I have been unable to find a lipid-lowering medication that is dye-free for my hyperlipidemic patient who is allergic to all dyes. Any suggestions?—HEATHER EMANUEL, PA-C, Lacona, N.Y.
First, take a thorough history to make sure your patient is truly allergic to the offending medications. Many patients who claim allergy do not have convincing histories. All the same, use caution, and if the history suggests even a possibility of drug allergy, weigh the benefits of lipid-lowering therapy against the risk of a possible reaction. Sorting out the indications for therapy (primary vs. secondary prevention) and discussing nonpharmacologic interventions (e.g., diet and exercise) may help.—Reuben W. Zimmerman, PA-C (134-1)