In this slide i study about hyperlidimic drugs.

1. ANTI
HYPERLIPIDEMIC
DRUGS

2. HYPERLIPIDEMIA:
➢It is a disorder of lipid metabolism also
called hyperlipoproteinemia, that results
in abnormally high levels of cholesterol,
triglycerides, and lipoproteins in
the blood circulation.

3. Classification Of
Anti Hyperlipidemic Drugs:
➢HMG-CoA Reductase Inhibitors (statins)
➢Fibrates
➢Bile acids sequestrants
➢niacin

4. Mechanism of statins:
HMG CoA Reductase
Acetyl CoA
HMG-CoA
Mevalonate
Squalene Cholestrol
statins

5. HMG CoA reductase inhibitor
Atorva Statin
▪ Generic name: atorva statin
Brands:
➢Lipitor
➢Lova

6. Indications
➢Hyperlipidemia
➢Atherosclerosis
➢Angina

7. Doses:
➢Initial dose: 10 mg or 20 mg orally once
a day
➢Maintenance dose: 10 mg to 80 mg
orally once a day

8. Side effects
➢Headache
➢Muscle pain
➢diabetes

9. Interactions:
➢Grapefruit juice increase blood
level of atorva statin
➢Ciprofloxacin
➢Itraconazole increase the risk of
muscle pain

10. Contraindications:
➢Pregnancy (category X)
➢Lactation
➢Liver disease

11. Counseling:
➢Take atorvastatin at the same time of
day.
➢Take with or without food.
➢Avoid grape fruit juice

12. ROSUVASTIN

13. Indications
• Primary hyperlipidemia (heterozygous
familial and nonfamilial)
• Mixed dyslipidemia and
hypertriglyceridemia.

14. Brand Name
• X-Plended 5-10 mg Tablets.
Dose:
• Adult Dose in primary hyperlipidemia:
• Dose: 5 to 20 mg/day
• Route: PO

15. Side Effects
• The most frequently reported side
effects included headache, myalgia,
abdominal pain, asthenia, and nausea.
• If severe muscle weakness or myopathy
occurs due to statins then along with
statins coenzyme Q10 supplement is
given. It is not a common side effect.

16. Drug Interactions:
• Lopinovir significantly increased
rosuvastatin exposure.

17. Contraindications:
• Liver diseases
• Renal impairment
• Pregnancy
• Lactation
• Hypersensitivity to any component of
product.

18. Precautions:
• Rosuvastatin therapy should be
discontinued if markedly elevated
creatinine kinase levels occur or
myopathy is diagnosed or suspected.

19. FIBRATES
➢Fibrates are derivatives of fibric acid
which are particularly suited to reducing
the triglyceride levels of lipid in the
blood.​

20. drug
➢Generic: Fenofibrate​
➢Brand Name: Fenoget® by Getz
Pharma.
➢Available as: Capsules.
➢Strength: 67 MG, 200MG​

21. Mechanism OF ACTION:

22. INDICATIONS:
➢ Hypercholesterolemia
DOSE:
The dose of fenofibrate Capsules is 150 mg
orally once daily.​

23. DRUG INTERACTIONS:
➢ Immunosuppressants
nephrotoxicity
➢ Anti coagulants increase the
effect of
anti
coagulants

24. side effects:
➢GIT disturbance
➢ gall stone formation.

25. CONTRAINDICATIONS:​
➢ hypersensitivity
➢Pregnancy category C

26. COUNSELING:
➢Eat a low-fat, low-cholesterol diet.​
➢Take the missed dose as soon as you
remember it.
➢Do not take a double dose to make up
for a missed one.​

27. CLOFIBRATE
Brand Names:
Atromid-S

28. Indications
• Hyperlipoproteinemia type III
• Severe hypertriglyceridemia.

29. Dose
Adult Dose in sever hypertriglyceridemia:
Dose: 2 grams
Route: PO

30. Side effects
• Diarrhea
• gall stones

31. Interactions
• liver damage
• Nephrotoxicity
• kidney damage
Contraindications:
• renal or hepatic impairment
• Hypoalbuminemia
• primary biliary cirrhosis
• gallbladder disease

32. Precautions:
Withdraw the drug after 3 months if
adequate response is not achieved. It
should be used with caution in patients
with history of liver disease, jaundice or
peptic ulcer. Perform complete blood
count periodically because anemia and
leukopenia have been reported in patients
taking clofibrate.

