Febuxostat, atorvastatin, fenofibrate... Reduce uric acid and blood lipids together

2021/10/1423:34:02 regimen 1816

Source: Life Times

Wuhan Central Hospital Pharmacist Cheng Peng

Hyperlipidemia and hyperuricemia are both metabolic disease, which is atherosclerosis And coronary heart disease are the two main risk factors. Long-term exposure to hyperlipidemia will cause atherosclerosis, damage the kidneys, and reduce the excretion of uric acid; uric acid is involved in multiple links in the occurrence, progression and deterioration of atherosclerosis, and the two promote and influence each other. For these two diseases, there are a variety of treatment drugs, and there are also three drugs that both lower uric acid and lower blood lipids, which can kill two birds with one stone.

Febuxostat, atorvastatin, fenofibrate... Reduce uric acid and blood lipids together - DayDayNews

1. Febuxostat . It selectively inhibits xanthine oxidase, prevents the production of uric acid, and reduces the blood uric acid level of . It is suitable for the long-term treatment of hyperuricemia in patients with gout; it also has a significant effect on lowering blood lipids. Can make patients triglyceride, low-density lipoprotein cholesterol and serum total cholesterol indicators decreased.

The cardiovascular adverse reactions of febuxostat need to be paid attention to. Although there are still controversies from the current research, we should still be vigilant: patients over 65 years of age who are also complicated by severe cardiovascular disease may increase the use of the drug for a long time. Risk of cardiovascular death.

Generally speaking, febuxostat should only be used after the acute symptoms of gout are relieved for ≥2 weeks, so as to avoid the rapid decrease of blood uric acid concentration, which may cause the mobilization of urate deposited in the tissues and aggravate the pain. During the acute attack of gout, anti-inflammatory and analgesic treatment should be carried out as soon as possible (within 24 hours). Anti-inflammatory analgesics such as diclofenac and celecoxib can be used.Or colchicine , glucocorticoids, etc.

2. Atorvastatin. dyslipidemia is mainly reflected in 4 indicators: triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), general medication goals It is to decrease the first 3 items and increase the fourth item.

statin is the basic treatment drug for patients with hyperlipidemia. Among them, atorvastatin directly inhibits the synthesis of cholesterol in the blood vessel wall and the liver, can effectively reduce total cholesterol and low-density lipoprotein cholesterol, and has a clear inhibitory effect on the progression of atherosclerosis. It has good safety and reduces triglycerides. The effect is also stronger in statins . At the same time, atorvastatin can inhibit the reabsorption of uric acid in the renal tubules, increase the excretion of uric acid, and thus significantly reduce blood uric acid.

Be careful when taking statins. A small number of patients will have serious adverse reactions, which may lead to abnormal liver function indicators. Occasionally, a small number of rhabdomyolysis and muscle pain, muscle weakness should be consulted in time. .

3. fenofibrate . As lipid-lowering drug , the drug has a significant effect on lowering triglycerides. Studies have shown that long-term use of fenofibrate can reduce triglycerides by 30%-40%, high-density lipoprotein cholesterol increases by 10%-15%, and at the same time reduce total cholesterol by lowering low-density lipoprotein cholesterol by 15% %about. Fenofibrate has a good promoting effect on uric acid excretion, and long-term use can reduce blood uric acid concentration by about 20%. The point is that while fenofibrate can quickly lower uric acid, it will not cause an acute attack of gout.

It should be noted that fibrates and statins are generally not used at the same time, because it may increase the occurrence of more serious adverse reactions (rhabdomyolysis) of statins.Mainly manifested as muscle pain, muscle weakness, numbness of hands and feet, and brown urine.

This article comes from [Life Times], and only represents the author's views. The national party media information public platform provides information publishing and dissemination services.

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