Treatment Regimen
Table 5A. Drugs Affecting Lipid Metabolism Drug Class, Agents and Daily Doses Lipid/Lipoprotein Effects Side Effects
HMG CoA reductase inhibitors Atorvastatin (10-80 mg) Lipitor® Fluvastatin (20-80 mg) Lescol ® Lovastatin (20-80 mg) Mevacor®
Pitavastatin (1-4 mg) Livalo ® Pravastatin (20-40 mg) Pravachol ®
Rosuvastatin (5-40 mg) Crestor ® Simvastatin (20-80 mg) Zocor ®
, Generics , Generics
, Generics
Bile acid sequestrants Cholestyramine (4-16 g) Questran ®
, Generics
Colestipol (5-20 g) Colestid ® Colesevelam (2.6-3.8 g) Welchol ®
, Generics
Nicotinic acid Immediate release (crystalline) nicotinic acid (1.5-3 g) Niacor ®
, Nicolar ®
Extended release nicotinic acid (1-2 g) Niaspan ® Sustained release nicotinic acid (1-2 g) Slo-Niacin ®
Fibric acids Gemfibrozil (600 mg bid) Lopid ®
, Lipofen ® , Lofibra ® , Generics
Fenofibrate (various doses) Antara ® Lipanthyl ® Triglide ®
Clofibrate (1000 mg bid) Generics Fenofibric acid (135 mg) Trilipix ®
Cholesterol absorption blocker Ezetimibe, Zetia ®
Omega-3, Lovaza ® (4 g)
, Generics ,
, Tricor ® ,
LDL-C 15-30% LDL particle number 15-30% HDL-C 3-5% TG No change or increase
LDL-C 5-25% LDL particle number 10-25% HDL-C 15-35% TG 20-50%
GI distress Constipation Decreased absorption of other drugs
Flushing Hyperglycemia Hyperuricemia (or gout) Upper GI distress Hepatotoxicity
LDL-C 5-20% (may be increased in patients with high TG) LDL particle number 5-20% HDL-C 10-20% TG 20-50%
LDL-C 15-20% LDL particle number 15-25% HDL-C 1-2% TG 10%
LDL-C neutral or increase LDL Particle Number 0-5% HDL-C neutral to +10% TG > 40%
Dyspepsia Gallstones Myopathy Unexplained non-CHD deaths in WHO study
Myalgia, rare LFT increase
Fishy taste Increased bleeding time
LDL-C 18-55% LDL particle number 18-55% HDL-C 5-15% TG 7-30%
Myopathy Increased liver enzymes
