Mixed dyslipidemia

Fibrates are being combined with statins to expand their potential in the dyslipidemia market. A recent clinical study examined the effects of rosuvastatin (10) and fenofibrate as mono and combination therapy in hyperlipidemic diabetic patients [43]. In late 2006, large scale Phase III clinical trials of rosuvastatin in combination with a next-generation fibrate, ABT 335, were initiated for evaluation of safety and efficacy in patients with mixed dyslipidemia. 

Hypercholesterolemia (heterozygous familial and nonfamilial) and mixed dyslipidemia (Fredrickson type I la and lib) - The dose range for rosuvastatin is 5 to 40 mg once daily. Individualize rosuvastatin therapy according to goal of therapy and response. The usual recommended starting dose of rosuvastatin... 

Hypercholesterolemia Adjunctive therapy to diet for the reduction of LDL-C, total-C, triglycerides, and apolipoprotein B (apo B) and to increase HDL-C in adult patients with primary hypercholesterolemia or mixed dyslipidemia (Fredrickson Types lla and Mb). 

Primary hypercholesterolemia/mixed dyslipidemia For the treatment of primary hypercholesterolemia (heterozygous familial and nonfamilial) and mixed dyslipidemia (Frederickson Types lla and Mb) in the following Patients treated with lovastatin who require further TG-lowering or FIDL-raising who may benefit from having niacin added to their regimen patients treated with niacin who require further... 

Rosuvastatin (Crestor) [Antilipemic/HMG-CoA Reductase Inhibitor] Uses Rx primary hypercholesterolemia mixed dyslipidemia ... 

Pravastatin is indicated as an adjunct to diet in patients with primary hypercholesterolemia, mixed dyslipidemia, elevated serum triglyceride levels and primary dysbetalipoproteinemia who do not respond adequately to diet. 

Indication Adjunct to diet for the reduction of elevated total cholesterol. LDL. apo B. and TG levels in patients with primary hypercholesterolemia (heterozygous familial and nonfamilial). mixed dyslipidemia (Fredrickson types Ila and 1 lb), elevated TG (type IV) and primary dysbetali-poproteinemia (type III) Adjunct to other lipid lowering treatments for homozygous familial hypercholesterolemia ... 

Atorvastatin calcium is used as an adjunct to diet to reduce the elevated total-cholesterol, LDL, apolipoprotein B (apo B), and triglyceride (TG) levels, and to increase the HDL-C level in patients with primary hypercholesterolemia and mixed dyslipidemia. The drug is also used for the treatment of patients with an elevated serum TG levels, and for the patients with primary dysbetaliproteinemia, which do not respond adequately to diet. Atorvastatin calcium is also indicated to reduce the total-cholesterol and LDL-C in patients with homozygous familial hypercholesterolemia (e.g., LDL apheresis) [6]. 

Yee HS, Fong NT. Atorvastatin in the treatment of primary hypercholesterolemia and mixed dyslipidemias. Ann Pharmacother 1998 32(10) 1030-43. 

Baycol was indicated as an adjunct to diet to reduce elevated total-cholesterol, low-density lipoprotein cholesterol (LDL-C), apo B, and triglycerides (TG) and to increase high-density lipoprotein cholesterol (HDL-C) levels in patients with primary hypercholesterolemia and mixed dyslipidemia (Fredrickson types Ila and Ilb) when the response to dietary restriction of saturated fat and cholesterol and other nonpharmacological measures alone had been inadequate. Therapy with lipid altering drugs should bea component of multiple risk factor intervention in those patients at significantly high risk for atherosclerotic vascular disease due to hypercholesterolemia. 

Indications Hypercholesterolemia, Mixed dyslipidemia Category HMG-CoA reductase inhibitor Statin Half-life 19 hours... 

Farmer M (2008) Update on the clinical utility of fenofibrate in mixed dyslipidemias mechanisms of action and rational prescribing. Vase Health Risk Manag 4 991-1000... 

The manufacturer does not recommend use of the fixed combination as initial therapy of primary hypercholesterolemia or mixed dyslipidemia. It is specifically Indicated in patients receiving lovastatin alone plus diet who require an additional reduction in triglyceride levels or increase in HDL cholesterol levels it is also Indicated In those treated with niacin alone who require additional decreases in LDL cholesterol. 

Rosuvastatin is a 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor that inhibits HMG-CoA reductase, the rate-limiting enzyme that converts HMG-CoA to mevalonate, a precursor of cholesterol. It is indicated as an adjunct to diet to reduce elevated total cholesterol (C), LDL-C, non-HDL-C, ApoB, and TG levels and to increase HDL-C in patients with primary hypercholesterolemia and mixed dyslipidemia as an adjunct to diet for the treatment of patients with elevated serum TG levels and to reduce LDL-C, total C, and ApoB in patients with homozygous familial hypercholesterolemia as an adjunct to other lipidlowering treatments or if such treatments are not available. 

Pravastatin has been shown to increase levels of HDLC in patients with heterozygous familial and nonfamilial primary hypercholesterolemia and mixed dyslipidemia. as well as Frederickson Types 2a and 2b. 

Indications Hyper cholesterol, mixed dyslipidemia, secondary prevention of cardiovascular events (except atorvastatin)... 

Parhofer, K.G., 2009. Review of extended-release niacin/laropiprant fixed combination in the treatment of mixed dyslipidemia and primary hypercholesterolemia. Journal of Vascular Health and Risk Management. 5 901-908. 

Bays HE, Jones PH, Mohiuddin SM, Kelly MT, Sun H, Seize CM, Buttler SM, Sleep DJ, Stolzenbach JC. Long-term safety and efficacy of fenofibric acid in combination with statin therapy for the treatment of patients with mixed dyslipidemia. J Clin Lipidol 2008 2(6) 426-35. 

Stolzenbach JC. Efficacy and safety of fenofibric acid in combination with a statin in patients with mixed dyslipidemia pooled analysis of three phase 3,12-week randomized, controlled studies. J Clin Lipidol 2009 3(2) 125-37. 

Laropiprant (registered under the trademark Tredaptive (Merck) in combination with niacin) is a prostaglandin D2 (PG D2) receptor antagonist indicated for the treatment of dyslipidemia, particularly in patients with combined mixed dyslipidemia (characterized by elevated levels of low-density lipoprotein (LDL)-cholesterol and triglycerides and low high-density lipoprotein (HDL)-cholesterol) as well as in patients with primary hypercholesterolaemia (heterozygous familial and non-familial). Tredaptive can be used... 

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