Indications for LOPID:
Type IV and V hyperlipidemias resistant to dietary management, when TG levels are >1000mg/dL and pancreatitis is likely. Reduction in risk of coronary artery disease in certain Type IIb patients with inadequate response to nonpharmacological management and other pharmacologic agents (eg, bile acid sequestrants, nicotinic acid) and have HDL-C levels <35mg/dL, elevated LDL-C and TG. Limitations of use: not indicated for Type I hyperlipoproteinemia with elevated chylomicrons and triglycerides but have normal VLDL. Not indicated for treating patients with low HDL-C as their only lipid abnormality.
1.2g daily in 2 divided doses 30 mins before AM and PM meals.
Hepatic or severe renal dysfunction. Primary biliary cirrhosis. Gallbladder disease. Concomitant simvastatin, repaglinide, dasabuvir, selexipag.
Monitor serum lipids and liver function. Discontinue if lipid response is inadequate after 3 months, or if persistent liver abnormalities or gallstones develop. Obtain blood counts periodically during first 12 months. Evaluate any signs/symptoms of muscle pain, tenderness, or weakness; discontinue if myositis is suspected. Patients with baseline creatinine >2mg/dL: consider alternative therapy. Elderly. Pregnancy. Nursing mothers: not recommended.
See Contraindications. Caution with concomitant anticoagulants; reduce warfarin dose and monitor. May potentiate CYP2C8 substrates (eg, dabrafenib, enzalutamide [seizure risk], loperamide, montelukast, paclitaxel, pioglitazone, rosiglitazone) or OATP1B1 substrates (eg, atrasentan, atorvastatin, bosentan, ezetimibe, fluvastatin, glyburide, SN-38 [active metabolite of irinotecan], rosuvastatin, pitavastatin, pravastatin, rifampin, valsartan, olmesartan); may need to reduce dose of these substrates. Myopathy, rhabdomyolysis, and acute renal failure with HMG-CoA reductase inhibitors, colchicine (esp. in elderly or renal dysfunction). Separate dosing of bile acid-binding resins (eg, colestipol) by at least 2hrs.
Dyspepsia, abdominal pain, acute appendicitis, atrial fibrillation, gallbladder disease, cholestatic jaundice, blurred vision, hypesthesia, paresthesias, altered taste, dizziness, somnolence, peripheral neuritis, headache, depression, impotence, decreased libido, myopathy, arthralgia, synovitis, abnormal LFTs, blood dyscrasias, angioedema, rash, cataracts.