Matching articles for "Colesevelam"
Lipid-Lowering Drugs
The Medical Letter on Drugs and Therapeutics • September 19, 2022; (Issue 1659)
Cholesterol management guidelines from the
American College of Cardiology/American Heart
Association Task Force were last published in...
Cholesterol management guidelines from the
American College of Cardiology/American Heart
Association Task Force were last published in 2019.
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
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.
Drugs for Irritable Bowel Syndrome
The Medical Letter on Drugs and Therapeutics • March 23, 2020; (Issue 1594)
Irritable bowel syndrome (IBS) is a common disorder
characterized by recurrent abdominal pain and altered
bowel habits, often accompanied by bloating.IBS
is classified according to the predominant...
Irritable bowel syndrome (IBS) is a common disorder
characterized by recurrent abdominal pain and altered
bowel habits, often accompanied by bloating.IBS
is classified according to the predominant bowel
symptom as IBS with constipation (IBS-C), IBS with
diarrhea (IBS-D), mixed type (IBS-M), or unclassified
(IBS-U). Alterations in the microbiome, stress
responses, sensory and motor function of the gut,
and host genetic factors may be contributing factors.
Since the exact cause of IBS is unknown, the goal of
treatment is symptom control.
Table: Safety of Drugs for IBS in Pregnancy and Lactation (online only)
The Medical Letter on Drugs and Therapeutics • March 23, 2020; (Issue 1594)
...
View the Table: Safety of Drugs for IBS in Pregnancy and Lactation
Drugs for Type 2 Diabetes
The Medical Letter on Drugs and Therapeutics • November 4, 2019; (Issue 1584)
Diet, exercise, and weight loss can improve glycemic
control, but almost all patients with type 2 diabetes
eventually require drug therapy. Treating to a glycated
hemoglobin (A1C) concentration of...
Diet, exercise, and weight loss can improve glycemic
control, but almost all patients with type 2 diabetes
eventually require drug therapy. Treating to a glycated
hemoglobin (A1C) concentration of <7% can prevent
microvascular complications (retinopathy, nephropathy,
and neuropathy), but whether it prevents macrovascular
complications and death is unclear. An A1C target of
<8% may be appropriate for older patients and those
with underlying cardiovascular disease (CVD), a history
of severe hypoglycemia, diabetes-related complications,
a limited life expectancy, or a long duration of disease.
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.
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
Drugs for Type 2 Diabetes
The Medical Letter on Drugs and Therapeutics • January 16, 2017; (Issue 1512)
The goal of drug therapy for type 2 diabetes is
to achieve and maintain a near-normal glycated
hemoglobin (A1C) concentration without inducing
hypoglycemia; the target is generally an A1C of
≤7%. Treating...
The goal of drug therapy for type 2 diabetes is
to achieve and maintain a near-normal glycated
hemoglobin (A1C) concentration without inducing
hypoglycemia; the target is generally an A1C of
≤7%. Treating to this target has been shown to
prevent microvascular complications (retinopathy,
nephropathy, and neuropathy), but whether it prevents
macrovascular outcomes is unclear. An A1C target of
<8% may be appropriate for older patients and those
with underlying cardiovascular disease, a history of
severe hypoglycemia, diabetes-related complications
or comorbidities, or a long duration of disease.
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.
Drugs for Irritable Bowel Syndrome
The Medical Letter on Drugs and Therapeutics • September 26, 2016; (Issue 1504)
Irritable bowel syndrome (IBS) is a common disorder
characterized by chronic, intermittent abdominal pain
or discomfort and altered bowel habits. It is subtyped
according to the predominant bowel symptom as...
Irritable bowel syndrome (IBS) is a common disorder
characterized by chronic, intermittent abdominal pain
or discomfort and altered bowel habits. It is subtyped
according to the predominant bowel symptom as IBS
with constipation (IBS-C), IBS with diarrhea (IBS-D),
mixed type (IBS-M), or unclassified (IBS-U). Since the
exact cause of IBS is unknown, the goal of treatment
is symptom control.
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.
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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.
- 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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Drugs for Type 2 Diabetes
The Medical Letter on Drugs and Therapeutics • March 1, 2014; (Issue 139)
The goal of drug therapy for type 2 diabetes is to achieve and
maintain a near-normal A1C concentration without
inducing hypoglycemia; the target is generally an A1C
of 10,000 patients with type 2...
The goal of drug therapy for type 2 diabetes is to achieve and
maintain a near-normal A1C concentration without
inducing hypoglycemia; the target is generally an A1C
of <7.0%. Treating to this target has been shown to
prevent the microvascular complications of retinopathy
and nephropathy, but whether it prevents macrovascular
outcomes remains unclear. Three large trials found
that intensive glucose control did not reduce the
incidence of macrovascular events. One of these trials
(ACCORD) in >10,000 patients with type 2 diabetes,
with or at high-risk for cardiovascular disease, found
that treating patients intensively with antihyperglycemic
drugs to an A1C target of 6.0% for a mean of 3.7 years
did not significantly reduce the incidence of major
cardiovascular events (the primary endpoint) and was
associated with increased all-cause mortality compared
to patients treated to an A1C target of 7.0-7.9%. An
A1C target of 7-8% may be prudent in older patients
and in those with underlying cardiovascular disease,
severe hypoglycemia, or multiple diabetes-related
complications or co-morbidities.
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.
Drugs for Type 2 Diabetes
The Medical Letter on Drugs and Therapeutics • August 1, 2011; (Issue 108)
The development of hyperglycemia in type 2 diabetes
results from a combination of metabolic abnormalities
that includes insulin resistance, diminished
insulin secretion and excess hepatic glucose...
The development of hyperglycemia in type 2 diabetes
results from a combination of metabolic abnormalities
that includes insulin resistance, diminished
insulin secretion and excess hepatic glucose production.
Diet, exercise and weight loss are helpful in
improving glucose control, but most patients ultimately
require drug therapy.
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.
Drugs for Thyroid Disorders
The Medical Letter on Drugs and Therapeutics • August 1, 2009; (Issue 84)
Primary hypothyroidism is usually the result of Hashimoto's thyroiditis, thyroidectomy for hyperthyroidism, goiter or cancer, or radioactive iodine therapy for...
Primary hypothyroidism is usually the result of Hashimoto's thyroiditis, thyroidectomy for hyperthyroidism, goiter or cancer, or radioactive iodine therapy for hyperthyroidism.
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.
Drugs for Type 2 Diabetes
The Medical Letter on Drugs and Therapeutics • July 1, 2008; (Issue 71)
The development of hyperglycemia in type 2 diabetes results from a combination of metabolic abnormalities including insulin resistance, diminished insulin secretion and excess hepatic glucose production. Diet,...
The development of hyperglycemia in type 2 diabetes results from a combination of metabolic abnormalities including insulin resistance, diminished insulin secretion and excess hepatic glucose production. Diet, exercise and weight loss are helpful in improving glucose control, but most patients ultimately require drug therapy.
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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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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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.
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%.
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.
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.
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.
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.
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.