Matching articles for "Cholesterol"

Comparison Table: Some Lipid-Lowering Drugs (online only)

   
The Medical Letter on Drugs and Therapeutics • September 19, 2022;  (Issue 1659)
...
View the Comparison Table: Some Lipid-Lowering Drugs
Med Lett Drugs Ther. 2022 Sep 19;64(1659):e152-6 | Show Full IntroductionHide Full Introduction

Bempedoic Acid (Nexletol) for Lowering LDL-Cholesterol

   
The Medical Letter on Drugs and Therapeutics • April 6, 2020;  (Issue 1595)
The FDA has approved the oral adenosine triphosphate-citrate lyase (ACL) inhibitor bempedoic acid for use alone (Nexletol – Esperion) and in a fixed-dose combination with the cholesterol absorption...
The FDA has approved the oral adenosine triphosphate-citrate lyase (ACL) inhibitor bempedoic acid for use alone (Nexletol – Esperion) and in a fixed-dose combination with the cholesterol absorption inhibitor ezetimibe (Nexlizet) as an adjunct to diet and maximally tolerated statin therapy in adults with heterozygous familial hypercholesterolemia (HeFH) or established atherosclerotic cardiovascular disease (ASCVD) who require additional lowering of LDL-cholesterol (LDL-C). Bempedoic acid is the first ACL inhibitor to be approved in the US.
Med Lett Drugs Ther. 2020 Apr 6;62(1595):53-5 | Show Full IntroductionHide Full Introduction

Reduction of Cardiovascular Risk with Icosapent Ethyl (Vascepa)

   
The Medical Letter on Drugs and Therapeutics • February 10, 2020;  (Issue 1591)
Icosapent ethyl (Vascepa – Amarin), the ethyl ester of eicosapentaenoic acid (EPA), has been approved by the FDA for use as an adjunct to maximally tolerated statin therapy to reduce the risk of...
Icosapent ethyl (Vascepa – Amarin), the ethyl ester of eicosapentaenoic acid (EPA), has been approved by the FDA for use as an adjunct to maximally tolerated statin therapy to reduce the risk of major adverse cardiovascular events in adults with hypertriglyceridemia (≥150 mg/dL) who have either established cardiovascular disease (CVD) or diabetes and ≥2 additional risk factors for CVD. It is the only omega-3 polyunsaturated fatty acid (PUFA) product to be approved in the US for this indication. Icosapent ethyl and two other omega-3 PUFA prescription products (Lovaza, Epanova), which contain both EPA and docosahexaenoic acid (DHA), were approved earlier for treatment of severe hypertriglyceridemia (≥500 mg/dL).
Med Lett Drugs Ther. 2020 Feb 10;62(1591):17-8 | Show Full IntroductionHide Full Introduction

Turmeric Supplements

   
The Medical Letter on Drugs and Therapeutics • November 18, 2019;  (Issue 1585)
Turmeric is a spice derived from the Curcuma longa plant. Dietary supplements and foods containing turmeric are widely promoted for relief of pain and to improve joint mobility, immunity,...
Turmeric is a spice derived from the Curcuma longa plant. Dietary supplements and foods containing turmeric are widely promoted for relief of pain and to improve joint mobility, immunity, digestion, cardiovascular health, depression, anxiety, memory, and cognition.
Med Lett Drugs Ther. 2019 Nov 18;61(1585):185 | Show Full IntroductionHide Full Introduction

Lipid-Lowering Drugs

   
The Medical Letter on Drugs and Therapeutics • February 11, 2019;  (Issue 1565)
Cholesterol management guidelines from the American College of Cardiology/American Heart Association Task Force have recently been published. See Table 1 for a brief summary of their...
Cholesterol management guidelines from the American College of Cardiology/American Heart Association Task Force have recently been published. See Table 1 for a brief summary of their recommendations.
Med Lett Drugs Ther. 2019 Feb 11;61(1565):17-24 | Show Full IntroductionHide Full Introduction

Expanded Table: Lipid-Lowering Drugs (online only)

   
The Medical Letter on Drugs and Therapeutics • February 11, 2019;  (Issue 1565)
...
View the Expanded Table: Lipid-Lowering Drugs
Med Lett Drugs Ther. 2019 Feb 11;61(1565):e24-30 | Show Full IntroductionHide Full Introduction

In Brief: Pitavastatin Magnesium (Zypitamag) for Hyperlipidemia

   
The Medical Letter on Drugs and Therapeutics • June 18, 2018;  (Issue 1549)
The FDA has approved the HMG-CoA reductase inhibitor (statin) pitavastatin magnesium (Zypitamag – Zydus) for use in adults with primary hyperlipidemia or mixed dyslipidemia. The FDA considers pitavastatin...
The FDA has approved the HMG-CoA reductase inhibitor (statin) pitavastatin magnesium (Zypitamag – Zydus) for use in adults with primary hyperlipidemia or mixed dyslipidemia. The FDA considers pitavastatin magnesium bioequivalent to pitavastatin calcium (Livalo), which was approved in 2009.1

Statins remain the treatment of choice for most patients who require lipid-lowering therapy. Taken as an adjunct to diet modification, increased exercise, and smoking cessation, statins can reduce the risk of primary and secondary cardiovascular events and death in patients with or at high risk for atherosclerotic cardiovascular disease.2 Even in patients at low risk for cardiovascular disease, treatment with a statin can significantly reduce the incidence of cardiovascular events.3

Controlled trials in patients with cardiovascular disease have shown that high-intensity statin therapy (defined as reducing LDL-cholesterol [LDL-C] by ≥50% on average) reduces the incidence of cardiac events, stroke, and coronary death significantly more than less intensive regimens. In one meta-analysis, each additional 1 mmol/L (39 mg/dL) reduction in LDL-C was associated with a 20% reduction in major vascular events and a 10% reduction in all-cause mortality.4 In a randomized trial in 13,054 Japanese patients with stable coronary artery disease, over a median follow-up of 3.9 years, patients taking pitavastatin calcium 4 mg daily were significantly less likely than those taking 1 mg daily to have a cardiovascular event (4.3% vs 5.4%).5

Approval of pitavastatin magnesium was based on the results of trials with pitavastatin calcium; no new efficacy trials were required. The Medical Letter's review of pitavastatin calcium concluded that recommended doses of the drug had not been shown to decrease LDL-C more than other statins with longer safety records and there was no good reason to use it. That conclusion applies to pitavastatin magnesium as well.

