Combination drug therapy for combined hyperlipidemia.
Combination therapy for hyperlipidemia, especially combined hyperlipidemia, may have advantages over single drug therapy, affording better improvement in lipoprotein risk factors and possibly better prevention of atherothrombotic events. Although preliminary experience has been gained using treatment combinations of niacin with statins, and fibrates with statins, few studies have focused on angiographic or clinical outcomes. Both of these treatment combinations increase the risk of drug-induced myopathy and rhabdomyolysis. Current estimates of myopathy incidence are much lower than original estimates, but the relative safety of combined therapy might depend upon employing low or moderate statin doses. Safety depends critically upon educating the patient to respond appropriately to muscle symptoms, to intercurrent illness, and to concurrent use of certain other medications. Other useful drug combinations include those derived by addition of fish oil, bile acid binding resins, or stanol esters, as well as nonstatin combinations such as niacin-resin or fibrate-niacin.
Guyton
J R
JR
Department of Medicine, Box 3510, Duke University Medical Center, Durham, NC 27710, USA.
D001161:Arteriosclerosis / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005395:Fish Oils / Q000627:therapeutic use; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D009135:Muscular Diseases / Q000139:chemically induced; D009525:Niacin / Q000009:adverse effects / Q000627:therapeutic use; D012206:Rhabdomyolysis / Q000139:chemically induced; D012307:Risk Factors
D005395:Fish Oils; D000960:Hypolipidemic Agents; D009525:Niacin