100
Complications of Management
Table 26. Safety Considerations for Triglyceride-Lowering
Medications
Medication Class Common Side Effects Contraindications*
Fibrates
(fenofibrate,
fenofibric acid,
gemfibrozil)
Myalgia; persistently
elevated hepatic
transaminases
Severe renal dysfunction; active liver
disease; gallbladder disease; during
lactation; history of hypersensitivity
to the fibrate product
Omega-3 fatty
acids (icosapent
ethyl, omega-3-acid
ethyl esters)
Eructation, dyspepsia, and
taste perversion
History of hypersensitivity to the
omega-3 fatty acid product
Niacin Facial flushing,
gastrointestinal symptoms
(diarrhea, nausea, vomiting )
are common; persistent
hepatic transaminase and
glucose elevations
Active liver disease (including
unexplained persistent elevated
hepatic transaminases), active
peptic ulcer disease, arterial
bleeding, known hypersensitivity
to product components
ApoC-III
inhibitor: ASO-
directed therapy
(olezarsen)
Injection site reactions Prior serious hypersensitivity to
olezarsen or any of the excipients
* Contraindications from FDA-approved labeling
(available at: http://dailymed.nlm.nih.gov/dailymed/index.cfm).
ApoC-III indicates apolipoprotein C-III; ASO, antisense oligonucleotide; DHA,
docosahexanoic acid; FCS, familial chylomicronemia syndrome; and NSAID, nonsteroidal
anti-inflammatory drug.
