first statin you would pick, ezetimibe ?

[whoremoan]

as the title states

if your ldl was out of range, even after changes of diet, increasing cardio, supplements, coming off, lowering dose etc etc
what would be the first statin you would pick
i hear alot of great things about ezetimibe so would that be the first place to start?

 

[Delt123]

Rosuvastatine, 10mg.

Either every day or a couple times per week

 

[NattyNuts]

Citrus Bergamot 750mg AM and 750mg PM, standarized to 40% polyphenols
Rosuvastatine 5mg ED

Wonderful, they keep my LDL under 70.
Ive tried pitavastatin, it was good, 2mg kept my LDL between 70-80 but gave me muscle and tendon pain. Rosu at 5 doesnt seem to cause that

 

[JAP426]

I would probably go with 10 mg lipitor. I take 10 mg crestor. This red yeast rice is standardized and each tablet is the equivalent of 10 mg mevacor (a statin). I used it without a statin and yes it worked very well

 

[stackdizzy]

Atorvastatin lowered my GFR big time. So not that one..lol. After that I told them I was not taking another statin as they just put me on it because of age.

 

[OuchThatHurts]

Rosuvastatine, 10mg.

Either every day or a couple times per week

I just got a prescription for this 3 days ago. I had one years ago but quit taking it. No idea why. Laziness most likely. Any advice? Sides, benefits, morning or evenings, etc? My doc said he likes it because it's been shown to give HDL a small boost up while lowering LDL and VLDL. But with my LDL at > 200 for a decade, he said it's time. He was pretty adamant so I'm taking my first dose tomorrow.

 

[pesty4077]

I just got a prescription for this 3 days ago. I had one years ago but quit taking it. No idea why. Laziness most likely. Any advice? Sides, benefits, morning or evenings, etc? My doc said he likes it because it's been shown to give HDL a small boost up while lowering LDL and VLDL. But with my LDL at > 200 for a decade, he said it's time. He was pretty adamant so I'm taking my first dose tomorrow.

Nothing has lowered my LDL and Total Cholesterol like Ezetimibe at 10 mg.

 

[Dave Perez]

I am currently taking atorvastatin after a quadruple bypass...I am also on Xarelto...lipitor was initially prescribed but the cost ($600 a month) was just too expensive...

 

[slesh]

I use 10mgs Lipitor MWF. Made a huuuuuge difference on my lipid levels. Only minor issue is some memory fog. But no muscle pain or lethargy.

 

[nothuman]

Ezetimibe is not a statin. It's the first thing I would do to lower ApoB/LDL.

If that's not enough, you could add Rosuvastatin 10mg.

 

[OuchThatHurts]

Ezetimibe is not a statin. It's the first thing I would do to lower ApoB/LDL.

If that's not enough, you could add Rosuvastatin 10mg.

So I'm Rx'ed Crestor 20mg daily. Would you recommend an every other day approach? I'm new to cholesterol control because my heart ECG, echo, EF have always been good. It sounds like you guys really know the real world usage/effects of these meds. I'm just over 50 so I think it would be wise now to take this more seriously.

I've always thought (secretly) that the whole cholesterol control industry is a multi-billion dollar scam. My father will be 86 and has always had high cholesterol and triglycerides. The only heart event he had many years ago, they cathed his heart and the cardiologist said my father's arteries were cleaner than his own so I don't know.

All this is new to me. Even ezetimibe in their own literature says that while it reduces cholesterol, shows little or no reduction in cardiac events. Although granted, much of this research was conducted on individuals who had already experienced cardiac events and/or heart disease. Would appreciate any thoughts.

Ezetimibe for the prevention of cardiovascular disease and all-cause mortality events - PubMed

Moderate- to high-quality evidence suggests that ezetimibe has modest beneficial effects on the risk of CVD endpoints, primarily driven by a reduction in non-fatal MI and non-fatal stroke, but it has little or no effect on clinical fatal endpoints. The cardiovascular benefit of ezetimibe might...

pubmed.ncbi.nlm.nih.gov

 

[OuchThatHurts]

Nothing has lowered my LDL and Total Cholesterol like Ezetimibe at 10 mg.

How should I approach my doc with this? If it's better than Crestor then I definitely want to go that way. (Also, he trains and is a friend)

 

[pesty4077]

How should I approach my doc with this? If it's better than Crestor then I definitely want to go that way. (Also, he trains and is a friend)

I used 20 mg of Atorvastatine and had little effect, then I added Ezetimibe at 10 mg and did this.

Total cholesterol 279, down to 111.
LDL from 231 down to 61.
HDL is about same at 40.

I dropped the Atorvastatine, just using Ezetimibe at 10 mg and experimenting. Worse case scenario I will use a mild statin like Nothuman suggests.

 

[bg65]

I am currently taking atorvastatin after a quadruple bypass...I am also on Xarelto...lipitor was initially prescribed but the cost ($600 a month) was just too expensive...

