There are sometimes advantages to pairing cholesterol-lowering medications. Such combinations can be more beneficial than either medication alone. Equally important, multidrug regimens may cause fewer side effects, partly because they rely on lower doses of each medication. For example, gemfibrozil and niacin are an oft-used and well-tolerated combination. Another example is a drug that just hit the market in the summer of 2004 — Vytorin — which is a combination of the drugs ezetimibe and simvastatin.Although doctors had been prescribing this combination of drugs already, Vytorin allows patients to get the two medications in one pill, which can be cheaper and more convenient. Not all cholesterol drug combinations are safe. The combined use of any statin and a fibric acid derivative can lead to severe muscle damage, causing kidney failure and even death. While it is difficult to estimate the frequency of this risk, it is likely lower than 0.01%.
New evidence suggests that fenofibrate may be safer than gemfibrozil when used in combination with a statin. With any multidrug regimen, routine exams and blood testing for signs of either muscle damage or liver dysfunction is prudent, both at the start and during the course of the therapy.
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