HYPERTRIGLYCERIDEMIA - MEDICINES FOR THE TREATMENT OF HIGH TRIGLYCERIDES - MEDICATIONS

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Medicines to Treat Hypertriglyceridemia

Definition

Hypertriglyceridemia is a form of dyslipidemia: it is a disease in which the serum levels of triglycerides in an individual are much higher than normal. In an adult man, we speak of high triglycerides when their concentration in the blood is between 200 and 499 mg / dl, higher values refer to an extremely serious condition. Often hypertriglyceridemia is also associated with an exaggerated increase in bad cholesterol levels in the blood.

hypertriglyceridemia greatly increases the risk of cardiovascular disease

Causes

There are numerous cases of familial hypertriglyceridemia, therefore dependent on a genetic defect: in this case, high triglycerides are not related in any way to hypercholesterolemia. , corticosteroids, diuretics, estrogens, birth control pills, retinoids), alcoholism, diet rich in carbohydrates, diabetes mellitus, pregnancy, hypothyroidism, sedentary lifestyle, Cushing's syndrome, smoking.

Symptoms

Hypertriglyceridemia is often framed in the context of the metabolic syndrome, characterized by diabetes, hypertension and obesity, which exponentially increases the risk of contracting cardiovascular diseases, such as angina pectoris, atherosclerosis, coronary heart disease, heart attack and thrombosis.

Complications (triglycerides> 1000mg / dl): painful abdominal crises, acute pancreatitis, xanthoma

Diet and Nutrition

The information on Hypertriglyceridemia - High Triglyceride Medicines is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Hypertriglyceridemia - High Triglyceride Medicines.

Medicines

The goal of the treatment is the control of all those satellite pathological conditions that are associated with hypertriglyceridemia: as we have seen, often high triglycerides are also accompanied by an "alteration in blood pressure and serum cholesterol values, by" obesity , from the unbalanced diet and sedentary lifestyle. It is precisely from here that the treatment must begin: the correction of predisposing factors, in fact, falls both among the primary prevention rules of hypertriglyceridemia, and among the prophylactic measures to contain cardiovascular risk. The people most at risk are all those who they record a genetic propensity to hypertriglyceridemia, those with a previous history of heart attack, diabetics over 40 years of age, smokers and alcoholics.
It is therefore recommended to follow the rules dictated by dietary education, so do not exceed with sugars, do not consume too abundant meals, limit the consumption of lipids, chew slowly, prefer fish to meat, consume foods rich in antioxidants and practice constant physical exercise.

To understand: but why do you have to limit sugars (carbohydrates) if the problem in question is the increase in triglycerides (fats)?
The exaggerated administration of simple sugars and carbohydrates over 60% of the total daily energy favors the increase of triglycerides in the blood, since sugars, not having an effective storage system such as lipids, arrived in the liver are transformed into triglycerides .

Drug therapy is often essential to keep triglyceride levels within the physiological range; fibrates are the most used drugs to treat familial hypertriglyceridemia, but statins are also effective (particularly suitable for lowering bad cholesterol levels in the blood), nicotinic acid derivatives, omega-3 acids and bile acid sequestrants. It should be emphasized that it would be useless and unintelligent to follow a drug treatment for hypertriglyceridemia in the absence of a healthy, balanced diet and sports.

The following are the classes of drugs most used in the therapy for hypertriglyceridimia, and some examples of pharmacological specialties; it is up to the doctor to choose the most suitable active ingredient and dosage for the patient, based on the severity of the disease, the state of health of the patient and his response to treatment:

Fibrates: drugs of choice for the treatment of hypertriglyceridemia, especially when triglycerides exceed the value of 885mg / dl. Fibrates can also have varying therapeutic effects on bad cholesterol levels. However, it is advisable to start treatment first with a statin, and then move on to treatment with fibrates (if the combination is tolerated); clearly, in case of resistance to statins, it is recommended to choose a fibrate. patients with type 2 diabetes, hypercholesterolemia and hypertriglyceridemia, it is recommended to start therapy with a statin (for 6 months), combining subsequently a fibrate when triglyceride levels exceed 204mg / dl.

