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Lipid Management in Endocrine Disorders

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Other Conditions 18 Table 5. Medications for Additional LDL-C Reduction in Patients Taking Statins (maximal tolerated doses) Medication Mechanism of action Dose for LDL-C reduction Ezetimibe Binds to Nieman Pick N1L1 receptor and prevents absorption of cholesterol from GI tract 10 mg daily Alirocumab* Prevents degradation of LDL receptor by inhibiting PCSK9 75 mg Q 2 wks or 300 mg Q 4 wks Evolocumab* Prevents degradation of LDL receptor by inhibiting PCSK9 140 mg every 2 wks SC or 420 mg SC once monthly Cholestyramine Bile acid sequestrant 8–16 g daily in divided doses, once or twice a day starting with 4 g Colesevelam Bile acid sequestrant 1250–1875 mg PO BID Bempedoic acid ATP citrate lyase inhibitor, inhibitor of cholesterol synthesis 180 mg PO daily * Alirocumab and evolocumab are indicated to reduce the risk of ASCVD events in patients with established CVD. ey are also indicated as adjunct to diet alone, or in combination with other lipid lowering therapies to reduce LDL-C in patients with primary hyperlipidemia (e.g., heterozygous FH). Evolocumab is also approved alone in combination with other lipid lowering therapies in patients with homozygous FH who require additional lowering of LDL-C. e other medications in this table are not indicated to reduce ASCVD events.

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