
Symbicort® 160/4.5
Dulera® 100/5
Dulera® 200/5
Advair® HFA 45/21
Advair® HFA 115/21
Advair® HFA 230/21
Advair® Diskus 100/50
Advair® Diskus 250/50
Advair® Diskus 500/50
Dose Equivalents (puffs per day)
2 puffs twice daily
N/A
N/A
2 puffs twice daily
2 puffs twice daily
N/A
N/A
2 puffs twice daily
2 puffs twice daily
N/A
N/A
2 puffs twice daily
N/A
2 puffs twice daily
1 inhalation twice daily
N/A
N/A
1 inhalation twice daily
N/A
1 inhalation twice daily
*Formulary agent in bold.
Notes:
Flovent® and Advair® Diskus are the preferred delivery devices unless specified HFA.
The following Flovent® HFA will be maintained in inventory: 220 mcg.
The following Flovent® Diskus will be maintained in inventory: 50 mcg, 100 mcg, 250 mcg.
The following Advair® HFA will be maintained in inventory: 230 mcg.
The following Advair® Diskus will be maintained in inventory: 100 mcg, 250 mcg, 500 mcg.
Document created: 01/08.
Revised: 01/13.
Marquette General Health System
Pharmacy and Therapeutics Committee-approved
Therapeutic Interchange: Corticosteroids, Intranasal
Generic Name
Fluticasone propionate
Beclomethasone
Budesonide
Ciclesonide
Flunisolide
Fluticasone furoate
Mometasone
Triamcinolone
Brand Name
Flonase®
Beconase AQ®
Rhinocort Aqua®
Omnaris®
Nasarel®
Veramyst®
Nasonex®
Nasacort AQ®
Dose Equivalents
2 sprays in each nostril daily
1 to 2 sprays in each nostril twice daily
1 spray in each nostril daily
2 sprays in each nostril daily
2 sprays in each nostril 2 to 3 times daily
2 sprays in each nostril daily
2 sprays in each nostril daily
1 to 2 sprays in each nostril daily
*Formulary agent in bold.
Document created: 01/08.
Revised: 08/11.
Marquette General Health System
Pharmacy and Therapeutics Committee-approved
Therapeutic Interchange: Fluoroquinolones
Generic Name
Brand Name
Ciprofloxacin
Moxifloxacin
Cipro®
Avelox®
Levofloxacin
Ofloxacin
Norfloxacin
Gemifloxacin
Levaquin®
Floxin®
Noroxin®
Factive®
Dose Equivalents (mg/day)
Intravenous
Oral
Mild to moderate infections: 200 Mild to moderate infections: 250
to 400 mg every 12 hours
to 500 mg every 12 hours
Severe infections: 400 mg every
8 to 12 hours
400 mg every 24 hours
Mild to moderate infections: 250
to 500 mg every 24 hours
Severe infections: 500 to 750 mg
every 8 to 12 hours
400 mg every 24 hours
Mild to moderate infections: 250
to 500 mg every 24 hours
Severe infections: 500 to 750 mg
every 24 hours
N/A
N/A
N/A
Severe infections: 500 to 750 mg
every 24 hours
200 to 400 mg every 12 hours
400 mg every 12 hours
320 mg every 24 hours
*Formulary agents in bold.
Note:
Moxifloxacin should not be used for genitourinary infections and gram-negative bacteremias.
Document created: 05/06.
Revised: 01/13.
Marquette General Health System
Pharmacy and Therapeutics Committee-approved
Therapeutic Interchange: Thiazolidinediones (Glitazones)
Generic Name
Pioglitazone
Rosiglitazone
Brand Name
Actos®
Avandia®
Dose Equivalents (mg/day)
15
30
2
4
*Formulary agent in bold.
Document created: 06/07.
Revised: 08/11.
45
8
Marquette General Health System
Pharmacy and Therapeutics Committee-approved
Therapeutic Interchange: Histamine Receptor Blockers
Generic Name
Famotidine, oral
Cimetidine
Nizatidine
Ranitidine
Brand Name
Pepcid®
Tagamet®
Axid®
Zantac®
Famotidine, injection
Cimetidine
Ranitidine
Pepcid IV®
Tagamet IV®
Zantac IV®
Dose Equivalents (mg/day)
20
N/A
150
150
20
N/A
50 to 100
40
600 to 1200
300
300
40
900 to 1200
150 to 200
*Formulary agent in bold.
