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  • Atorvastatin calcium: PLACE IN THERAPY(5)

Other available treatment options often are not adequate as monotherapy for patients with elevated LDL-C and triglyceride levels (ie, combined [mixed] dyslipidemia or Fredrickson type Ilb dyslipidemia) . These patients require significant reductions in triglyceride and LDL-C levels. Whereas available statins lower LDL-C levels, they are only moderately effective in reducing triglyceride levels . On the other hand, fibric acid derivatives and niacin significantly reduce triglycerides but only modestly lower LDL-C levels. flovent inhaler

Treatment of combined (mixed) dyslipidemia can include combination therapy of statin plus fibric acid derivatives or niacin, or niacin plus fibric acid derivatives . Although these combinations may be effective, their use is often limited by associated adverse effects. Skin flushing, rash and itching are associated with the use of niacin, and the risk of myositis has been associated with the combined use of statins and fibric acid derivatives. Therefore, close monitoring and frequent follow-up of these patients may be necessary. Although atorvastatin lowered triglyceride levels to a lesser extent than fibric acid derivatives or niacin in patients with combined (mixed) dyslipidemia, the reductions were still significant. Additionally, atorvastatin produced much greater reductions in LDL-C levels. Thus atorvastatin may be a very useful first-line agent in patients with combined (mixed) dyslipi-demia.

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