  1. Pitavastatin (Livalo) – the seventh statin. Med Lett Drugs Ther 2010; 52:57.
  2. Lipid-lowering drugs. Med Lett Drugs Ther 2016; 58:133.
  3. CTT Collaboration et al. The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials. Lancet 2012; 380:581.
  4. CTT Collaboration et al. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet 2010; 376:1670.
  5. I Taguchi et al. High-dose versus low-dose pitavastatin in Japanese patients with stable coronary artery disease (REAL-CAD): a randomized superiority trial. Circulation 2018; 137:1997.


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Med Lett Drugs Ther. 2018 Jun 18;60(1549):106 | Show Full IntroductionHide Full Introduction

Addendum: Statins for Primary Prevention of Cardiovascular Disease

   
The Medical Letter on Drugs and Therapeutics • December 5, 2016;  (Issue 1509)
In our recent article on Lipid-Lowering Drugs,1 we said that statins can reduce the risk of first cardiovascular events and death (primary prevention) in patients at high risk for atherosclerotic cardiovascular...
In our recent article on Lipid-Lowering Drugs,1 we said that statins can reduce the risk of first cardiovascular events and death (primary prevention) in patients at high risk for atherosclerotic cardiovascular disease (CVD) and significantly reduce the incidence of cardiovascular events in patients at lower risk for CVD. Now the United States Preventive Services Task Force (USPSTF) has issued new recommendations on the appropriate use of statins for primary prevention of CVD.2

The USPSTF states that clinicians should periodically screen all persons 40-75 years old for cardiovascular risk factors and evaluate their 10-year risk of CVD using the ACC/AHA Pooled Cohort Equation.3 It recommends starting low- to moderate-intensity statin therapy (lowintensity statin therapy lowers LDL-cholesterol <30%; moderate-intensity statin therapy lowers it 30-<50%) in adults 40-75 years old without CVD who have one or more CVD risk factors (dyslipidemia, diabetes, hypertension, or smoking) and a calculated 10-year CVD event risk of >10%. For patients with the same characteristics but a 7.5-10% 10-year risk, the USPSTF recommends that clinicians "selectively offer" the same treatment.

The new recommendations do not apply to patients with familial hypercholesterolemia or LDL-cholesterol levels ≥190 mg/dL, who should take a statin regardless of calculated risk. The USPSTF found the evidence insufficient to recommend starting a statin for primary prevention in persons >75 years old.

  1. Lipid-lowering drugs. Med Lett Drugs Ther 2016; 58:133.
  2. US Preventive Services Task Force et al. Statin use for the primary prevention of cardiovascular disease in adults: US Preventive Services Task Force Recommendation Statement. JAMA 2016; 316:1997.
  3. American Heart Association and American College of Cardiology. ASCVD Risk Estimator. Available at: tools.acc.org. Accessed November 22, 2016.


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Med Lett Drugs Ther. 2016 Dec 5;58(1509):158 | Show Full IntroductionHide Full Introduction

Lipid-Lowering Drugs

   
The Medical Letter on Drugs and Therapeutics • October 24, 2016;  (Issue 1506)
Lipid-lowering drugs should be taken indefinitely; when they are stopped, plasma lipoproteins return to pretreatment levels. HMG-CoA reductase inhibitors (statins) remain the drugs of choice for treatment...
Lipid-lowering drugs should be taken indefinitely; when they are stopped, plasma lipoproteins return to pretreatment levels. HMG-CoA reductase inhibitors (statins) remain the drugs of choice for treatment of most patients who require lipid-lowering therapy.
Med Lett Drugs Ther. 2016 Oct 24;58(1506):133-40 | Show Full IntroductionHide Full Introduction

In Brief: Adding Ezetimibe to a Statin Improves Clinical Outcomes

   
The Medical Letter on Drugs and Therapeutics • December 8, 2014;  (Issue 1457)
Combining a statin with another drug that lowers low-density lipoprotein cholesterol (LDL-C), such as colesevelam (Welchol), niacin (Niaspan, and others), or ezetimibe (Zetia), can reduce LDL-C levels more than...
Combining a statin with another drug that lowers low-density lipoprotein cholesterol (LDL-C), such as colesevelam (Welchol), niacin (Niaspan, and others), or ezetimibe (Zetia), can reduce LDL-C levels more than a statin alone, but studies convincingly demonstrating that such combinations improve clinical outcomes have been lacking. The results of a long-term randomized, double-blind clinical trial (IMPROVE-IT) recently presented at the American Heart Association's Scientific Sessions 2014 indicate that addition of ezetimibe to simvastatin in high-risk patients reduces cardiovascular events.1

IMPROVE-IT compared the efficacy of simvastatin 40 mg plus placebo with that of simvastatin 40 mg plus ezetimibe 10 mg (Vytorin) in preventing the primary endpoint, a composite of cardiovascular events (cardiovascular death, MI, hospital admission for unstable angina, coronary revascularization, or stroke) in patients with acute coronary syndrome and normal LDL-C levels (≤125 mg/dL; mean 95 mg/dL). After one year, mean LDL-C was reduced further with the addition of ezetimibe (to 53.2 vs. 69.9 mg/dL with simvastatin alone). After 7 years, 2742 events had occurred among the 9077 patients taking simvastatin plus placebo and 2572 among the 9067 taking simvastatin plus ezetimibe (event rate: 34.7% vs. 32.7%; p = 0.016). There was no significant difference between the 2 groups in noncardiovascular adverse events, including gallbladder-related events, myopathy, or cancer.