By declaration of the P&T Committee, the H2RAs are subject to automatic IV to PO interchange.
Please refer to the Intravenous to Oral Medication Conversion Program for further details.
Document created: 02/08.
Revised: 08/11.
Marquette General Health System
Pharmacy and Therapeutics Committee-approved
Therapeutic Interchange: Ipratropium Metered Dose Inhalers
Generic Name
Albuterol MDI
Albuterol nebulization solution
Ipratropium nebulization solution
Ipratropium/albuterol nebulization solution
Tiotropium inhalation
Ipratropium/albuterol MDI
Ipratropium MDI
Brand Name
Proventil®
Proventil®
Atrovent®
DuoNeb®
Spiriva®
Combivent®
Atrovent®
Dose Equivalents
1-2 inhalations every 4-6 hours
1 vial three to four times per day
1 vial three to four times per day
1 vial four times per day
1 capsule once daily
2 inhalations four to six times per day
2 inhalations four to six times per day
*Formulary agents in bold.
Notes:
Combivent® Respimat inhalers are not available for inpatient use at MGH. Non-ventilated patients may
be switched to tiotropium inhalation with or without an albuterol MDI (albuterol must be ordered
separately). Ventilated patients may be switched to ipratropium/albuterol (DuoNeb®) nebulization
Atrovent® metered dose inhalers (MDIs) are no longer available for inpatient use at MGH. Non-ventilated
patients may be switched to tiotropium inhalation. Ventilated patients may be switched to ipratropium
(Atrovent®) nebulization solution.
Combivent® Respimat inhaler contains ipratropium 20 mcg and albuterol 100 mcg in each inhalation (120
inhalations per cartridge).
DuoNeb® contains ipratropium 0.5 mg and albuterol 3 mg in each 3 mL unit-dose vial.
Spiriva® HandiHaler is to be used for administration of tiotropium which is dosed at 2 inhalations of a
single 18 mcg capsule once daily.
Document created: 08/11.
Revised: 01/14.
Marquette General Health System
Pharmacy and Therapeutics Committee-approved
Therapeutic Interchange: Intravenous to Oral
Generic Name
Azithromycin
Cefazolin
Ciprofloxacin
Famotidine
Fluconazole
Levofloxacin
Levothyroxine
Linezolid
Metronidazole
Moxifloxacin
Ondansetron
Pantoprazole
Rifampin
Valproic acid
Voriconazole
IV Dosage
500 mg every 24 hours
1 gm every 8 hours
400 mg every 12 hours
20 mg every 12 hours
400 mg every 24 hours
500 mg every 24 hours
50 mcg every 24 hours
600 mg every 12 hours
500 mg every 6 hours
400 mg every 24 hours
4-8 mg
40 mg every 24 hours
300 mg every 12 hours
500 mg every 6 hours
LD: 6 mg/kg every 12 hours x2;
MD: 4 mg/kg every 12 hours
Oral Dosage
500 mg every 24 hours
Cephalexin 500 mg every 6 hours
500-750 mg every 12 hours
20 mg every 12 hours
400 mg every 24 hours
500 mg every 24 hours
100 mcg every 24 hours
600 mg every 12 hours
500 mg every 6 hours
400 mg every 24 hours
8-16 mg
Omeprazole 20 mg every 24 hours
300 mg every 12 hours
500 mg every 6 hours
Pt wt ≥40 kg: 200 mg every 12 hours
Pt wt ≤40 kg: 100 mg every 12 hours
Notes:
Dosage for PO conversion of ciprofloxacin depends upon severity of infection.
Recommendation for valproic acid conversion based on using immediate-release formulation of solution or
capsules.
Situations where IV to PO conversion is appropriate:
q Patient is receiving/tolerating other oral medications;
q Patient is receiving regular diet and has not been designated ‘Nothing Per Os’ (NPO);
q Patient’s enteral route is functional [i.e., receiving enteral feedings without residuals or has evidence that
gastrointestinal (GI) tract is functional (i.e., no evidence of ileus or profuse diarrhea)];
q Patient does not have active GI bleeding;
q Patient has been afebrile for at least 24 hours (antibiotics only);
q Patient is not hypotensive (i.e., SBP < 90 mmHg) or on vasopressor support to maintain blood pressure;
q Patient does not have mucositis (for patients undergoing chemotherapy and who do not have a nasogastric
tube).
