Avorstatin 80mg + Ezetimibe anyone?

[EU95PTM]

Following a HA in April I have overhauled my diet, attended cardiac rehab, remained as active as my energy levels allow and will continue this moving forward. My recent bloods show my total cholesterol has reduced to 4.8 (but should be ideally below 4) but my LDL (bad cholesterol) remains stubborn at 3.08. My target is 1.4. I am being referred to a lipid clinic as they feel this is probably genetic as I am on the maximum dose of statin, but they want to add in Ezetimibe to specifically target the LDL cholesterol.

Has anyone else been on this combination and did it help? Besides these I am on the usual cocktail of drugs plus warfarin.

[pasigal]

Yep, this is what I'm on. I was on just the Atorvastatin, but my brother (who shares our genetic high levels of Lipoprotein A) suggested I ask my cardio about adding Ezetimibe.

It's gotten my LDL down to ridiculously low levels (0.99 g/l), but ofc can't do much about raising the HDL.

A note is that it also comes as a combination pill but it's often unavailable.

[EU95PTM in reply to pasigal]

It’s good to hear that it helped you. Were you offered genetic testing to find out cause of raised LDL?

[pasigal in reply to EU95PTM]

no, you can detect Lipoprotein A levels through a blood test. medlineplus.gov/lab-tests/l...

Both my brother and I have very high levels of it. So even though we are extremely healthy and fit otherwise, we are genetically disposed to coronary artery disease. He has been on statins for 20 years and has some blockage but not enough to warrant an intervention. I, on the other hand, have 4 stents and have had 2 heart attacks...

[Raylpa in reply to pasigal]

Hi pasigal my brother and I share the inherited high lipoprotein (a) curse too and same ref your comments fitness and lifestyle 😞 stent in 2014 for me at age 56 and most recently found to have aortic calcification which is closely associated with high Lpa. I don’t think ‘we’ have a patient’s forum or go to info centre on this topic, although I have found the heart UK site helpful. Do please share if you know of any other helpful resources.

[Mart25]

After angina which led to a triple bypass in 2020 I was given a target for LDL of less than 1.8. We (my GP and I) tried 20mg atorvastatin - not enough effect on LDL. 40mg atorvastatin - not much different. 80mg atorvastatin alone also didn't do enough. My LDL was pretty much fixed at about 2.8 regardless of the dose of statin. So we tried 40mg atorvastatin plus 10mg ezetimibe. This took my LDL to 1.7. Job done! So I think ezetimibe is helpful for people whose cholesterol levels do not respond enough to a statin alone.....and it's probably not tried by GPs enough.

Note that the scientific literature (which I have looked at) says you need ezetimibe plus a statin. Ezetimibe alone is much less effective.

Note too that we (the GP and I ) decided to use 40mg atorvastatin plus ezetimibe because 80mg alone wasn't any different from 40mg so that extra 40mg was just unecessary and a stress on my liver that I didn't need.

Be aware that I found ezetimibe made me very gassy (a polite way to put it!) but that settled down after a while. They will also want to check your liver function from time to time.

[EU95PTM in reply to Mart25]

Thank you, this is useful to know

[Hidden]

I probably have the genetic FH condition since my natural total cholesterol identified over 20 years ago is between 9 and 10. I have been on Atorvastatin ever since including max dose of 80mg for the last four years due to an NSTEMI. Even then my total cholesterol has never been less than 4.5 usually 5 or over. However over the summer I have deliberately lost a lot of weight reducing my BMI from a peak of about 28 down to about 25. One week ago I had my annual lipid blood test and arranged a follow up review with my GP intending to discuss adding Ezetimibe or Inclisiran to my meds, but to my surprise my total cholesterol was 3.7 with a better lipid profile than before. In short my best ever over the years. My GP has attributed this considerable improvement down to my weight loss and some increase in activity, especially since my diet is pretty much the same apart from me cutting out unnecessary sugar. I know we are all different but what apparently works for me may work for others too.

[EU95PTM]

Thank you

[Gail1967]

Hi- yes been on combination for a while now- certainly seems to have an impact on ldl & I have no side effects thankfully

[EU95PTM in reply to Gail1967]

Thank you, that’s really good news

[valeriep]

Yes, I’m on both. The way it was explained to me was that they work in tandem: while the statins lower your cholesterol levels, Ezetimibe helps to stop your body from absorbing cholesterol. It reduced my cholesterol levels for a while, but then they started to creep up again, so I was referred to a lipid clinic, who found I had FH and gave me additional medication. I think you’ll find your appointment with the lipid clinic very helpful in pinpointing the best medication for you.

[EU95PTM in reply to valeriep]

Thank you for sharing your experience, I do hope that I will find the lipid clinic useful too.

[Unawatuna]

I was on 80mg Atorvastatin and Ezetimibe but this combination has affected the ATL levels in my liver. I have been taken off the statins at a hospital appointment and am waiting to see my GP to have an alternative prescribed. It is always wise to make sure you have regular blood tests to make sure you have no detrimental side effects.

[golfwatcher]

I have been on Rosuvastatin 20mg and Ezitimibe 10mg for about a year. Liver enzymes ALT and AST are elevated and are being monitored monthly. Total cholesterol 3.6, LDL 2.2 (target 1.7) and HDL stubbornly 1.0.