  1. C Cannon et al. IMProved Reduction of Outcomes: Vytorin Efficacy International Trial. Available at www.timi.org. Accessed November 21, 2014.


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Med Lett Drugs Ther. 2014 Dec 8;56(1457):126 | Show Full IntroductionHide Full Introduction

Drugs for Lipids

   
The Medical Letter on Drugs and Therapeutics • January 1, 2014;  (Issue 137)
HMG-CoA reductase inhibitors (statins) inhibit the enzyme that catalyzes the rate-limiting step in cholesterol synthesis. The subsequent reduction in hepatic cholesterol leads to increased expression of LDL...
HMG-CoA reductase inhibitors (statins) inhibit the enzyme that catalyzes the rate-limiting step in cholesterol synthesis. The subsequent reduction in hepatic cholesterol leads to increased expression of LDL receptors, which in turn increases uptake and clearance of LDL-C from the blood. Statins also lower very low-density lipoprotein cholesterol (VLDL-C) and triglycerides. Most statins increase high-density lipoprotein cholesterol (HDL-C), but only modestly.
Treat Guidel Med Lett. 2014 Jan;12(137):1-6 | Show Full IntroductionHide Full Introduction

Liptruzet: A Combination of Ezetimibe and Atorvastatin

   
The Medical Letter on Drugs and Therapeutics • June 24, 2013;  (Issue 1419)
The FDA has approved a fixed-dose combination of the cholesterol absorption inhibitor ezetimibe and the HMG-CoA reductase inhibitor (statin) atorvastatin as Liptruzet (Merck) for treatment of...
The FDA has approved a fixed-dose combination of the cholesterol absorption inhibitor ezetimibe and the HMG-CoA reductase inhibitor (statin) atorvastatin as Liptruzet (Merck) for treatment of hyperlipidemia. Ezetimibe is also available in a fixed-dose combination with simvastatin (Vytorin).
Med Lett Drugs Ther. 2013 Jun 24;55(1419):49-50 | Show Full IntroductionHide Full Introduction

Icosapent Ethyl (Vascepa) for Severe Hypertriglyceridemia

   
The Medical Letter on Drugs and Therapeutics • April 29, 2013;  (Issue 1415)
Icosapent ethyl (Vascepa [vas EE puh] – Amarin), the ethyl ester of eicosapentaenoic acid (EPA), has been approved by the FDA as an adjunct to diet for treatment of severe hypertriglyceridemia (≥500...
Icosapent ethyl (Vascepa [vas EE puh] – Amarin), the ethyl ester of eicosapentaenoic acid (EPA), has been approved by the FDA as an adjunct to diet for treatment of severe hypertriglyceridemia (≥500 mg/dL). Vascepa is the second omega-3 polyunsaturated fatty acid (PUFA) product to become available by prescription for this indication; Lovaza (formerly Omacor), which is a combination of the ethyl esters of EPA and docosahexaenoic acid (DHA), was the first. Many omega-3 PUFA-containing fish oil capsules are sold over the counter as dietary supplements.
Med Lett Drugs Ther. 2013 Apr 29;55(1415):33-4 | Show Full IntroductionHide Full Introduction

Two New Drugs for Homozygous Familial Hypercholesterolemia

   
The Medical Letter on Drugs and Therapeutics • April 1, 2013;  (Issue 1413)
The FDA has approved mipomersen (Kynamro – Genzyme) and lomitapide (Juxtapid – Aegerion), each in addition to a low-fat diet and other lipid-lowering medications, to reduce cholesterol levels in patients...
The FDA has approved mipomersen (Kynamro – Genzyme) and lomitapide (Juxtapid – Aegerion), each in addition to a low-fat diet and other lipid-lowering medications, to reduce cholesterol levels in patients with homozygous familial hypercholesterolemia (HoFH).
Med Lett Drugs Ther. 2013 Apr 1;55(1413):25-7 | Show Full IntroductionHide Full Introduction

Drugs for Hypertriglyceridemia

   
The Medical Letter on Drugs and Therapeutics • March 4, 2013;  (Issue 1411)
Fibrates, niacin and fish oil are promoted for treatment of hypertriglyceridemia. HMG-CoA reductase inhibitors (statins) can lower elevated serum concentrations of triglycerides, but less so than fibrates,...
Fibrates, niacin and fish oil are promoted for treatment of hypertriglyceridemia. HMG-CoA reductase inhibitors (statins) can lower elevated serum concentrations of triglycerides, but less so than fibrates, niacins or fish oil. Lifestyle changes such as weight reduction, exercise and decreasing alcohol intake can also lower serum triglyceride levels and should be tried first.
Med Lett Drugs Ther. 2013 Mar 4;55(1411):17-9 | Show Full IntroductionHide Full Introduction

What about Niacin?