Document created: 07/11.
Revised: 12/12.
Marquette General Health System
Pharmacy and Therapeutics Committee-approved
Therapeutic Interchange: Leukotriene Receptor Antagonists
Generic Name
Montelukast
Zafirlukast
Brand Name
Singulair®
Accolate®
Dose Equivalents (mg/day)
*Formulary agent in bold.
Document created: 06/07.
Revised: 08/11.
10
40
Marquette General Health System
Pharmacy and Therapeutics Committee-approved
Therapeutic Interchange: Levalbuterol
Generic Name
Albuterol nebulization solution
Levalbuterol nebulization solution
Brand Name
Generic
Xopenex®
Dose Equivalents
2.5 mg every 4 hours
0.63 mg to 1.25 mg every 4-6 hours
*Formulary agent in bold.
Generic Name
Albuterol MDI
Levalbuterol MDI
Brand Name
Dose Equivalents
Ventolin HFA® 1-2 inhalations every 4 hours
Xopenex HFA® 1-2 inhalations every 4-6 hours
*Formulary agent in bold.
Notes:
The automatic therapeutic interchange for levalbuterol is approved for inpatients 12 years of age and older
unless appropriate documentation is provided for levalbuterol use (see guidelines for use).
Levalbuterol orders with a PRN frequency will be interchanged with albuterol orders with a PRN frequency.
Albuterol nebulization solution contains albuterol 2.5 mg in each 3 mL unit-dose vial (0.083%).
Levalbuterol HFA contains 45 mcg per actuation
Albuterol HFA contains 90 mcg per actuation
Document created: 03/08.
Revised: 12/13.
Marquette General Health System
Pharmacy and Therapeutics Committee-approved
Therapeutic Interchange: Long Acting Insulin Analogs
Generic Name
Insulin glargine
Insulin detemir
Brand Name
Lantus®
Levemir®
Dose Equivalents
Initial dose of 0.2 units/kg (10 units) once daily
Initial dose of 0.2 units/kg (10 units) once daily
*Formulary agent in bold (detemir preferred).
Notes:
When changing therapy in patients receiving basal insulin with insulin detemir once-daily to insulin glargine, a
1:1 conversion is recommended. However, for patients receiving basal dosing two or more times per day, a
20% reduction in the total daily basal dose is recommended for conversion to the insulin glargine dose.
Document created: 02/08.
Revised: 04/13.
Marquette General Health System
Pharmacy and Therapeutics Committee-approved
Therapeutic Interchange: Miscellaneous Antidepressants
Generic Name
Citalopram
Escitalopram
Brand Name
Celexa®
Lexapro®
Venlafaxine, extended release
Desvenlafaxine
Effexor XR®
Pristiq®
Dose Equivalents (mg/day)
10
20
40
5
10
20
75
50
150
100
N/A
N/A
*Formulary agents in bold.
Notes:
Escitalopram is the S-enantiomer of the racemic citalopram.
Desvenlafaxine is the major active metabolite of venlafaxine.
In clinical studies, desvenlafaxine dosages of 50 to 400 mg/day were shown to be effective, although no
additional benefit was demonstrated at dosages of more than 50 mg/day. Adverse reactions and
discontinuations were more frequent at higher doses.
Document created: 08/11.
Revised: None
Marquette General Health System
Pharmacy and Therapeutics Committee-approved
Therapeutic Interchange: Non-benzodiazepine Hypnotics
Generic Name
Zolpidem
Eszopiclone
Zaleplon
Zolpidem, extended release
Brand Name
Ambien®
Lunesta®
Sonata®
Ambien CR®
Dose Equivalents (mg/day)
N/A
5
10
1
2
N/A
N/A
5
10
N/A
6.25
12.5
*Formulary agent in bold.
Document created: 11/05.
Revised: 08/11.
N/A
3
20
N/A
Marquette General Health System
Pharmacy and Therapeutics Committee-approved
Therapeutic Interchange: Non-sedating Antihistamines
Generic Name
Loratadine
Cetirizine
Desloratadine
Fexofenadine
Brand Name
Claritin®
Zyrtec®
Clarinex®
Allegra®
Dose Equivalents (mg/day)
5
10
10
2.5
5
10
N/A
5
5
60
120
180
*Formulary agent in bold.
Notes:
Patients receiving decongestant/antihistamine combination products (i.e., Allegra-D 12 and 24 hour, ClaritinD, and Zyrtec-D) will be converted to loratadine and pseudoephedrine individually.
