title: Effect of a combination of gemfibrozil and niacin on lipid levels.
abstract: To determine the effect of the combination of niacin and gemfibrozil on the lipid profile, a retrospective review was conducted of 161 patients who were prescribed a combination of gemfibrozil and niacin for 6 to 12 months at a community-based lipid clinic. Low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol, total cholesterol, triglycerides, ratio of total cholesterol to HDL, alanine aminotransferase (ALT), and weight were measured at entry to the clinic, 2 months after dietary instruction, during single-agent therapy, and during combination therapy. Mean doses of niacin and gemfibrozil were 1,229 mg/day and 1,200 mg/day, respectively. Patient weight decreased significantly after dietary instruction and after institution of combination therapy. There were no significant changes in ALT levels with either single-agent therapy or with combination therapy. The combination of niacin and gemfibrozil produced marked and significant changes in lipid levels: total cholesterol and LDL decreased by 14%, HDL increased by 24%, the ratio of total cholesterol to HDL decreased by 30%, and triglycerides decreased by 52%. The combination of niacin and gemfibrozil in the setting of dietary instruction has a marked beneficial effect on serum lipid levels, and was most effective in patients with initial levels of HDL < 40 mg/dL, triglycerides > 250 mg/dL, and LDL > 160 mg/dL. No episodes of ALT elevation or symptomatic myositis were seen.
authors.affiliation: Department of General Internal Medicine, Wilford Hall Medical Center, Lackland AFB, Texas 78236-5300, USA.
authors.forename: G A
authors.initials: GA
authors.lastname: Spencer
authors.forename: S
authors.initials: S
authors.lastname: Wirebaugh
authors.forename: E J
authors.initials: EJ
authors.lastname: Whitney
mesh_terms: D004035:Diet Therapy; D004359:Drug Therapy, Combination; D005260:Female; D015248:Gemfibrozil / Q000008:administration & dosage*; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000188:drug therapy / Q000628:therapy*; D000960:Hypolipidemic Agents / Q000008:administration & dosage*; D008055:Lipids / Q000097:blood*; D008297:Male; D009525:Niacin / Q000008:administration & dosage*; D012189:Retrospective Studies
chemical_list: D000960:Hypolipidemic Agents; D008055:Lipids; D009525:Niacin; D015248:Gemfibrozil