[wiseguy]

Anyone on a combination of these two cholesterol lowering drugs? Results? Side effects?

[BlueSky]

There is an increased risk of myopathy and rhabdomyolysis with combined statin/fibrate therapy. But it is felt that, if the risk is outweighed by other threapeutic benefits, it is worth taking. It highlights the need to understand what is driving those lipids up, and what the benefit of bringing them down is. Personally, I would want the cause of the massive rise in triglycerides to be more fully investigated before taking medication. An endocrinologist or a specialist physician would know what to look for.

[wiseguy]

Originally Posted by BlueSky

There is an increased risk of myopathy and rhabdomyolysis with combined statin/fibrate therapy. But it is felt that, if the risk is outweighed by other threapeutic benefits, it is worth taking. It highlights the need to understand what is driving those lipids up, and what the benefit of bringing them down is. Personally, I would want the cause of the massive rise in triglycerides to be more fully investigated before taking medication. An endocrinologist or a specialist physician would know what to look for.

I was told about the increased risk associated with this combination although the doctor said that he had seen only two instances of myopathy in 14 years of prescribing statin/fibrate combinations. Of course I have to do my own investigating and at this point I do not like what I've been reading about Gemfibrozil. For the time being I have decided to take only the Lipitor.

Recently discovering that my father once had a similar triglyceride reading adds credence to the genetics theory.

[MJB]

I took a fibrate (Tricor) in combination with Lipitor for a few days when the myopathy hit me. I was lifting a 5gal bottle of water when my pectoral muscle pained me severely. Later that day I just bent over and my back went out and I assume that was also related. I generally have no back problems.

Lipitor alone causes me no problems but I'll never do that combo again.

[BlueSky]

Originally Posted by wiseguy

....the doctor said that he had seen only two instances of myopathy in 14 years .....

You don't have to get myopathy, diagnosed by high levels of liver enzymes, for statins to make you life miserable. Lots of people have normal enzymes but get muscle pain, balance problems, memory loss etc. Often they never realise what is causing it.

Originally Posted by wiseguy

.... For the time being I have decided to take only the Lipitor .....

Lipitor won't make much difference to your Triglycerides. Maybe it would make more sense to skip the Lipitor and take the Gemfibrozil. You could also consider taking Niacin to bring down the Tri's. Niacin is a vitamin (vitamin B3) and in moderate quantities doesn't cause side effects. But it is very effective in reducing triglycerides. You just have to watch out for the flushing.

[wiseguy]

Originally Posted by BlueSky

You don't have to get myopathy, diagnosed by high levels of liver enzymes, for statins to make you life miserable. Lots of people have normal enzymes but get muscle pain, balance problems, memory loss etc. Often they never realise what is causing it.

Lipitor won't make much difference to your Triglycerides. Maybe it would make more sense to skip the Lipitor and take the Gemfibrozil. You could also consider taking Niacin to bring down the Tri's. Niacin is a vitamin (vitamin B3) and in moderate quantities doesn't cause side effects. But it is very effective in reducing triglycerides. You just have to watch out for the flushing.

Lipitor claims to lower Triglycerides by 19-39%. I'm looking into the Niacin.

[georgepds]

Originally Posted by BlueSky

... Niacin is a vitamin (vitamin B3) and in moderate quantities doesn't cause side effects. But it is very effective in reducing triglycerides. You just have to watch out for the flushing.

FWIIW, if you increase the niacin dose by 250 mg/ meal up to the desired amount (1000/meal) you can reduce the flushing.

week 1 250 bfast
week 2 250 bfast 250 lunch
week 3 250 bfast 250 lunch 250 dinner
week 4 500 bfast 250 lunch 250 dinner
and so on

It also helps to take an aspirin.

[wiseguy]

Originally Posted by georgepds

FWIIW, if you increase the niacin dose by 250 mg/ meal up to the desired amount (1000/meal) you can reduce the flushing.

week 1 250 bfast
week 2 250 bfast 250 lunch
week 3 250 bfast 250 lunch 250 dinner
week 4 500 bfast 250 lunch 250 dinner
and so on

It also helps to take an aspirin.

I've read that the slow release type of Niacin (Slo-Niacin) reduces the odds of side effects. I've also read that Niacin causes higher BG levels.