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Working Together To Manage Diabetes: A guide for Pharmacy, Podiatry, Optometry, and Dental professionals


Drug Table Supplement Contents

SECTION C Medications for the Treatment of Dyslipidemia

Category
Generic Name
Brand Name
Minimum Daily Dose
Maximum Daily Dose
Special Considerations for class of drugs
HMG-Coa = 3-hydroxy-3-methylglutaryl coenzyme A   LDL = low-density lipoprotein   HDL = high-density lipoprotein
TC = total cholesterol   TG = plasma triglycerides   generic = generic drug manufacturers
HMG-CoA reductase
inhibitors (statins)
atorvastatin Lipitor™ 10 mg QD 80 mg in divided doses

Main action: Lowers LDL (“bad”) cholesterol.
Also lowers TG and modestly raises HDL.

Have blood tests for liver enzyme concentrations.

Notify physician if muscle aches or weakness develops.

Use caution if combined with fibric acid derivatives due to the increased risk of rhabdomyolysis.

fluvastatin Lescol™ 20 mg QD 80 mg in divided doses
fluvastatin Lescol XL™ 80 mg QD 80 mg in divided doses
lovastatin Mevacor™ 10 mg QD 80 mg in divided doses
lovastatin (extended-release) Altocor™ 20 mg QD 60 mg QD
pravastatin Pravachol™ 10 mg QD 80 mg QD
rosuvastatin Crestor™ 5 mg QD 40 mg QD
simvastatin Zocor™ 5 mg QD 80 mg in divided doses
Cholesterol absorption
inhibitors
ezetimibe Zetia™ 10 mg QD 10 mg QD

Main action: Lowers LDL cholesterol; inhibits absorption of cholesterol.

If used with a statin, take together.

If used with bile acid sequestrant, ezetimibe should be taken 2 hr before or 4 hr after bile acid sequestrant.

Nicotinic acid (niacin) nicotinic acid
(extended release)
Niaspan™ 50–100 mg QD 2,000 mg QD

Main action: Lowers LDL cholesterol increases HDL (“good”) cholesterol, lowers triglycerides.

Take with food.

May cause flushing.

May increase blood glucose levels.

Have blood tests for liver enzyme concentrations.

Long-acting forms may be more likely to cause liver malfunction.

nicotinic acid   250 mg/day QD

Titrated up to 1500mg therapeutic dose in 3 divided doses.

Maximum dose= 3000mg

Lipid combinations lovastatin-niacin Advicor™ 20 mg/500 mg QD 40 mg/2,000 mg QD Main Action: Reduces LDL, TC , and TG and increases HDL
due to the individual actions of niacin and lovastatin.
simvastatin-ezetimibe Vytorin™ 10 mg/10 mg QD 80 mg/10 mg QD Main Action: Reduces LDL cholesterol.
Amlodipine+atorvastatin Caduet™ 2.5mg/10mg QD 10 mg/80 mg QD Blood Pressure medication (Calcium channel blocker) (see Blood pressure med chart)+lipid (statin) medication. Same comments as individual
Fibric acid derivatives fenofibrate Tricor™ 48 mg QD 145 mg QD

Main action: Lowers triglycerides, increases HDL cholesterol.

Perform blood tests for liver enzyme concentrations.

Adjust dose based on age and renal impairment.

Notify physician if muscle aches or weakness develops.

fenofibrate Lofibra™ 67 mg QD 200 mg QD
fenofibrate Triglide™ 50 mg QD 160 mg QD
fenofibrate Antara™ 43 mg QD 130 mg QD
gemfibrozil Lopid™ 1,200 mg BID 1,200 mg BID
Bile acid sequestrants cholestyramine LoCHOLEST™ 4 g QD 24 g in divided doses

Main action: Lowers LDL cholesterol.

May cause constipation and stomach upset.

May need to be taken at a different time than other medications to avoid drug interactions.

May increase triglycerides blood concentrations.

Can be combined with other agents such as statins.

cholestyramine light LoCHOLEST light™ 4 g QD 24 g in divided doses
cholestyramine Questran™ 4 g QD 24 g in divided doses
cholestyramine light Questran light™ 4 g QD 24 g in divided doses
cholestyramine Prevalite™ 4 g QD 24 g in divided doses
cholestipol Colestid™ 2g QD or BID 6g QD or BID
colesevelam Welchol™ 1,875 mg (3 tablets) QD 4,375 mg (7 tabs) QD or BID

 

NDEP-54-S

March 2007

 

     
 

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