Combining statin drugs with fibrates greatly multiplies danger to patients

It is recommended that patients who are currently taking statins and fibrates to lower their LDL cholesterol check with their doctor to discern the risks of their developing this muscle disease and, if appropriate, seek alternative cholesterol lowering strategies that do not depend on dangerous prescription drugs.

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• Millions of Americans take medications to lower their cholesterol, but one such medication was taken off the market a few years ago after it led to a muscle disorder in those taking it.
• The drugs involved are called statins, drugs used to lower cholesterol.
• "The contents of the muscle cell are released into the blood stream and the pigments that are inside muscle that give muscle its red color get filtered by the kidneys and can cause kidney failure," said Dr. David Graham, of the Food and Drug Administration.
• Dr. David Graham and his colleagues at the FDA and five other research institutions wanted to know if other statins caused the same muscle disorder.
• "The three major statins that are used to treat elevated cholesterol in the United States -- atorvastatin, pravastatin and simvastatin -- had very similar, virtually identical risk of rhabdomyolysis, and this risk was very low," Graham said.
• About one in every 23,000 patients per year treated with one of these statins could develop the muscle disorder, according to the study.
• Graham and his associates also looked at fibrates, another kind of cholesterol medication which increased the risk of rhabdomyolysis by five-fold.
• "What we saw with those patients is that their risk of rhabdomyolysis was increased to a rate of about one in 500 per year."
• But that's nothing compared to what happened when patients took cerivastatin, before it was recalled, in combination with fibrates.
• "For the combination therapy of cerivastatin plus fibrate, the risk of rhabdomyolysis was increased over 1,400-fold.
• Graham said his study shows that the right drug was taken off the market, and that patients can consider the three statins mentioned to be safe.