高血脂治療藥

高血脂症治療藥

藥物	↓LDL	↑HDL	↓TG	TC	忍受性	副作用
Statins	20-60%	5-10%	10-25%	15-30%	Good	↑ALT (0.5-3%) (dose-dependent) Myalgia <10%, myositis 0.5%, rhabdo < 0.1%
Ezetimibe	15-20%	-	-	?	Good
Fibrate	5-15% (↑LDL ?)	5-15%	35-50%	15%	Good	Myopathy risk↑with statin. Dyspepsia, 膽結石
Niacin*	10-25%	~30%	40%	25%	Poor – reasonable	NO clinical benefit (NEJM 2011;365:2255; THRIVE)
Resin	20%	3-5%	? ↑	20%	Poor	Bloating, 結合他藥
Ω-3 FA	↑5%	3%	25-30%			Dyspepsia, 腹瀉

Statins	HMG-CoA Reductase inhibitors	DOSE	標準劑量 QD	↓LDL
Rosuvastatin	Crestor (10)	0.5-2#	0.5-2# (max 40/d) CCr <30: 0.5-1#qd	39-55%	ALT (0.5-2%), 週邊神經炎, myopathy
Atorvastatin	Lipitor (10, 40)		10-20-40 (max 80/d)	39-50%	同上
Pitavastatin	Livalo (2)		0.5-2#	38-49%	C/I: 急性肝衰竭, 末期LC
Simvastatin	Vytorin (simva (20)-ezetimibe (10)		20-40mg (0.5-1-2#)	35-40%	ALT, myopathy, GI
Fluvastatin	Lescol XL (80)		0.5-1#	25-35%	C/I: 同上 TG: ↓19%
Lovastatin			40mg /d	31%

Combo
Ezetinibe (10)-simvastatin (20)	Vytorin

Fibrate	PPARα activator
Fenofibrate	Fenolip (200/cap)	1# qd		[副]:週邊神經炎, myopathy, rhabdo -與TZD併用, may↓HDL -may↑LDL, esp., in TG很高pt (due to improve VLDL to LDL轉化)