Beta-blockers introduction:
Beta-blockers, also known as fibrates, can reduce triglycerides by 30% to 40% and increase high-density lipoprotein by 20% to 30%. They are the first-line drugs for hypertriglyceridemia, with fenofibrate and gemfibrozil being commonly used. They are suitable for patients with primarily elevated triglycerides and mixed type patients with elevated cholesterol.
(1) Gemfibrozil (Lopid) (Beta-blockers introduction):
- [Action] It can treat xanthoma caused by high blood lipids, low levels of high-density lipoprotein (HDL), or coronary heart disease with low HDL. It is mainly used for types IIa, IIb, and IV hyperlipidemia.
- [Dosage and Administration] Take 0.9-1.2 grams daily, divided into 2-3 doses before meals. Significant effects are usually observed after 3-4 weeks of treatment.
- [Adverse Reactions] After taking the medication, gastrointestinal discomfort such as nausea, heartburn, vomiting, loss of appetite, abdominal pain, and diarrhea may occur, with an incidence rate of approximately 5%. Transient elevation of serum transaminases and creatine kinase can be observed, and abdominal pain can be relieved upon discontinuation of the drug. The incidence of gallstones is 1%-1.5%, and the dosage of anticoagulants should be adjusted when used in combination.
- [Precautions] a. Regular monitoring of liver, kidney function, and CK is recommended when taking gemfibrozil. If significant abnormalities occur, the dosage should be promptly reduced or discontinued. b. Gemfibrozil enhances the anticoagulant effect and increases blood glucose levels. Adjustments in the dosage of anticoagulant and antidiabetic medications should be made when taking gemfibrozil.
(2) Fenofibrate (Lipanthyl) (Beta-blockers introduction):
- [Action] This drug is highly effective in reducing serum triglyceride levels. In addition to regulating blood lipids, it can also reduce uric acid levels, decrease fibrinogen levels, and increase the efficacy of anticoagulants. It is suitable for hypercholesterolemia, mixed hyperlipidemia, hyperuricemia, and secondary hyperlipidemia. Furthermore, it is beneficial in preventing the occurrence and development of atherosclerotic lesions.
- [Dosage and Administration] Standardized tablets: Take 0.1-0.2 grams per dose, 2-3 times daily. Micronized formulations can increase absorption by 30% and maintain stable blood drug concentrations, allowing for a daily dosage of 0.2 grams in a single administration.
- [Adverse Reactions] Adverse reactions are rare and mild. After taking the medication, some individuals may experience dry mouth, decreased appetite, increased bowel movements, and eczema. In isolated cases, elevated transaminases, urea nitrogen, or creatinine levels may occur, but they quickly return to normal upon discontinuation of the drug.
- [Precautions] a. When taking anticoagulants concurrently, adjustments in the anticoagulant dosage should be made. b. Pregnant women, breastfeeding women, women of childbearing potential, and individuals with liver or kidney dysfunction should avoid using this medication. c. Long-term use of fenofibrate requires regular monitoring of liver and kidney function. In case of significant abnormalities, the dosage should be promptly reduced or the medication should be discontinued.
(3) Bezafibrate (Bezalip) (Beta-blockers introduction):
- [Action] This drug inhibits platelet aggregation, reduces plasma fibrinogen levels and blood viscosity, and enhances fibrin activity. These actions help prevent the occurrence and development of atherosclerosis, reduce the incidence of coronary artery events, and improve metabolism in diabetic patients with lipid metabolism disorders, resulting in lower fasting blood glucose levels.
- [Dosage and Administration] Oral administration: Take 200 milligrams per dose, 3 times daily, after meals.
- [Adverse Reactions] Common adverse reactions include gastrointestinal discomfort, nausea, and loss of appetite, which are usually transient and do not require discontinuation of the medication. When used in combination with oral anticoagulants, the anticoagulant dosage should be reduced by approximately 30%. This medication should not be used in combination with statins. Rarely, myositis-like pain accompanied by elevated serum creatine kinase (CK) levels and elevated transaminases may occur, requiring prompt discontinuation of the drug.
- [Precautions] a. Use with caution in patients with renal insufficiency. b. This medication should not be used in patients with liver or gallbladder diseases (except for fatty liver), pregnant or breastfeeding women, and children. c. The adverse reactions caused by bezafibrate are usually mild and most commonly observed within the first few months of treatment. They tend to resolve on their own with continued medication. During long-term use, regular monitoring of liver and kidney function, as well as CK activity, is recommended. In case of significant abnormalities, the dosage should be promptly reduced or the medication should be discontinued.
(4) Clofibrate (Alromid-S, Bofibiate) (Beta-blockers introduction):
- [Action] Clofibrate reduces the adhesion and aggregation function of platelets, decreases the elevated levels of fibrinogen in the blood, increases fibrinolysis activity, and reduces the formation of blood clots.
- [Dosage and Administration] Oral administration: Take 0.25-0.5 grams three times daily.
- [Adverse Reactions] Common adverse reactions include diarrhea, abdominal distension, and nausea. Rare adverse reactions include rash, hair loss, headache, fatigue, impotence, or decreased libido. In some cases, patients may experience muscle pain, weakness, spasms, and stiffness, accompanied by a significant increase in serum CK activity. Prolonged use of this medication can significantly increase the incidence of gallstones.
- [Precautions] a. This medication should be avoided in pregnant women, breastfeeding women, and women of childbearing potential. b. When used in combination with sulfonylurea antidiabetic drugs, precautions should be taken to prevent hypoglycemia. c. Regular monitoring of liver and kidney function, as well as CK levels, is recommended during medication. In case of significant abnormalities, the dosage should be promptly reduced or the medication should be discontinued.