   
The Medical Letter on Drugs and Therapeutics • November 28, 2011;  (Issue 1378)
The results of the AIM-HIGH trial conducted by the US National Heart, Lung and Blood Institute (NHLBI) were recently published. The goal of the trial was to test whether addition of niacin to intensive...
The results of the AIM-HIGH trial conducted by the US National Heart, Lung and Blood Institute (NHLBI) were recently published. The goal of the trial was to test whether addition of niacin to intensive statin therapy would further reduce the risk of cardiovascular disease. The trial was stopped prematurely after an average follow-up of 3 years because niacin therapy had not shown any clinical benefit.
Med Lett Drugs Ther. 2011 Nov 28;53(1378):93-4 | Show Full IntroductionHide Full Introduction

Sitagliptin and Simvastatin (Juvisync)

   
The Medical Letter on Drugs and Therapeutics • November 14, 2011;  (Issue 1377)
The FDA has approved Juvisync (Merck), a fixed-dose combination of the antihyperglycemic DPP-4 inhibitor sitagliptin (Januvia) and the HMG-CoA reductase inhibitor simvastatin (Zocor, and...
The FDA has approved Juvisync (Merck), a fixed-dose combination of the antihyperglycemic DPP-4 inhibitor sitagliptin (Januvia) and the HMG-CoA reductase inhibitor simvastatin (Zocor, and others).
Med Lett Drugs Ther. 2011 Nov 14;53(1377):89 | Show Full IntroductionHide Full Introduction

Drugs for Lipids

   
The Medical Letter on Drugs and Therapeutics • March 1, 2011;  (Issue 103)
Drugs that lower low-density lipoprotein cholesterol (LDL-C) concentrations can prevent formation, slow progression and cause regression of atherosclerotic lesions. Lipid-regulating drugs must be taken...
Drugs that lower low-density lipoprotein cholesterol (LDL-C) concentrations can prevent formation, slow progression and cause regression of atherosclerotic lesions. Lipid-regulating drugs must be taken indefinitely; when they are stopped, plasma lipoproteins return to pretreatment levels in 2-3 weeks.
Treat Guidel Med Lett. 2011 Mar;9(103):13-20 | Show Full IntroductionHide Full Introduction

Pitavastatin (Livalo) - The Seventh Statin

   
The Medical Letter on Drugs and Therapeutics • July 26, 2010;  (Issue 1343)
The FDA has approved the marketing of pitavastatin (Livalo – Kowa), an HMG-CoA reductase inhibitor (“statin”), for treatment of primary hyperlipidemia or mixed dyslipidemia. It has been available in...
The FDA has approved the marketing of pitavastatin (Livalo – Kowa), an HMG-CoA reductase inhibitor (“statin”), for treatment of primary hyperlipidemia or mixed dyslipidemia. It has been available in Japan since 2003. All of the statins now available in the US are listed in the table on page 58.
Med Lett Drugs Ther. 2010 Jul 26;52(1343):57-8 | Show Full IntroductionHide Full Introduction

Red Yeast Rice

   
The Medical Letter on Drugs and Therapeutics • September 7, 2009;  (Issue 1320)
Red yeast rice is a food product that has been used in Chinese cooking and medicine for centuries. It is available in the US in a capsule formulation and is often used by patients who want a "natural" product...
Red yeast rice is a food product that has been used in Chinese cooking and medicine for centuries. It is available in the US in a capsule formulation and is often used by patients who want a "natural" product to lower cholesterol.
Med Lett Drugs Ther. 2009 Sep 7;51(1320):71-2 | Show Full IntroductionHide Full Introduction

When a Statin Fails

   
The Medical Letter on Drugs and Therapeutics • July 27, 2009;  (Issue 1317)
The National Cholesterol Education Program recommends that LDL-C be lowered to less than 100 mg/dL (2.6 mmol/L) and considers a value...
The National Cholesterol Education Program recommends that LDL-C be lowered to less than 100 mg/dL (2.6 mmol/L) and considers a value <70 mg/dL (1.8 mmol/L) a reasonable goal for patients at very high risk.
Med Lett Drugs Ther. 2009 Jul 27;51(1317):58-60 | Show Full IntroductionHide Full Introduction

Drug Interactions with Simvastatin

   
The Medical Letter on Drugs and Therapeutics • October 20, 2008;  (Issue 1297)
A recent letter to the editor of the Annals of Internal Medicine documented a single case of myopathy apparently due to an interaction between simvastatin (Zocor, and others) and green tea. Since it became...
A recent letter to the editor of the Annals of Internal Medicine documented a single case of myopathy apparently due to an interaction between simvastatin (Zocor, and others) and green tea. Since it became available generically, simvastatin has surpassed atorvastatin (Lipitor) as the best selling statin. As such, it is probably the most common cause of statin-induced myopathy, which is often a result of drug interactions.
Med Lett Drugs Ther. 2008 Oct 20;50(1297):83-4 | Show Full IntroductionHide Full Introduction

Ezetimibe Revisited

   
The Medical Letter on Drugs and Therapeutics • August 25, 2008;  (Issue 1293)
In recent months, both the lay media and some medical experts have raised concerns about the effectiveness and safety of ezetimibe, a widely used drug that prevents absorption of cholesterol from the GI tract....
In recent months, both the lay media and some medical experts have raised concerns about the effectiveness and safety of ezetimibe, a widely used drug that prevents absorption of cholesterol from the GI tract. Ezetimibe is available alone as Zetia and in combination with 10, 20, 40 and 80 mg of simvastatin (Zocor, and others) as Vytorin.
Med Lett Drugs Ther. 2008 Aug 25;50(1293):67-8 | Show Full IntroductionHide Full Introduction

In Brief: A New Indication for Colesevelam (Welchol)

   
The Medical Letter on Drugs and Therapeutics • May 5, 2008;  (Issue 1285)
Colesevelam (Welchol - Daiichi Sankyo - Med Lett Drugs Ther 2000; 42:102), a bile-acid sequestrant used to lower LDL cholesterol, has been approved by the FDA as an adjunct to diet and exercise in the treatment...
Colesevelam (Welchol - Daiichi Sankyo - Med Lett Drugs Ther 2000; 42:102), a bile-acid sequestrant used to lower LDL cholesterol, has been approved by the FDA as an adjunct to diet and exercise in the treatment of type 2 diabetes. In unpublished studies summarized in the package insert, patients with type 2 diabetes taking metformin (Glucophage, and others), a sulfonylurea or insulin (each as either monotherapy or in combination with other anti-diabetic agents) were given colesevelam 3800 mg per day or placebo; colesevelam significantly reduced glycosylated hemoglobin (A1c) by about 0.5% more than placebo in all three trials. The mechanism is unclear.

