Friday, February 29, 2008


Here's the latest two-fer-one pill newly approved by the FDA. Two-fers are a real boon to patients with age and weight-related metabolic troubles who struggle with hypertension, cholesterol abnormalities, and abnormal blood sugar levels. Not only are two-fer drugs less expensive by one co-pay, they increase compliance by decreasing pills swallowed per day. I love Lotrel (now available generically, combines an ACE inhibitor with a vasodilator for really good blood pressure control) and lisinopril/HCTZ which pairs an ACE inhibitor with a diuretic, also for hypertension. Diabetics also have a choice of this-plus-that drugs, including Actosplusmet and Janumet.

The problem with medicating cholesterol troubles is that no one drug addresses all the fat-related abnormalities. The statins have little effect on triglycerides and virtually no effect on HDL-cholesterol, drugs like Tricor don't change LDL-cholesterol much, and nobody likes niacin. Niacin, however, favorably lowers triglycerides and raises HDL-cholesterol, and the manufacturers of Niaspan have gone to a lot of trouble to make their extended-release niacin more tolerable.

Up until this month, we had two cholesterol-lowering two-fers. Vytorin teamed up Zocor and Zetia, but we all know what happened to Zetia this year. The other one called Advicor pairs lovastatin, a weakish sort of statin, with niacin. Enter Simcor, a combo of Zocor (simvastatin) plus extended-release niacin. Not only did study patients on Simcor 1000/20 achieve significantly better cholesterol scores compared with those on simvastatin 20 mg alone, the combination product lowered triglyceride levels by 27%.

1 comment:

Mauigirl said...

Good to know,thanks for posting this!