Drug Comparisons Types of lipid disorders & recommended treatments

Type Of Lipid Disorders & Recommended Treatments

Saturday, 20 October 2007 01:18
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There are 3 main types of lipid disorders: one where serum cholesterol is too high (hypercholesterolemia), one where serum tryiglycerides are too high (hypertriglyceridemia), and a combination of the two where both types of lipids are too high (combined hyperlipidemia). Each type of hyperlipidemia (also called "dys"lepidemia) must be treated with a different class or combination of drugs.

The following drugs are recommended as standard therapy when diet and lifestyle changes fail to have a sufficient impact on lipid levels:

Medical Name Of Disorder Threshold Blood Values Recommended Drug Class

Hypercholesterolemia

LDL cholesterol above 130 mg/dL
  • Statins for reductions of 20% and more
  • Ezetimibe if patient is statin intolerant
  • Sequestrants ("resins") or Phytosterols for reductions of less than 20%

Hypertriglyceridemia

Triglycerides above 200 mg/dL
  • Statins if triglycerides must be lowered by a maximum of 20% to 40%
  • Fibrates ("fibric acids") if triglycerides must be lowered by more than 40%
  • Fish Oil if triglycerides must be lowered by more than 40% and as an alternative to fibrates (fibrate intolerant)
  • Niacin if HDL cholesterol is very low and triglycerides is high

Combined (or mixed) Hyperlipidemia

LDL cholesterol above 130 mg/dL

&

Triglycerides above 200 mg/dL
  • Statins for very high LDL and moderately high triglycerides
  • Combination of Statins* with Fibrates*, Fish Oil or Niacin for very high LDL and triglyceride levels
*Care must be taken when combining Statins with Fibrates because of a potential increase in severe side effects. If Fibrates must be combined with a Statin, Fenofibrate should be used because this fibrate causes fewer side effects.

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