Colesevelam can cause constipation, nausea and dyspepsia, increase serum triglyceride concentrations, and interfere with absorption of other oral drugs. One month's treatment with Welchol obtained from drugstore.com would cost about $200. Medical Letter consultants are not enthusiastic about prescribing it for this indication.

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Med Lett Drugs Ther. 2008 May 5;50(1285):33 | Show Full IntroductionHide Full Introduction

Which Statin?

   
The Medical Letter on Drugs and Therapeutics • April 21, 2008;  (Issue 1284)
Advertisements for atorvastatin (Lipitor), the market leader facing generic competition, have been in the news recently in the US. Lovastatin, pravastatin and simvastatin are all available generically at a much...
Advertisements for atorvastatin (Lipitor), the market leader facing generic competition, have been in the news recently in the US. Lovastatin, pravastatin and simvastatin are all available generically at a much lower retail price or lower co-pay than atorvastatin.
Med Lett Drugs Ther. 2008 Apr 21;50(1284):29-31 | Show Full IntroductionHide Full Introduction

Drugs for Lipids

   
The Medical Letter on Drugs and Therapeutics • February 1, 2008;  (Issue 66)
Drugs that lower low-density lipoprotein cholesterol (LDL-C) concentrations can prevent formation, slow progression and cause regression of atherosclerotic lesions. They should not be used as a substitute for...
Drugs that lower low-density lipoprotein cholesterol (LDL-C) concentrations can prevent formation, slow progression and cause regression of atherosclerotic lesions. They should not be used as a substitute for lifestyle changes; a combination of diet, exercise and lipid-lowering drugs is optimal for prevention of coronary disease. Lipid-regulating drugs must be taken indefinitely; when they are stopped, plasma lipoprotein levels return to pretreatment levels in 2-3 weeks.
Treat Guidel Med Lett. 2008 Feb;6(66):9-16 | Show Full IntroductionHide Full Introduction

Reducing Intake of Trans Fatty Acids

   
The Medical Letter on Drugs and Therapeutics • August 13, 2007;  (Issue 1267)
The New York City Board of Health has recently required that city restaurants reduce the content of industrially produced trans fatty acids so that each serving contains...
The New York City Board of Health has recently required that city restaurants reduce the content of industrially produced trans fatty acids so that each serving contains <0.5 g. This initiative is intended to reduce the number of coronary heart disease events in New York City. A more comprehensive approach used in Denmark since 2004 requires by law that fats and oils in all food contain <2% industrially produced trans fatty acids. The FDA requires that labels of packaged food include their trans fatty acid content. This requirement has led food manufacturers to develop brands containing zero or small amounts of trans fat.
Med Lett Drugs Ther. 2007 Aug 13;49(1267):65-6 | Show Full IntroductionHide Full Introduction

Omega-3 Polyunsaturated Fatty Acids (Omacor) for Hypertriglyceridemia

   
The Medical Letter on Drugs and Therapeutics • November 7, 2005;  (Issue 1221)
A highly concentrated omega-3 polyunsaturated fatty acid (PUFA) preparation (Omacor - Reliant) has been approved by the FDA as an adjunct to diet for treatment of very high plasma triglyceride concentrations...
A highly concentrated omega-3 polyunsaturated fatty acid (PUFA) preparation (Omacor - Reliant) has been approved by the FDA as an adjunct to diet for treatment of very high plasma triglyceride concentrations (>=500 mg/dL). Omacor is a combination of the ethyl esters of icosapentaenoic (EPA) and docosahexaenoic (DHA) acids. It is the first drug derived from omega-3 PUFAs to be sold by prescription.
Med Lett Drugs Ther. 2005 Nov 7;47(1221):91-2 | Show Full IntroductionHide Full Introduction

Dehydroepiandrosterone (DHEA)

   
The Medical Letter on Drugs and Therapeutics • May 9, 2005;  (Issue 1208)
Dehydroepiandrosterone (DHEA), an endogenous adrenal steroid, is marketed as a dietary supplement in the US. It is widely promoted to reverse the effects of aging (loss of muscle, memory and libido) and has...
Dehydroepiandrosterone (DHEA), an endogenous adrenal steroid, is marketed as a dietary supplement in the US. It is widely promoted to reverse the effects of aging (loss of muscle, memory and libido) and has been used by athletes as a substitute for anabolic steroids. DHEA is banned by the International Olympic Committee, National Collegiate Athletic Association, National Football League and other sports organizations, but it was specifically exempted from becoming a controlled substance in the Anabolic Steroid Control Act of 2004.
Med Lett Drugs Ther. 2005 May 9;47(1208):37-8 | Show Full IntroductionHide Full Introduction

