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Tonvasca is an oral fixed-dose combination of the HMG-CoA reductase inhibitor (statin) pitavastatin and the cholesterol absorption inhibitor ezetimibe. Developed by Orient Pharma, Tonvasca is approved for the treatment of primary hypercholesterolemia and mixed dyslipidemia. Pitavastatin works by competitively inhibiting HMG-CoA reductase, the rate-limiting enzyme in hepatic cholesterol synthesis, which leads to an increase in LDL receptor expression and enhanced clearance of LDL-C from the blood. Ezetimibe targets the Niemann-Pick C1-Like 1 (NPC1L1) sterol transporter in the small intestine, selectively inhibiting the absorption of biliary and dietary cholesterol. Together, these complementary mechanisms of action provide a synergistic reduction in LDL-C levels with a favorable metabolic safety profile.
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