Hyperlipidemia Flashcards
Lescol Generic
Fluvastatin
Livalo Generic
Pitavastatin
Mevacor/Altoprev Generic
Lovastatin
Pravachol Generic
Pravastatin
Zocor Generic
Simvastatin
Lipitor Generic
Atorvastatin
Crestor Generic
Rosuvastatin
Fluvastatin Dose
Low: 20-40 mg/day
Moderate: 80 mg/day
Pitavastatin Dose
Low: 1 mg/day
Moderate: 2-4 mg/day
Lovastatin Dose
Low: 20 mg/day
Moderate: 40 mg/day
Pravastatin Dose
Low: 10-20 mg/day
Moderate: 40-80mg/day
Simvastatin Dose
Low: 10 mg/day
Moderate: 20-40mg/day
Atorvastatin Dose
Moderate: 10-20mg/day
High: 40-80 mg/day
Rosuvastatin Dose
Moderate: 5-10mg/day
High: 20-40 mg/day
Statin Side Effects
Myopathy Rhabdomyolysis Muscle pain Liver enzyme abnormalities HA Dyspepsia Abdominal pain Nausea Upper respiratory infection
Statin Monitoring
FLP: Baseline, 4-12 wks after starting, then 3-12 months
CK: Baseline, if muscle symptoms
LFT: Baseline, if suspected liver damage
Muscle pain symptoms
Zetia Generic
Ezetimibe
Ezetimibe Dose
10 mg daily
Ezetimibe Side Effects
Arthralgia
Upper respiratory tract infection
Diarrhea
Ezetimibe Monitoring
FLP baseline
LFTs
Praluent Generic
Alirocumab
Alirocumab Dose
75 mcg SQ q 2 weeks
150 mcg q 2 weeks post 4-8 weeks
Alirocumab Side Effects
GI side effects ↑ LFT Injection site reaction Myalgia Influenza
Alirocumab Monitoring
LDL-C within 4-8 weeks of starting or changing dose
Hypersensitivity
Repatha Generic
Evolocumab
Evolocumab Dose
120 mcg q 2 weeks
420 mcg monthly
Evolocumab Side Effects
GI side effects ↑ LFT Injection site reaction Myalgia Influenza
Evolocumab Monitoring
LDL-C within 4-8 weeks of starting or changing dose
Hypersensitivity
Lovaza Generic
Omega-3-acid ethyl esters
Omega-3-acid ethyl esters Dose
4 g daily
2 g BID
Omega-3-acid ethyl esters Side Effects
GI – diarrhea Dysgeusia Dyspepsia Eructation Nausea
Omega-3-acid ethyl esters Monitoring
TG and LDL at baseline and periodically
ALT periodically
GI disturbances, skin changes, bleeding
WelChol Generic
Colesevelam
Colesevelam Dose
- 75 g once daily
1. 875 g BID
Colesevelam Side Effects
↑ TG Constipation Bloating Nausea Flatulence ↓ absorption of fat-soluble vitamins Hypernatremia Hyperchloremia GI Obstruction
Colesevelam Monitoring
FLP: Baseline, 3 months after, q 6—12 months after
Should not use if TG>300 mg/dL
Questran/Prevalite Generic
Cholestyramine
Cholestyramine Dose
4g (1 packet or scoop) once or 2 times daily
Max: 24 g/day
Cholestyramine Side Effects
↑ TG Constipation Bloating Nausea Flatulence ↓ absorption of fat-soluble vitamins Hypernatremia Hyperchloremia GI Obstruction
Cholestyramine Monitoring
FLP: Baseline, 3 months after, q 6—12 months after
Should not use if TG>300 mg/dL
Colestid Generic
Colestipol
Colestipol Dose
Start: 5g once or twice a day
Increase by 5g at 1-2 month intervals
Go up to 30g/day or in divided doses
Colestipol Side Effects
↑ TG Constipation Bloating Nausea Flatulence ↓ absorption of fat-soluble vitamins Hypernatremia Hyperchloremia GI Obstruction
Colestipol Monitoring
FLP: Baseline, 3 months after, q 6—12 months after
Should not use if TG>300 mg/dL
Niacor/Niaspan/Slo-Niacin Generic
Niacin
Niacin Dose
Start: 500 mg at bedtime for 4 weeks
Go to 1 g at bedtime for 4 weeks
Max: 2g/day
Usual: 1-2 g/day at bedtime
Niacin Side Effects
Prostaglandin mediated flushing and itching
Skin rash
Upset stomach
Low blood pressure when standing
Niacin Monitoring
LFT baseline
FBH or A1C
Uric acid
Monitor during titration and every 6 months after
Lopid Generic
Gemfibrozil
Gemfibrozil Dose
600 mg BID 30 mins AC
Adjust following lipid determinations at 4-8 week intervals
Consider reducing if lipids significantly lower than target
Gemfibrozil Side Effects
GI disturbances Rash Myalgia Dizziness Anemia, leukopenia, thrombocytopenia Renal insufficiency
Gemfibrozil Monitoring
Serum cholesterol
LFTs
CBC – first year
Tricor Generic
Fenofibrate
Fenofibrate Dose
48-145 mg/day
Max: 145 mg/day
Adjust following lipid determinations at 4-8 week intervals
Consider reducing if lipids significantly lower than target
Fenofibrate Side Effects
GI disturbances Rash Myalgia Dizziness Anemia, leukopenia, thrombocytopenia Renal insufficiency
Fenofibrate Monitoring
Periodic blood cell count: first year
FLP every 6-8 weeks until goal then every 4-6 months
LFTs
Renal function: Baseline, 3 months after, every 6 months
Trilipix/Fibricor Generic
Fenofibric Acid
Fenofibric Acid Dose
Trilipix: 45-135mg/day
Max: 135mg/day
Fibricor: 35-105 mg/day
Max: 105 mg/day
Adjust following lipid determinations at 4-8 week intervals
Consider reducing if lipids significantly lower than target
Fenofibric Acid Side Effects
GI disturbances Rash Myalgia Dizziness Anemia, leukopenia, thrombocytopenia Renal insufficiency
Fenofibric Acid Monitoring
Periodic blood cell count: first year
FLP every 6-8 weeks until goal then every 4-6 months
LFTs
Renal function: Baseline, 3 months after, every 6 months
Vytorin Generic
Simvastatin and Ezetimibe
Juvisync Generic
Simvastatin with Sitagliptin