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


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?



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

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Frank J. Pearl, M.D.


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

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