Fenofibrate (eg Lipsin, Fulcro, Fenolibs, Lipofene): the dosage involves taking a dose of active equal to 200 mg (1 capsule), once a day; alternatively, take 3 capsules of 67 mg per day.
Gemfibrozil (eg. LOPID, Genlip, Gemfibrozil DOC): for the treatment of hypertriglyceridemia, the normally recommended posology is 600 mg of active ingredient to be taken orally, divided equally into three daily doses, preferably 30 minutes before breakfast and dinner Alternatively, take the long-acting tablets: 400 mg, once daily, after meals.

Statins: although they are also used to reduce serum triglyceride levels, statins are most used in therapy to lower bad cholesterol levels in the blood; however, they are also effective in the treatment of mild hypertriglyceridemia. These drugs exert their therapeutic activity through the inhibition of the enzyme 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase, involved in the synthesis of cholesterol in the liver Statins prevent cardiovascular events and associated mortality;

Atorvastatin (eg Totalip, Torvast, Xarator). Typically, the starting dose ranges from 10 to 40 mg per day, to be taken orally. Continue with this dosage for 2-4 weeks. The maintenance dose provides for the assumption of 10-80 mg of active per day. For children with familial hypertriglyceridemia, it is recommended to take 10 mg per day (max. 20 mg), possibly modulating the dose every 4 weeks, in based on the subject's response to treatment.
Simvastatin (eg Zocor, Simvastat, Omistat, Quibus, Setorilin). It is recommended to start treatment with a dose ranging from 10 to 20 mg, to be taken orally, once a day. The maintenance dose involves taking 5-40 mg of active daily (once a day, in the evening). Sometimes the drug is formulated with other active ingredients, such as Sitagliptin (eg Juvisync), useful for fighting diabetes in the context of hypercholesterolemia / hypertriglyceridemia, and Ezetimibe (eg Vytorin). For the treatment of familial hypertriglyceridemia, it is advisable to take a drug dose of 10 mg for children between 10 and 17 years of age, possibly modulating the dose every 4 weeks. For children under 5 years of age having this problem, reduce the initial dose to 5 mg per day, and then gradually increase it up to 10 mg / day, every 4 weeks Do not exceed 20 mg / day.
Pravastatin (eg Selectin, Langiprav, Sanaprav). Indicatively, for the treatment of hypertriglyceridemia, take the drug at a dosage of 10-40 mg, orally, once a day. For the maintenance dose, it is possible to take 40-80 mg of the drug per day (the increase dose can be done every 4 weeks). The pediatric dose for the treatment of familial hypertriglyceridaemia suggests taking 20 mg of the drug orally, once a day for children aged between 8 and 13 years, while from 14 to 18 years, it is possible to increase the dose up to 40 mg, to be taken by mouth once a day.

Derivatives of nicotinic acid: nicotinic acid, in monotherapy, is not widely used, due to its considerable side effects. However, it is observed that at a dosage of 1.5-3 mg per day, the drug inhibits the synthesis of triglycerides and cholesterol, thus lowering the serum levels. The drug can be combined with a statin, in order to obtain a better control on the lipid profile.

Acipomix (eg Olbetam): it is a derivative of nicotinic acid, used in therapy for the treatment of hypertriglyceridemia, at a dosage of 500-750 mg per day, equally divided into several daily doses. The drug, although it causes fewer side effects than nicotinic acid, is also less effective. Consult your doctor.

Compounds of omega-3 acids: this category includes both marine omega-3 triglycerides and the ethyl esters of omega-3 acids. They are indicated for the treatment of:

Hypertriglyceridemia, as an alternative to fibrates
Hyperlipidemia in general, associated with a statin

The administration of omega-3 acid compounds is very useful to prevent complications (eg pancreatitis) deriving from hypertriglyceridemia (Triglycerides> 885mg / dl)

Omega-3 (eg. Esapent, Seacor, Eskim): indicatively, take 4 grams of the drug per day, in a single dose or in two divided doses. For the precise dosage: consult your doctor.

Sequestrants of bile acids: indicated only in case of resistance to statins in the context of hypertriglyceridemia. They are more suitable for the treatment of high cholesterol; paradoxically, in some patients the administration of these drugs (alone) can even worsen the hypertriglyceridemia. For this reason, only the drugs and pharmacological specialties belonging to this category are listed below, but not the posology. Consult your doctor.