Drugs for Lipids

   
The Medical Letter on Drugs and Therapeutics • March 1, 2005;  (Issue 31)
Drugs that lower low-density lipoprotein cholesterol (LDL-C) concentrations can prevent formation, slow progression and cause regression of atherosclerotic lesions. In controlled trials in patients with...
Drugs that lower low-density lipoprotein cholesterol (LDL-C) concentrations can prevent formation, slow progression and cause regression of atherosclerotic lesions. In controlled trials in patients with coronary disease, some of these drugs have reduced mortality by 20% to 30%.
Treat Guidel Med Lett. 2005 Mar;3(31):15-22 | Show Full IntroductionHide Full Introduction

In Brief: Rhabdomyolysis with Ezetimibe

   
The Medical Letter on Drugs and Therapeutics • February 28, 2005;  (Issue 1203)
Health Canada, the Canadian equivalent of the FDA, recently issued a public advisory about postmarketing reports of myalgia, rhabdomyolysis, hepatitis, pancreatitis and thrombocytopenia associated with use of...
Health Canada, the Canadian equivalent of the FDA, recently issued a public advisory about postmarketing reports of myalgia, rhabdomyolysis, hepatitis, pancreatitis and thrombocytopenia associated with use of ezetimibe (Zetia in the US; Ezetrol in Canada). Ezetimibe is often added to a statin to increase LDL cholesterol lowering (Drugs for Lipids, Treat Guidel Med Lett 2005; 3:15). The advisory did not specify whether these patients were also taking a statin, but according to the Canadian manufacturer Merck Frosst/Schering (Merck/Schering-Plough in the US), some of the patients who developed rhabdomyolysis were taking ezetimibe without a statin. In the US, ezetimibe is also available in a combination with simvastatin (Vytorin - Med Lett Drugs Ther 2004; 46:73). Recently, a few patients already taking a statin developed myalgia when ezetimibe was added (R Fux et al, Ann Intern Med 2004; 140:671). The possibility that adding ezetimibe to a statin could increase the risk of rhabdomyolysis should be kept in mind.
Med Lett Drugs Ther. 2005 Feb 28;47(1203):17 | Show Full IntroductionHide Full Introduction

Safety of Aggressive Statin Therapy

   
The Medical Letter on Drugs and Therapeutics • November 22, 2004;  (Issue 1196)
New guidelines from The National Cholesterol Education Program recommend, as a therapeutic option, lowering treatment goals for LDL cholesterol (LDL-C) from...
New guidelines from The National Cholesterol Education Program recommend, as a therapeutic option, lowering treatment goals for LDL cholesterol (LDL-C) from <100 mg/dL to <70 mg/dL for patients at very high risk for coronary heart disease and from 130 mg/dL to <100 mg/dL for those at moderately high risk. A likely consequence of these recommendations is increased use of statins and use of higher doses with a concomitant increase in adverse effects.
Med Lett Drugs Ther. 2004 Nov 22;46(1196):93-5 | Show Full IntroductionHide Full Introduction

Vytorin: A Combination of Ezetimibe and Simvastatin

   
The Medical Letter on Drugs and Therapeutics • September 13, 2004;  (Issue 1191)
Vytorin, a fixed-dose combination of the cholesterol absorption inhibitor ezetimibe (Zetia - Merck/Schering Plough) and the HMG-CoA reductase inhibitor ("statin") simvastatin (Zocor - Merck), has been approved...
Vytorin, a fixed-dose combination of the cholesterol absorption inhibitor ezetimibe (Zetia - Merck/Schering Plough) and the HMG-CoA reductase inhibitor ("statin") simvastatin (Zocor - Merck), has been approved by the FDA for treatment of hypercholesterolemia. It is available as tablets containing 10 mg of ezetimibe combined with 10, 20, 40 or 80 mg of simvastatin.
Med Lett Drugs Ther. 2004 Sep 13;46(1191):73-4 | Show Full IntroductionHide Full Introduction

Amlodipine/Atorvastatin (Caduet)

   
The Medical Letter on Drugs and Therapeutics • July 5, 2004;  (Issue 1186)
Caduet (Pfizer), a combination of the calcium-channel blocker amlodipine (Norvasc - Pfizer) and the HMG-CoA reductase inhibitor (statin) atorvastatin (Lipitor - Pfizer), is now available in the US. It was...
Caduet (Pfizer), a combination of the calcium-channel blocker amlodipine (Norvasc - Pfizer) and the HMG-CoA reductase inhibitor (statin) atorvastatin (Lipitor - Pfizer), is now available in the US. It was approved by the FDA for use in patients with indications for treatment with both amlodipine, which is used to treat hypertension and/or angina pectoris, and atorvastatin, which is used to treat dyslipidemia. The combination is bioequivalent to the 2 components taken separately.
Med Lett Drugs Ther. 2004 Jul 5;46(1186):56 | Show Full IntroductionHide Full Introduction

Cholesterol Rethink for High-Risk Patients

   
The Medical Letter on Drugs and Therapeutics • May 10, 2004;  (Issue 1182)
The recent "PROVE IT" trial in patients with coronary heart disease showed clinical benefits associated with reducing LDL cholesterol concentrations lower than the 100 mg/dL (2.59 mmol/L) or less that had been...
The recent "PROVE IT" trial in patients with coronary heart disease showed clinical benefits associated with reducing LDL cholesterol concentrations lower than the 100 mg/dL (2.59 mmol/L) or less that had been considered optimal.
Med Lett Drugs Ther. 2004 May 10;46(1182):37-9 | Show Full IntroductionHide Full Introduction

