Dave-K
08-20-2006, 06:28 PM
I guess it's about time to check in.
My latest results:
Total Cholesterol: 179
HDL: 38
LDL: 68
Triglycerides: 365
I like the results but my Tryglicerides are up 100 points. My diet hasn't been that great so I'm going to be more conscious going forward and see what the next results look like.
I have been taking Vytorin for the past 6 months or so but now my doctor wants me to take Tricor (48mg) along with the Vytorin (10/40mg). I checked out the drug interactions and I did not like what I was looking at.
I called the doctors office and told the nurse that I did not want to take the Tricor because of the side effects and... after playing phone tag, I finally told them that they should call my wife if I was not available. I gave my wife all the information on the side effects and ... the doctor decided he wants to switch me to Zocor and Tricor?! I told my wife, since I was unable to get through to the office to tell the doctor that I have been on the Statin Curcuit and I want to stick to Vytorin.
In the end, I had to call the doctors office and all the girl kept saying was "The Doctor still wants you to take the Zocor and the Tricor", so I told her I would fax her over the sheet I had on the drug combination but she said "The doctor already knows". I told her I wanted to speak with the doc directly and ... I have to make an appointment. So I have an appointment in two weeks. Oui!
I'm not sure that my Triglyceride level warrant me taking Tricor but what do you guys think?
Dave
My latest results:
Total Cholesterol: 179
HDL: 38
LDL: 68
Triglycerides: 365
I like the results but my Tryglicerides are up 100 points. My diet hasn't been that great so I'm going to be more conscious going forward and see what the next results look like.
I have been taking Vytorin for the past 6 months or so but now my doctor wants me to take Tricor (48mg) along with the Vytorin (10/40mg). I checked out the drug interactions and I did not like what I was looking at.
I called the doctors office and told the nurse that I did not want to take the Tricor because of the side effects and... after playing phone tag, I finally told them that they should call my wife if I was not available. I gave my wife all the information on the side effects and ... the doctor decided he wants to switch me to Zocor and Tricor?! I told my wife, since I was unable to get through to the office to tell the doctor that I have been on the Statin Curcuit and I want to stick to Vytorin.
In the end, I had to call the doctors office and all the girl kept saying was "The Doctor still wants you to take the Zocor and the Tricor", so I told her I would fax her over the sheet I had on the drug combination but she said "The doctor already knows". I told her I wanted to speak with the doc directly and ... I have to make an appointment. So I have an appointment in two weeks. Oui!
I'm not sure that my Triglyceride level warrant me taking Tricor but what do you guys think?
Dave
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Lenin
08-21-2006, 09:41 AM
Dave,
I'll go with your doctor.
The Tricor is specifically aimed at your triglycerides, a problem for you.
The switch to Zocor (simvastatin) from Vytorin (simvastain + ezetimibe) is merely the loss of one of the drugs, ezetimibe, that can be hard on the liver and muscles.
Give it a month with the Zocor and Tricor and have a retest to see what you cholesterol numbers look like...have you liver enzymes, ALT and AST run at the same time.
I think you'll be happy with the combo.
I'll go with your doctor.
The Tricor is specifically aimed at your triglycerides, a problem for you.
The switch to Zocor (simvastatin) from Vytorin (simvastain + ezetimibe) is merely the loss of one of the drugs, ezetimibe, that can be hard on the liver and muscles.
Give it a month with the Zocor and Tricor and have a retest to see what you cholesterol numbers look like...have you liver enzymes, ALT and AST run at the same time.
I think you'll be happy with the combo.
Dave-K
08-21-2006, 10:54 PM
Thanks Lenin,
See.. there I was, ready to fight the doctor and you come in and say to give it a try! I reluctantly started with the Tricor last week and today I got my perscription filled for the Simvastatin and will stop taking the Vytorin today and replace it with the Simvastatin.
The one thing I really need to work on is the right diet, I don't want to take these meds forever. Let me ask you this (or anyone else reading this) once you get those numbers down on statins- is it in effect, clearing out your system and is there a point in which you can stop taking them and just maintain it by diet alone? I know there are several answers to that question such as it depends on where the problem is- Food or just the body producing it.
...and if it is being produced in the body, are there other options other than statins? such as Zetia?
Just tossing some things out.
Dave
See.. there I was, ready to fight the doctor and you come in and say to give it a try! I reluctantly started with the Tricor last week and today I got my perscription filled for the Simvastatin and will stop taking the Vytorin today and replace it with the Simvastatin.
The one thing I really need to work on is the right diet, I don't want to take these meds forever. Let me ask you this (or anyone else reading this) once you get those numbers down on statins- is it in effect, clearing out your system and is there a point in which you can stop taking them and just maintain it by diet alone? I know there are several answers to that question such as it depends on where the problem is- Food or just the body producing it.
