Drug combination therapy for selected hyperlipidemic patients

Abstract

We performed individual patient clinical trials with hypolipidemic drug combinations in thirty-one patients who failed to either tolerate or normalize their lipid profile with single drug treatment. Type IIA, IIB or IV hyperlipoproteinemics were randomly assigned to sequential treatment with resins, lovastatin, fish oil, niacin or gemfibrozil alone or in combination. In successful cases, lovastatin plus resin exerted greater hypolipidemic effect than either one alone or than twice the lovastatin dose. Lovastatin suppressed the hypertriglyceridemic effect of resins. Fish oil plus resin prevented the undesirable effects of resin on triglycerides and of fish oil on LDL-C levels. Fish oil plus niacin resulted in better control of LDL-C and triglycerides than either alone. Fish oil and gemfibrozil had additive hypotriglyceridemic effects. In selected patients, hypolipidemic drug combinations may result in more effective control of serum lipid levels than monotherapy.