Rosuvastatin - a New Lipid-lowering Drug

   
The Medical Letter on Drugs and Therapeutics • October 13, 2003;  (Issue 1167)
Rosuvastatin (Crestor - AstraZeneca), an HMG-CoA reductase inhibitor (or "statin"), was recently approved by the FDA for lowering serum cholesterol and triglyceride concentrations and raising HDL cholesterol...
Rosuvastatin (Crestor - AstraZeneca), an HMG-CoA reductase inhibitor (or "statin"), was recently approved by the FDA for lowering serum cholesterol and triglyceride concentrations and raising HDL cholesterol levels. Rosuvastatin, like other statins, inhibits the enzyme that catalyzes the rate-limiting step in cholesterol synthesis, but it is claimed to be more potent than the others. All of these drugs must be taken indefinitely; if they are discontinued, lipid levels return to baseline.
Med Lett Drugs Ther. 2003 Oct 13;45(1167):81-3 | Show Full IntroductionHide Full Introduction

Drugs For Lipid Disorders

   
The Medical Letter on Drugs and Therapeutics • August 1, 2003;  (Issue 12)
Drugs that lower low-density lipoprotein (LDL) cholesterol concentrations can prevent formation, slow progression and cause regression of atherosclerotic lesions, and also improve vasodilatation. In controlled...
Drugs that lower low-density lipoprotein (LDL) cholesterol concentrations can prevent formation, slow progression and cause regression of atherosclerotic lesions, and also improve vasodilatation. In controlled trials in patients with coronary disease, they have reduced mortality by 30% to 40%. Lipid-regulating drugs must be taken indefinitely; when they are stopped, plasma lipid levels return to pretreatment levels in 2-3 weeks.
Treat Guidel Med Lett. 2003 Aug;1(12):77-82 | Show Full IntroductionHide Full Introduction

Three New Drugs for Hyperlipidemia

   
The Medical Letter on Drugs and Therapeutics • March 3, 2003;  (Issue 1151)
The FDA recently approved three new drugs for treatment of hyperlipidemia. Ezetimibe (ez et' i mibe; Zetia) is the first in a new class of drugs that inhibit intestinal absorption of cholesterol....
The FDA recently approved three new drugs for treatment of hyperlipidemia. Ezetimibe (ez et' i mibe; Zetia) is the first in a new class of drugs that inhibit intestinal absorption of cholesterol. Extended-release lovastatin (Altocor) is a new formulation of lovastatin (Mevacor, and others). Extended-release niacin plus (immediate-release) lovastatin (Advicor) is the first fixed-dose combination of lipid-lowering drugs.
Med Lett Drugs Ther. 2003 Mar 3;45(1151):17-9 | Show Full IntroductionHide Full Introduction

Choice of Lipid-Regulating Drugs

   
The Medical Letter on Drugs and Therapeutics • May 28, 2001;  (Issue 1105)
New recommendations for drug treatment of hypercholesterolemia, if widely followed, will lead to a marked increase in the number of people taking lipid-regulating...
New recommendations for drug treatment of hypercholesterolemia, if widely followed, will lead to a marked increase in the number of people taking lipid-regulating drugs.
Med Lett Drugs Ther. 2001 May 28;43(1105):43-8 | Show Full IntroductionHide Full Introduction

Home Testing of Cholesterol

   
The Medical Letter on Drugs and Therapeutics • September 30, 1994;  (Issue 932)
The new Advanced Care Cholesterol Test (Johnson & Johnson) now being advertised to the general public encourages patients to test their own serum cholesterol concentrations. Approved by the US Food and Drug...
The new Advanced Care Cholesterol Test (Johnson & Johnson) now being advertised to the general public encourages patients to test their own serum cholesterol concentrations. Approved by the US Food and Drug Administration, this product is available in pharmacies without a prescription at a cost of about $20 for a single determination.
Med Lett Drugs Ther. 1994 Sep 30;36(932):85-6 | Show Full IntroductionHide Full Introduction

Fluvastatin for Lowering Cholesterol

   
The Medical Letter on Drugs and Therapeutics • May 27, 1994;  (Issue 923)
Fluvastatin (Lescol - Sandoz), an HMG-CoA reductase inhibitor, was recently marketed in the USA for treatment of hypercholesterolemia. A synthetic mevalonolactone derivative, it is chemically distinct from...
Fluvastatin (Lescol - Sandoz), an HMG-CoA reductase inhibitor, was recently marketed in the USA for treatment of hypercholesterolemia. A synthetic mevalonolactone derivative, it is chemically distinct from previously available drugs in this class.
Med Lett Drugs Ther. 1994 May 27;36(923):45-6 | Show Full IntroductionHide Full Introduction

Choice of Cholesterol-Lowering Drugs

   
The Medical Letter on Drugs and Therapeutics • March 5, 1993;  (Issue 891)
Lowering elevated serum cholesterol concentrations can slow progression and sometimes cause regression of atherosclerotic lesions. Most authorities advise patients with high cholesterol concentrations to eat...
Lowering elevated serum cholesterol concentrations can slow progression and sometimes cause regression of atherosclerotic lesions. Most authorities advise patients with high cholesterol concentrations to eat less fat and less cholesterol and, when appropriate, to lose weight. If these measures do not lower serum lipids sufficiently, drugs are frequently added to the regimen. When drugs are discontinued, serum cholesterol concentrations generally return to pretreatment levels.
Med Lett Drugs Ther. 1993 Mar 5;35(891):19-22 | Show Full IntroductionHide Full Introduction

