Chem. there are concerns with using Fibrates WITH statins .
For those on Statins ...Vascepa is probably by far , the best option for most
From Medscape
Among the attractive options for the further lowering of non-HDL-C is the addition of a fibrate. The 2 fibrates currently approved in the United States are gemfibrozil and fenofibrate.
The major concern when using a statin-fibrate combination is the potential increased risk for myopathy and rhabdomyolysis. This risk was originally observed when gemfibrozil was combined with lovastatin,[3] and then became more prominently displayed when gemfibrozil was combined with cerivastatin,[4] leading to the latter agent being withdrawn from the market.
Further evaluation disclosed that gemfibrozil increased the blood concentrations of most statins by partially inhibiting the metabolism (or glucuronidation) of the statin acid byproduct.[5] In contrast, fenofibrate does not use this metabolic pathway and therefore has a minimal effect on the pharmacokinetics of statins, making it safe to use in combination with a statin.
However, as a cautionary note, it is important to recognize the predisposing factors associated with an increased risk for myopathy, whether a statin and/or fenofibrate is used singly or in combination. These include advanced age (> 65 years), impaired renal function (GFR < 30 mL/min), hepatic disease, hypothyroidism, small muscle mass, and female gender.
As such, when initiating this combination, it is often prudent to use a low or starting dose of statin with fenofibrate and then titrate upward as needed toward NCEP goal attainment.
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Believe Fenofibrate is generic ..ie low cost ....but if you can get V for anywhere near the cost mentioned by JT yesterday ...it's unlikely many would want a Fibrate instead .......if lowering TG's was you're sole concern .
Can't recall the Outcome trial using Fibrates ...think it was the ACCORD trial if U want more info
checking the ACCORD trial
"Overall, the ACCORD Lipid trial was negative.
There is no evidence from this trial to indicate that fenofibrate should be routinely added to a statin for the treatment of lipids in patients with type 2 diabetes.
Indeed, routine addition of fenofibrate might be harmful for women with type 2 diabetes.
However, the ACCORD data, together with post hoc analyses of three other fibrate trials, suggest that, when TG is >200 mg/dL and HDL is <35 mg/dL after statin therapy has significantly reduced LDL cholesterol levels, fibrate treatment can be considered, at least in men."
Wow ...forget Fibrates
JMO
Kiwi
