Effect of tablet splitting on serum cholesterol concentrations.
OBJECTIVE
To evaluate the effects of tablet splitting on low-density lipoprotein (LDL) cholesterol and total cholesterol values in patients taking simvastatin and atorvastatin.


METHODS
A retrospective chart review of total cholesterol and LDL cholesterol values of patients instructed to split simvastatin or atorvastatin between January 1999 and November 2000.


METHODS
Veterans Affairs Medical Center in Huntington, WV.


METHODS
Patients were included if they were taking simvastatin or atorvastatin with regular lipid management and follow-up laboratory results. Patients were required to remain on the same milligram-per-day dose at least 6-8 weeks before and after tablet-splitting initiation and have cholesterol values drawn at least 6 weeks after initiation of both whole-tablet and half-tablet dosing. Patients were excluded if they had a triglyceride level > 400 mg/dL or were noncompliant on the basis of pharmacy records and provider notes. MEASUREMENT OUTCOMES: The primary end points were changes in total cholesterol and LDL cholesterol values before and after the patient was switched to half-tablet therapy.


RESULTS
The overall results for this review demonstrated no statistically significant increase in total cholesterol and LDL cholesterol concentrations. Total cholesterol and LDL cholesterol values actually decreased from presplitting to postsplitting, p = 0.017 and p = 0.003, respectively.


CONCLUSIONS
The investigation showed that half-tablet dosing was as effective as whole-tablet dosing. The program will be continued as a part of quality patient care at the Huntington Veterans Affairs Medical Center.
Duncan
Megan C
MC
Veterans Affairs Medical Center, Huntington, WV, USA.
Castle
Sharon S
SS
Streetman
Daniel S
DS
D000069059:Atorvastatin; D002784:Cholesterol / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D018592:Cross-Over Studies; D016527:Drug Costs; D005260:Female; D006538:Heptanoic Acids / Q000008:administration & dosage* / Q000191:economics / Q000494:pharmacology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011758:Pyrroles / Q000008:administration & dosage* / Q000191:economics / Q000494:pharmacology; D012189:Retrospective Studies; D019821:Simvastatin / Q000008:administration & dosage* / Q000191:economics / Q000494:pharmacology; D013607:Tablets; D014903:West Virginia
D008078:Cholesterol, LDL; D006538:Heptanoic Acids; D011758:Pyrroles; D013607:Tablets; D002784:Cholesterol; D000069059:Atorvastatin; D019821:Simvastatin