33. NIACIN
➢Niacin (nicotinic acid) is one of the
vitamin B complex group.​
➢It can reduce LDL-CH by 10% to 20% and
is the most effective agent for increasing
HDL-CH.

34. MECHANISM OF ACTION:
➢ nicotinic acid strongly inhibits lipolysis
in adipose tissue thereby reducing
production of free fatty acids.

35. drug
➢Generic: Niacin​
➢Brand Name: NIASPAN® extended
release tablets by Abbot.
➢Available as: Tablets.
➢Strength: 500 mg​

36. INDICATIONS:
➢Hyperlipidemia ​
DOSE:
➢Extended-release: 500 mg/day PO at bedtime
initially; dose adjusted every 4 weeks on basis of
effect and tolerance. Not to exceed 1-2 g/day​

37. DRUG INTERACTIONS:
➢Aspirin​ decrease metabolic
clearance of
niacin
➢Statins increase risk of myopathy

38. SIDE EFFECTS:
➢intense cutaneous flush (accompanied
by an uncomfortable feeling of warmth)

39. CONTRAINDICATIONS:
➢ Diabetes​ mellitus
➢ Gout
WARNING AND PRECAUTIONS:
➢ Nicotinic acid should be used with caution in
patient predisposed to gout because of the
elevation of uric acid level.

40. COUNSELING:
➢Avoid drinking hot beverages shortly after taking
niacin. Hot drinks can worsen the flushing effect
(warmth, itching, redness, or tingly feeling under
your skin)

41. BILE ACID SEQUESTRANTS
➢Bile acid sequestrants are ion exchange
resins that bind bile acids in the intestine
and increase the excretion of bile acids
in the stool.

42. MECHANISM OF ACTION

43. COLESTIPOL
Generic:
➢ colestipol
Available brands:
➢Powder for suspension
(Flavored colestid.)
Tablets
➢Colestid.

44. INDICATIONS
➢ Primary Hyperlipidemia

45. SIDE EFFECTS
➢Abdominal pain
➢Constipation
➢Bad taste

46. DOSE
Tablets:
➢ 2 grams per oral/day or 12hr,
➢ Increases of 2 g should occur at 1- or 2-
month intervals,
➢ maximum 16 g/day.
Granules:
➢ 5 grams per oral/day,
➢Increases of 5 grams should occur at 1- or 2-
month intervals,
➢Maximum 30 g/day.

47. INTERACTIONS
COLESTIPOL
with
➢Leflunomide
(immuno suppresant)
➢Deferasirox
(chelating agent)
➢Hydrocortisone (oral) (anti-inflammatory)
➢diuretics

48. contraindication
➢Constipation
➢Gall stone

49. PRECAUTIONS
➢Vitamin K level monthly should be
monitored as it caused its deficiency,
hence increase bleeding.
➢As it is ion exchange resin so it may
cause hyperchoremia acidosis so does
not use it for very long time.

50. counselling
➢Take with plenty of water.
➢In case of missed dose, take it as soon as
you remind it.
➢Colestipol granules mix with liquid, after
administered granules add extra water
to the same glass to mix remaining
granules and drink it to assure full dose.

51. CHOLESTYRAMINE➢Generic:
• Cholestyramine
➢Brands:
• Quastran light
• Prevalite

52. SIDE EFFECTS
• Constipation
• Rashes
• Heart burn

53. DOSE
• 4-8 grams once daily.
• not to exceed 24 g/day.

54. INTERACTIONS
Decrease absorption of all these drugs from GIT
Alfacalcidol (vitamin D3)
Diclofenac Na (NAID)
Hydrochlorothiazide
(diuretics)

55. INDICATIONS
• Bile induced gastritis
• Digitalis toxicity
• Hyperlipidemia

56. CONTRAINDICATIONS

57. • if you are having surgery, tell the doctor
that you are taking cholestyramine.
• Tis may cause constipation so use
laxatives if needed.

58. COUNSELING
• Each sachet should mix with 150ml of water or
other liquid.
• Take full dose per day.
• Don’t miss the dose.
• Take atleast 1 hour before meal or take meal 4-6
hours after this drug.