Pravastatin, Simvastatin, and Lovastatin For Serum Cholesterol Concentrations

   
The Medical Letter on Drugs and Therapeutics • June 12, 1992;  (Issue 872)
Pravastatin - Bristol-Myers Squibb) and simvastatin (Zocor -Merck), two new inhibitors of cholesterol synthesis similar to lovastatin (Mevacor - Merck), have now been marketed in the USA for treatment of...
Pravastatin - Bristol-Myers Squibb) and simvastatin (Zocor -Merck), two new inhibitors of cholesterol synthesis similar to lovastatin (Mevacor - Merck), have now been marketed in the USA for treatment of hypercholesterolemia. Lovastatin (Medical Letter, 29:99, 1987) is the most frequently prescribed of all cholesterol-lowering drugs in the USA. Pravastatin and simvastatin were previously reviewed in The Medical Letter when they became available in Canada (volume 33, page 18, 1991).
Med Lett Drugs Ther. 1992 Jun 12;34(872):57-8 | Show Full IntroductionHide Full Introduction

A Subdermal Progestin Implant For Long-Term Contraception

   
The Medical Letter on Drugs and Therapeutics • March 8, 1991;  (Issue 839)
The Norplant System (Wyeth-Ayerst) for subdermal delivery of the synthetic progestin levonorgestrel was recently approved by the US Food and Drug Administration for use as a long-term...
The Norplant System (Wyeth-Ayerst) for subdermal delivery of the synthetic progestin levonorgestrel was recently approved by the US Food and Drug Administration for use as a long-term contraceptive.
Med Lett Drugs Ther. 1991 Mar 8;33(839):17-8 | Show Full IntroductionHide Full Introduction

Pravastatin And Simvastatin for Hypercholesterolemia

   
The Medical Letter on Drugs and Therapeutics • March 8, 1991;  (Issue 839)
Pravastatin (Pravachol - Bristol-Myers Squibb) and simvastatin (Zocor - Merck), two new inhibitors of cholesterol synthesis similar to lovastatin (Mevacor - Merck), have been marketed in Canada and several...
Pravastatin (Pravachol - Bristol-Myers Squibb) and simvastatin (Zocor - Merck), two new inhibitors of cholesterol synthesis similar to lovastatin (Mevacor - Merck), have been marketed in Canada and several European countries and may soon be available in the USA for treatment of high plasma cholesterol concentrations. Drugs already marketed here for this indication were recently reviewed in The Medical Letter (Volume 33, page 1, January 11, 1991).
Med Lett Drugs Ther. 1991 Mar 8;33(839):18-20 | Show Full IntroductionHide Full Introduction

Choice Of Cholesterol-Lowering Drugs

   
The Medical Letter on Drugs and Therapeutics • January 11, 1991;  (Issue 835)
Recent reports indicate that lowering elevated serum cholesterol concentrations not only decreases mortality from coronary artery disease, but may cause regression of atherosclerotic lesions (JP Kane et al,...
Recent reports indicate that lowering elevated serum cholesterol concentrations not only decreases mortality from coronary artery disease, but may cause regression of atherosclerotic lesions (JP Kane et al, JAMA, 264:3007, Dec 19, 1990). Most authorities advise patients with high cholesterol concentrations to eat less saturated and total fat and lose weight. If these measures do not lower serum lipids, drugs are frequently added to the regimen. When drugs are discontinued, serum cholesterol concentrations generally return to pretreatment levels.
Med Lett Drugs Ther. 1991 Jan 11;33(835):1-4 | Show Full IntroductionHide Full Introduction

Oat Bran for Lowering Blood Lipids

   
The Medical Letter on Drugs and Therapeutics • December 2, 1988;  (Issue 780)
Oat bran, the ground inner husk of the grain, has recently become popular as a dietary means of lowering blood lipids. It is available both separately and as a constituent of oatmeal, which is the ground...
Oat bran, the ground inner husk of the grain, has recently become popular as a dietary means of lowering blood lipids. It is available both separately and as a constituent of oatmeal, which is the ground product of the whole grain. Oat bran and oatmeal are available in various breakfast cereals and can also be used in baked goods, such as muffins or bread. Some of these sources are listed in the table on page 112.
Med Lett Drugs Ther. 1988 Dec 2;30(780):111-2 | Show Full IntroductionHide Full Introduction

Choice of Cholesterol-Lowering Drugs

   
The Medical Letter on Drugs and Therapeutics • September 9, 1988;  (Issue 774)
The recent surge of interest in lowering serum cholesterol concentrations has led to vigorous promotion of various hypocholesterolemic drugs in the USA. Since the risk of coronary heart disease is increased in...
The recent surge of interest in lowering serum cholesterol concentrations has led to vigorous promotion of various hypocholesterolemic drugs in the USA. Since the risk of coronary heart disease is increased in patients with high serum cholesterol concentrations, most authorities advise such patients to eat less fat and try to lose weight (The Expert Panel, Arch Intern Med, 148:36, 1988). When these measures fail, cholesterol-lowering drugs are frequently recommended.
Med Lett Drugs Ther. 1988 Sep 9;30(774):85-8 | Show Full IntroductionHide Full Introduction

Ursodiol for Dissolving Cholesterol Gallstones

   
The Medical Letter on Drugs and Therapeutics • August 26, 1988;  (Issue 773)
Ursodiol (ursodeoxycholic acid), a naturally occurring bile acid, will soon be marketed in the USA as (Ciba-Geigy), an oral drug for dissolution of gallbladder stones. The labeling for the drug, which has...
Ursodiol (ursodeoxycholic acid), a naturally occurring bile acid, will soon be marketed in the USA as (Ciba-Geigy), an oral drug for dissolution of gallbladder stones. The labeling for the drug, which has been available in other countries for the past ten years, will restrict its use to dissolution of radiolucent, noncalcified gallbladder stones less than 20 mm in diameter in patients who have refused or are at increased risk from surgery.
Med Lett Drugs Ther. 1988 Aug 26;30(773):81-2 | Show Full IntroductionHide Full Introduction