Can You Take Statins and Fibrates Together?

Question: Can You Take Statins and Fibrates Together?

I am not at my LDL cholesterol goal while taking Lipitor, so my doctor recently prescribed a fibrate, Tricor (fenofibrate), to also take to further lower my cholesterol. The package insert says that I should not take a statin and fibrates together. Is this true?

Answer: Not entirely. If your cholesterol levels are not decreasing much, your healthcare provider may want to add another cholesterol lowering medication – especially if your current drug regimen and lifestyle changes aren’t working. Fibrates, like statins, can affect all aspects of your lipid profile, but can especially affect your triglycerides and LDL cholesterol, or “bad” cholesterol.

Taking statins and fibrates together was previously discouraged, however nowadays, this combination has proven useful in providing additional lowering of LDL and triglycerides.

However, there are some things you should watch out for when you first begin taking this combination – just like when beginning a statin or fibrate by itself.

Potential Side Effects

Although these side effects are rare, they can be very serious if you ignore them:

• Myalgia – muscle soreness, tenderness, and weakness

• Soda-colored urine – caused by components resulting from the breakdown of muscle tissue being filtered out into the urine by the kidneys

While taking a fibrate or statin alone can cause these side effects, taking this drug combination can further increase your chances of experiencing these side effects – especially when you first begin taking this combination treatment. Although anyone is at risk for experiencing these side effects, individuals at higher risk include women, those with liver or kidney disease, trauma or surgical patients, diabetics and older individuals.

If you experience any of these symptoms, you should contact your healthcare provider immediately.

A new fibrate on the market, called Trilipix (fenofibric acid), promises to reduce these side effects. In fact, it has been approved by the Food and Drug Administration for use with a statin.

Even if you are feeling great, you should still go to your scheduled appointments. There, your healthcare provider will assess your lipid levels, as well as other aspects of your health.

_Sources:

Shek A, Ferrill MJ. Statin-fibrate combination therapy. Ann Pharmacother. 2001 Jul-Aug;35(7-8):908-17.

Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (PDF), July 2004, The National Institutes of Heath: The National Heart, Lung, and Blood Institute.