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Heart & Cardiology/What to do about uncontrolled lipids despite high dose statins

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Question
I am 57 year old male and medical school graduate. I am facing a problem of uncontrolled lipids since last 10 years despite taking rosuvastatin 20mg. Doc told me to take either Atorvastatin 80mg or rosuvastatin 40mg HS. But I am worried about silent damage it might cause to my liver and to my kidneys through myositis.? Also I have read about side effects such as depression that it causes. My Lipid Profile done in September 2012 is as follows: LDL-175, HDL-25, TG-232, VLDL-47, Total Chol.248. This was while on Rosuvastatin 20mg. Rosuvastatin is expensive so I prefer going back on Atorvastatin. Also is Fenofibrate safe ? Can I take combo of all Atorva+Fenofobrate+Niacin?

Can you suggest me a treatment modification for my Lipid management?

Thanks

Steve.

Answer
Atorvastatin 80mg should be the equivalent of Rosuvastatin 20mg. Ask your doctor about adding Niaspan 500mg to be uptitrated to 2000mg over 3 months. That should further lower your LDL and triglycerides and raise your HDL. If your triglycerides remain elevated you can then add fenofibrate. Good luck!!!
         Dr. P

Heart & Cardiology

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Frank J. Pearl, M.D.

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Voluntary Professor of Medicine, University of Miami Miller School of Medicine, Miami, FL. Board certified in cardiovascular disease

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