Replacing statins with fibrates?

[Wardp]

I have been on statins for 5 yrs I have tried most of them but the side effects are now unbearable . neurological and muscle pain sleep disturbance  etc. currently on pravastatin 20 mg when I have stopped stations for a few weeks my symptoms go away.i intend going to bumrungrad hospital and see if I can try fibrates. My questions are.are any members currently on fibrates and are they happy with the results.? Are fibrates expensive in Thailand ? Are there generic brands? Thank you in advance.

Edited September 10, 2022 by Wardp

[lopburi3]

No experience with replacement but it was just added to my medications this week to target triglycerides (which seems to be normal use) - remain on statin Xarator for general lipids.  Have no information on what is available but hospital price (normally about 50% markup) was 1,680 baht for 60 caps of Lipanthyl 200mg.

[Sheryl]

Aside from fibrates another option is ezetimibe.  Depending on how severe your problem, can be used either alone or in combination with fenofibramate. 

 

There are locally made brands of both ezetimibe and fenofibramate. However they do cost more than simvastatin if that is what you were on.

[Wardp]

Total chol 171 trig 80 hdl 65 ldl 100 ...on 20 mg pravastatin. Advice appreciated sheryl on if ezetimibe alone or with fibrates 

[SantiSuk]

On 9/10/2022 at 9:37 PM, Sheryl said:

Aside from fibrates another option is ezetimibe.  Depending on how severe your problem, can be used either alone or in combination with fenofibramate. 

 

There are locally made brands of both ezetimibe and fenofibramate. However they do cost more than simvastatin if that is what you were on.

I have had good experience this summer with replacing 40 mg of atorvastatin - giving me the often-quoted result of muscle pain, exhaustion and sleep disturbance - by 10mg of the same plus 10mg of ezetimibe. The health threads in the UK are full of stories of people's resistance to statins but also stories that should tell you to keep pressing your cardio to get to an acceptable alternative by changing the statin or going for combinations with other lipid controlling meds like ezetimibe.
 

Cost by the way - 250 baht for a strip of 10 (x 10mg 'Sandoz' of Japanese manufacture - equivalent to western brands) at my local pharmacy. More expensive than regular statins but worth it. Note of caution - the above conclusion is provided that my next - and first since the swap-over - lipid tests give the right results).

 

I didn't know there were local generics; might give those a trial sometime once I've had confirmation from the blood tests.

 

[Wardp]

What were your cholesterol readings prior to your change?

[Sheryl]

On 9/10/2022 at 11:25 AM, Wardp said:

Total chol 171 trig 80 hdl 65 ldl 100 ...on 20 mg pravastatin. Advice appreciated sheryl on if ezetimibe alone or with fibrates 

Those are great numbers. Discuss with your doctor but if me I'd try just ezetimibe and repeat labs after about 2 months

[Wardp]

Will ezetimibe be ok with my lad stent 5yrs. Does it work the same as statin? My diet is fairly good chicken fish brown rice veg lentil flaxseed.etc

[Sheryl]

6 hours ago, Wardp said:

Will ezetimibe be ok with my lad stent 5yrs. Does it work the same as statin? My diet is fairly good chicken fish brown rice veg lentil flaxseed.etc

Mechanism of action is different but result is same.

 

It is sometimes given in conjunction with low dose statin but your numbers are so good may not be necessary and you are having adverse effects from the statins

 

 

[Wardp]

Thanks again Sheryl.

[Wardp]

Just an update it's over two weeks since I started ezetimibe,I just had test ,liver kidney function fine actually my gfr is up to 80 from 60, maybe kidney function has improved from stopping statin?,my chol now 175, hdl 75 ldl 87 trig 62. But I have started having leg and arms muscle cramps, I read somewhere that 5 mg works just as good as 10mg so I shall try lowering the dose  and see if it helps. Sharing information is always helpful,