Where do you live/when was this?! Lipitor should be free or on the $4 list, without insurance. The xarelto may have been $600/month though

 

[OuchThatHurts]

I used 20 mg of Atorvastatine and had little effect, then I added Ezetimibe at 10 mg and did this.

Total cholesterol 279, down to 111.
LDL from 231 down to 61.
HDL is about same at 40.

I dropped the Atorvastatine, just using Ezetimibe at 10 mg and experimenting. Worse case scenario I will use a mild statin like Nothuman suggests.

Damn, that's a big improvement. I would love those numbers.

 

[warlock]

I would probably go with 10 mg lipitor. I take 10 mg crestor. This red yeast rice is standardized and each tablet is the equivalent of 10 mg mevacor (a statin). I used it without a statin and yes it worked very well

How do you know it's equivalent of 10mg mevacor? I thought red yeast rice products had that statin ingredient removed?

 

[nothuman]

So I'm Rx'ed Crestor 20mg daily. Would you recommend an every other day approach? I'm new to cholesterol control because my heart ECG, echo, EF have always been good. It sounds like you guys really know the real world usage/effects of these meds. I'm just over 50 so I think it would be wise now to take this more seriously.

I've always thought (secretly) that the whole cholesterol control industry is a multi-billion dollar scam. My father will be 86 and has always had high cholesterol and triglycerides. The only heart event he had many years ago, they cathed his heart and the cardiologist said my father's arteries were cleaner than his own so I don't know.

All this is new to me. Even ezetimibe in their own literature says that while it reduces cholesterol, shows little or no reduction in cardiac events. Although granted, much of this research was conducted on individuals who had already experienced cardiac events and/or heart disease. Would appreciate any thoughts.

Ezetimibe for the prevention of cardiovascular disease and all-cause mortality events - PubMed

Moderate- to high-quality evidence suggests that ezetimibe has modest beneficial effects on the risk of CVD endpoints, primarily driven by a reduction in non-fatal MI and non-fatal stroke, but it has little or no effect on clinical fatal endpoints. The cardiovascular benefit of ezetimibe might...

pubmed.ncbi.nlm.nih.gov

I used to feel the same way about statins but I've seen/read enough from trustworthy sources where I now feel they're helpful, especially low doses for prevention. I have even made old posts here that would contradict what I am saying now.

Many are prescribed 40mg of a statin but I take 10mg with 10mg Ezetimibe. The research shows you want to get your ApoB as low as possible, and both bring it down. I got mine down from 90 to 49, which I'm pretty happy with. If you are wondering about my LDL, it's 55 when it used to be just above 100.

Unfortunately, there seems to be two different camps that feel very strongly about whatever side they're on, but I think the benefit to risk ratio is overall positive.

 

[OuchThatHurts]

I used 20 mg of Atorvastatine and had little effect, then I added Ezetimibe at 10 mg and did this.

Total cholesterol 279, down to 111.
LDL from 231 down to 61.
HDL is about same at 40.

I dropped the Atorvastatine, just using Ezetimibe at 10 mg and experimenting. Worse case scenario I will use a mild statin like Nothuman suggests.

I used to feel the same way about statins but I've seen/read enough from trustworthy sources where I now feel they're helpful, especially low doses for prevention. I have even made old posts here that would contradict what I am saying now.

Many are prescribed 40mg of a statin but I take 10mg with 10mg Ezetimibe. The research shows you want to get your ApoB as low as possible, and both bring it down. I got mine down from 90 to 49, which I'm pretty happy with. If you are wondering about my LDL, it's 55 when it used to be just above 100.

Unfortunately, there seems to be two different camps that feel very strongly about whatever side they're on, but I think the benefit to risk ratio is overall positive.

This is good info. Perhaps in a month when I get my next lipid panel if it's not where we want it to be, I can use that as a springboard to bring up the ezetimibe as an adjunct to the Crestor. I definitely want my ApoB down as much as possible after reading about it in the Definitive Health Thread. Thanks again.

 

[JAP426]

How do you know it's equivalent of 10mg mevacor? I thought red yeast rice products had that statin ingredient removed?

So that particular brand is standardized to have 10 mg of monacolins in it. Which is the statin-like compound that lowers the ldl. Worked for me. Cut the ldl by 40 points. No change in hdl

 

[Reno911]

So I'm Rx'ed Crestor 20mg daily.

Have you started this dose yet? I dropped all my natural cholesterol support supps and tried 5mg Crestor 2x/week. Labs came back a hair worse so I bumped it to 5mg 3x/week. About 2 weeks in my whole body felt like I got hit by a truck if my body wasn't moving. It really started to fuck with my sleep so I dropped it.

Then added 10mg of Ezetimibe and 1200mg Jarrow Red Yeast Rice. This brought my LDL down to 63 from 90 with only Crestor at 5mg 2x/week.

Just my experience.

I may try adding the Crestor back in at 5mg 2x/week for the "plaque stabilization" effect.