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What do you recommend for those patients?
QOD Crestor or Lipitor?
Adding CoQ10?
Non-statins - and which ones?
Change to lipophilic or hydro?
I have a patient like this I will be seeing and I don't know her dose history yet. She has intolerance to prava, atorva, rosouva and fluva. She's tried the statins I'd usually switch to already. No h/o fibrates, Zetia or WelChol though.
She needs about 45% LDL reduction (has DM, HTN, advanced age, FH). I'm leaning towards a QOD trial of Crestor at a low dose and titrating up +/- CoQ10 (some people swear by it) because of the statin pleotropic effects. Gemfib won't get her anywhere LDL-wise, but there is the Helsinki data. The only thing she is on is fish oil.
Thoughts? I'm seeing lots of these myalgia patients and they are challenging.
QOD Crestor or Lipitor?
Adding CoQ10?
Non-statins - and which ones?
Change to lipophilic or hydro?
I have a patient like this I will be seeing and I don't know her dose history yet. She has intolerance to prava, atorva, rosouva and fluva. She's tried the statins I'd usually switch to already. No h/o fibrates, Zetia or WelChol though.
She needs about 45% LDL reduction (has DM, HTN, advanced age, FH). I'm leaning towards a QOD trial of Crestor at a low dose and titrating up +/- CoQ10 (some people swear by it) because of the statin pleotropic effects. Gemfib won't get her anywhere LDL-wise, but there is the Helsinki data. The only thing she is on is fish oil.
Thoughts? I'm seeing lots of these myalgia patients and they are challenging.