Drilldown: Medicines
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generic:
brand:
classes: (Click arrow to add another value)
mechanism:
None (3) ·
'"`UNIQ--vote-000000F7-QINU`"' Minimal CYP3A4 dependence (CYP2C9 minor) reduces drug-drug interactions; transport in and out of hepatocytes is largely via OATP1B1, making SLCO1B1 PGx genotype the most clinically actionable marker for statin-associated myopathy'"`UNIQ--ref-000000F8-QINU`"'. (1) ·
'"`UNIQ--vote-000003D1-QINU`"' SLCO1B1 polymorphism affects exposure but is most clinically actionable for simvastatin'"`UNIQ--ref-000003D2-QINU`"'. (1) ·
'"`UNIQ--vote-000004A9-QINU`"' Modest HDL rise; LDL effects mixed. Renally cleared; combination with statin carries elevated myopathy risk (greater for gemfibrozil than fenofibrate, but caution still warranted)'"`UNIQ--ref-000004AA-QINU`"'. (1)
uses:
'"`UNIQ--vote-000000F9-QINU`"', '"`UNIQ--vote-000000FA-QINU`"', '"`UNIQ--vote-000000FB-QINU`"' (1) ·
'"`UNIQ--vote-000003D3-QINU`"', '"`UNIQ--vote-000003D4-QINU`"' (1) ·
'"`UNIQ--vote-0000044C-QINU`"', '"`UNIQ--vote-0000044D-QINU`"', '"`UNIQ--vote-0000044E-QINU`"', '"`UNIQ--vote-0000044F-QINU`"' (1) ·
'"`UNIQ--vote-000004AB-QINU`"', '"`UNIQ--vote-000004AC-QINU`"' (1) ·
'"`UNIQ--vote-00000805-QINU`"', '"`UNIQ--vote-00000806-QINU`"' (1) ·
'"`UNIQ--vote-00001035-QINU`"', '"`UNIQ--vote-00001036-QINU`"', '"`UNIQ--vote-00001037-QINU`"' (1)
starting dose:
10 mg PO once daily, with or without food (1) ·
10-20 mg PO once daily (5 mg in Asian ancestry, elderly, hypothyroidism, or strong CYP/SLCO1B1 interactions) (1) ·
20 mg PO once daily with the evening meal; titrate to 40-80 mg/d (1) ·
40 mg PO once daily (10-20 mg in elderly, hepatic impairment, or strong drug interactions) (1) ·
Niaspan ER 500 mg PO at bedtime, titrate weekly to 1-2 g/d; flushing-protective aspirin 30-60 minutes before dose; pellagra replacement 100-500 mg/d (1) ·
Varies by salt form and brand; e.g., Tricor 145 mg PO daily; reduce to 48 mg in renal impairment (1)
preparations:
10 mg tablet; also as fixed-dose combinations with simvastatin (Vytorin) and atorvastatin (Liptruzet, withdrawn US 2015 but generics exist) (1) ·
10 mg, 20 mg, 40 mg, 80 mg tablets (1) ·
10, 20, 40 mg tablets; 20, 40, 60 mg ER tablets (1) ·
5, 10, 20, 40 mg tablets (1) ·
Multiple non-bioequivalent fenofibrate and fenofibric acid formulations: 48-200 mg (1) ·
OTC IR niacin 50-500 mg tablets; Niaspan ER 500, 750, 1000 mg tablets; "no-flush" niacin (inositol hexaniacinate, lacks evidence) (1)
fda max:
10 mg/d (1) ·
2 g/d (Niaspan); higher off-label use historical (1) ·
40 mg/d (rarely needed; 40 mg restricted to patients not at goal on 20 mg) (1) ·
80 mg/d (1) ·
80 mg/d (40 mg/d if combined with diltiazem, verapamil, danazol; lower limits with various interactions) (1) ·
Formulation-specific (e.g., 145 mg/d Tricor, 200 mg/d Lipofen) (1)
routes:
onset:
duration: (Click arrow to add another value)
halflife:
~1 hour (IR niacin); ER formulations extend functional duration'"`UNIQ--ref-00001038-QINU`"' (1) ·
~19 hours'"`UNIQ--ref-000000FC-QINU`"' (1) ·
~2-3 hours (parent); pharmacodynamic effect 24 hours via target turnover'"`UNIQ--ref-000003D5-QINU`"' (1) ·
~2-4 hours (parent and active β-hydroxy acid metabolite); pharmacodynamic effect 24 hours via target turnover'"`UNIQ--ref-00000807-QINU`"' (1) ·
~20 hours (fenofibric acid, the active metabolite)'"`UNIQ--ref-000004AD-QINU`"' (1) ·
~22 hours (parent + active glucuronide)'"`UNIQ--ref-00000450-QINU`"' (1)
bioavailability:
<5% (extensive hepatic first-pass; food enhances absorption of IR, hence the evening-meal dosing)'"`UNIQ--ref-00000808-QINU`"' (1) ·
High (oral; food enhances)'"`UNIQ--ref-00001039-QINU`"' (1) ·
Increased with food (varies by formulation; the micronized and nanocrystal forms are less food-dependent)'"`UNIQ--ref-000004AE-QINU`"' (1) ·
Variable (oral; rapidly conjugated to active glucuronide; food does not affect)'"`UNIQ--ref-00000451-QINU`"' (1) ·
~17% (oral; food slightly reduces absorption)'"`UNIQ--ref-000003D6-QINU`"' (1) ·
~20% (oral; hydrophilic, minimal CYP metabolism, mostly excreted unchanged in bile)'"`UNIQ--ref-000000FD-QINU`"' (1)
pregnancy:
Limited data; generally avoided particularly in combination with statin.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Limited data; generally avoided unless triglyceride pancreatitis risk is high.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Pharmacologic doses generally avoided in pregnancy; vitamin doses fine.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Previously Category X; FDA removed the blanket statin contraindication in pregnancy in 2021. Use individualized.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Previously Category X; FDA removed the blanket statin contraindication in pregnancy in 2021.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (2)
Showing below up to 6 results in range #1 to #6.