...and if it is being produced in the body, are there other options other than statins? such as Zetia?
Just tossing some things out.
Dave
Lenin
08-22-2006, 08:17 AM
Dave,
Alas, you can get the same effect by doing "the good life" now as you can by taking anti-cholesterol meds and THEN doing all the right things. Since high cholesterol isn't a disease that can be cured, it must be managed day in and day out for the rest of our lives. That management can either be stringent diet, exercise, and weight control or cholesterol controlling drugs.
So no, I do not think that anyonce should look at these drugs as something to help "get over the hump." Even worse, many people have bad blood lipids genetically and no amount of good living will help enough.
That Zetia, ezetimibe, is exactly the drug you just left behind in the Vytorin.
Alas, you can get the same effect by doing "the good life" now as you can by taking anti-cholesterol meds and THEN doing all the right things. Since high cholesterol isn't a disease that can be cured, it must be managed day in and day out for the rest of our lives. That management can either be stringent diet, exercise, and weight control or cholesterol controlling drugs.
So no, I do not think that anyonce should look at these drugs as something to help "get over the hump." Even worse, many people have bad blood lipids genetically and no amount of good living will help enough.
That Zetia, ezetimibe, is exactly the drug you just left behind in the Vytorin.
vipergg22
08-23-2006, 10:01 PM
I would share your concern about mixing fenofibrates and statins this is not a great idea unless your levels are severe which they do not appear to be , below is blurb from the warnings from tricor. CPK checks do not always catch the problems early enough.
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Dave-K
08-23-2006, 11:41 PM
I read something similar and I felt uncomfortable with the combination. My last doctor kept switching me from one Statin to another and I told this doctor I did not want to be anyones guinny (sp) pig. I am scheduled to see the doctor next tuesday as, apparently you can't talk to the doctor over the phone about your concerns.....however, I may just give it a month, see how my labs come out before making a decision. At the same time I'm adjusting my diet so I'm sure if my Tri's are better, my doctor will take credit. :-)
Dave
Dave
Lenin
08-24-2006, 08:52 AM
Dave,
I judge a triglyceride level of 365 in the presence of an HDL of 35 to be QUITE severe and an agent that attacks triglycerides directly seems to be very important.
An increase of 28% in the AUC (area under curve, or a measure of total drug exposure) of the statin doesn't seem too significant and perhaps might lend itself to an effective reduction of the Zocor.
The main effect of the fibrate and the fibrate-stating combo, as others have said, is to the liver and thus measuring liver functions AND CPK for muscle damage is important...have them run at 30 days and then maybe 90 days later.
If you want to give it a try WITHOUT the TRICOR, why not do a month with no alcohol or sugar and see what you get? But familial hypertriglyceridemia is a tough nut to crack.
I judge a triglyceride level of 365 in the presence of an HDL of 35 to be QUITE severe and an agent that attacks triglycerides directly seems to be very important.
An increase of 28% in the AUC (area under curve, or a measure of total drug exposure) of the statin doesn't seem too significant and perhaps might lend itself to an effective reduction of the Zocor.
The main effect of the fibrate and the fibrate-stating combo, as others have said, is to the liver and thus measuring liver functions AND CPK for muscle damage is important...have them run at 30 days and then maybe 90 days later.
If you want to give it a try WITHOUT the TRICOR, why not do a month with no alcohol or sugar and see what you get? But familial hypertriglyceridemia is a tough nut to crack.
vipergg22
08-24-2006, 09:31 AM
If it was me with Daves numbers I would take Tricor alone as this will keep regular choleterol down on its own along with lowering tri's . To keep side effects down always take the lowest possible dose or doses to get the job done . The rest of his numbers look pretty good other than the slightly low hdl . Tricor will lower regular cholesterol and raise the hdl along with lowering tri's . I would first try the lowest available dose of tricor first , just this guys opinion though . I have lived the damage these drugs can do ....
Lenin
08-25-2006, 10:18 AM
Unfortunately viper,
Dave's numbers were achieved with 6 months of daily simvastatin and ezetimibe, so that while decent now, they would SOAR with just the TRICOR.
If the numbers reported were the BASELINE numbers, I'd agree with you completely: only the triglycerides are the problem. But it seems Dave needs the simvastain to get the LDL and TC to manageable levels.
Dave's numbers were achieved with 6 months of daily simvastatin and ezetimibe, so that while decent now, they would SOAR with just the TRICOR.
If the numbers reported were the BASELINE numbers, I'd agree with you completely: only the triglycerides are the problem. But it seems Dave needs the simvastain to get the LDL and TC to manageable levels.