Document created: 08/05.
Revised: 08/11.
Marquette General Health System
Pharmacy and Therapeutics Committee-approved
Therapeutic Interchange: Ophthalmic Preparations
Generic Name
Latanoprost
Bimatoprost
Travoprost
Brand Name
Xalatan®
Lumigan®
Travatan®
Dose Equivalents
1 drop into affected eye(s) once daily in the evening
1 drop into affected eye(s) once daily in the evening
1 drop into affected eye(s) once daily in the evening
Brand Name
Trusopt®
Azopt®
Dose Equivalents
1 drop into affected eye(s) three times daily
1 drop into affected eye(s) three times daily
Brand Name
Timoptic®
Betoptic-S®
Ocupress®
Betagan®
Optipranolol®
Dose Equivalents
1 drop into affected eye(s) twice daily
1 to 2 drops into affected eye(s) twice daily
1 drop into affected eye(s) twice daily
1 to 2 drops into affected eye(s) twice daily
1 drop into affected eye(s) twice daily
*Formulary agent in bold.
Generic Name
Dorzolamide
Brinzolamide
*Formulary agent in bold.
Generic Name
Timolol
Betaxolol
Carteolol
Levobunolol
Metipranolol
*Formulary agent in bold.
Notes:
Initial dose for timolol is 0.25%, 1 drop into affected eye(s). Timoptic® is usually dosed twice daily; TimopticXE® is usually dosed once daily. If clinical response is not adequate, the dosage may be changed to the 0.5%
solution.
Betaxolol is available in 0.25% and 0.5% solutions.
Carteolol is available in a 1% solution.
Levobunolol is available in 0.25% and 0.5% solutions.
Metipranolol is available in a 0.3% solution.
Document created: 08/11.
Revised: None
Marquette General Health System
Pharmacy and Therapeutics Committee-approved
Therapeutic Interchange: Phosphate Binders
Generic Name
Calcium acetate
Sevelamer hydrochloride
Sevelamer carbonate
Lanthanum
Brand Name
PhosLo®
Renagel®
Renvela®
Fosrenol®
Dose Equivalents (mg/meal)
667
1334
2001
800
1600
2400
800
1600
2400
250
500
750
*Formulary agents in bold.
Notes:
Calcium acetate is available in 667 mg tablets.
Document created: 05/06.
Revised: 01/13.
2668
3200
3200
1000
Marquette General Health System
Pharmacy and Therapeutics Committee-approved
Therapeutic Interchange: Proton Pump Inhibitors
Generic Name
Omeprazole, oral
Dexlansoprazole
Esomeprazole
Lansoprazole
Pantoprazole
Rabeprazole
Brand Name
Prilosec®
Kapidex®
Nexium®
Prevacid®
Protonix®
Aciphex®
Pantoprazole, injection
Esomeprazole
Protonix IV®
Nexium IV®
Dose Equivalents (mg/day)
20
40
30
60
20
40
15
30
20
40
20
20
40
40
80
80
*Formulary agents in bold.
By declaration of the P&T Committee, the Proton Pump Inhibitors are subject to automatic IV to PO
interchange. Please refer to the Intravenous to Oral Medication Conversion Program for further details.
Document created: 03/02.
Revised: 08/11.
Marquette General Health System
Pharmacy and Therapeutics Committee-approved
Therapeutic Interchange: HMG CoA Reductase Inhibitors (Statins)
Generic Name
Atorvastatin
Pravastatin
Rosuvastatin
Simvastatin
Fluvastatin
Lovastatin
Pitavastatin
Brand Name
Lipitor®
Pravacol®
Crestor®
Zocor®
Lescol®
Mevacor®
Livalo®
Dose Equivalents (mg/day)
10
20
40
40
80
N/A
5
10
20
20
40
80
80
N/A
N/A
40
80
N/A
2
4
N/A
80
N/A
40
N/A
N/A
N/A
N/A
*Formulary agents in bold.
Notes:
Due to the increased risk of myopathy, including rhabdomyolysis, use of simvastatin 80 mg daily should be
restricted to patients who have been taking simvastatin 80 mg per day chronically (i.e., 12 months or longer)
without evidence of muscle toxicity.
Simvastatin is the preferred therapeutic substitution for lovastatin.
Document created: 08/11.
Revised: None