Lipid and Lipoprotein Disorders

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Selecting a Treatment Regimen Table 7B. FDA Approved Lipid Modulating Combination Tablets Drug Class, Agents and Daily Doses Extended-release niacin/ lovastatina ▶ Advicor® 500/20 to 2000/80 mg/day Extended-release niacin/ simvastatinc, d, e ▶ Simcor® 500/20 to 2000/40 mg/day Ezetimibe/simvastatinf ▶ Vytorin® 10/10 to 10/80 mg/day Fenofibric acid + low or moderate dose statin Lipid/Lipoprotein Effects (varies with dosage used) LDL-C 34-47% HDL-C 24-33% TG 35-48% ApoB (LDL-P) ≤ 40%b LDL-C 34-56% HDL-C 15-29% TG 22-38% ApoB (LDL-P) ≤ 50% LDL-C 45-60% HDL-C 6-10% TG 23-31% ApoB (LDL-P) ≤ 50%g LDL-C 33-37% (LDL-C drop entirely due to statin) HDL-C 16-17% TG > 40% LDL-P 39% (No additional reduction in LDL-P beyond statin therapy) HDL-P 15-16% VLDL-P 54% EPA/DHA EE + statin LDL-C 3% HDL-C 1% TG 30% LDL-P 43% (No additional reduction in LDL-P beyond statin therapy) HDL-P No change VLDL-P 9% a b c d Bays HE, Dujovne CA, McGovern ME, et al. Comparison of once-daily, niacin extended- release/lovastatin with standard doses of atorvastatin and simvastatin (The Advicor Versus Other Cholesterol-Modulating Agents Trial Evaluation [ADVOCATE]). Am J Cardiol. 2003;91:667-672. Simcor® Advicor® Prescribing Information, Abbott Laboratories, North Chicago, IL. Ballantyne CM, Davidson MH, McKenney J, et al. Comparison of the safety and efficacy of a combination tablet of niacin extended release and simvastatin vs simvastatin monotherapy in patients with increased non-HDL cholesterol (from the SEACOAST I study). Am J Cardiol. 2008;101(10):1428-1436. Prescribing Information, Abbott Laboratories, North Chicago, IL. 16 Side Effects ▶ Myopathy ▶ Flushing ▶ Hyperglycemia & hyperuricemia ▶ Hepatotoxicity ▶ Myopathy ▶ Flushing ▶ Hyperglycemia & hyperuricemia ▶ Liver enzyme elevations ▶ Myopathy ▶ Liver enzyme elevations

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