In general, adverse events are uncommon with statins and fibrates. The most serious adverse event is rhabdomyolysis, which rarely causes renal failure. Periodic monitoring of creatine phosphokinase levels is appropriate in patients taking a combination of a statin and a fibrate. The combination should be discontinued if the level exceeds the normal level by five to ten times. The offending drug should be discontinued if this enzyme level exceeds three times the normal level.
Gemfibrozil can also cause gastrointestinal disturbances.
Although diabetes adds a very significant risk of CAD, successfully controlling the risk factors for CAD will have an extremely beneficial effect. Because the risk of CAD is much higher in diabetic patients than in those without diabetes, the reduction in absolute risks may be even greater in these patients. First increase to 10 mg q.h.s. Not applicable 600 mg b.i.d. Click Here to download the PDF of Chart 2 Mayer B. Davidson, MD, is director of the Clinical Trials Unit at Charles R. Drew University in Los Angeles, and professor of medicine at the University of California, Los Angeles, School of Medicine.