when to add in ezetimibe?

[Ghoul]

debilitating? at what dose? I've been microdosing rosuvastatin at 10mg weekly without noticing anything. Simply for the anti-inflammatory benefits.

But I have some weird LDL thing going on where mine is low 30s on only 5mg ezetimibe.

40mg zocor
40mg lipitor

Calves and thighs would kill me walking up stairs. Like an unrecovered leg day.

TBH years later 10mg Rosuvastatin wasn't nearly as bad. I barely noticed soreness(might've even been psychosomatic), but I was just going through the motions with the doctor to get to Repatha. I wouldn't have considered a statin ever again until I stumbled upon Pitavastatin. I initially wanted Repatha because I knew there was zero chance of muscle sides.

Pain triggered by stairs is a pretty common statin side at 40mg+ doses, estimated to affect 10-25% of users.

In hindsight, I was on amlodipine at the time of the first two, which I now know significantly worsens SAMS (statin associated muscle symptoms) because amlodipine interferes with statin clearance, increasing concentration of the drug in muscle tissue.

 

[explodingHeart]

40mg daily or weekly total?

I recall reading 20mg+ rosuvastatin daily would develop protein in the urine, fuck with creatinine, etc.

Isn't a microdose (20mg weekly, meaning 2.8mg daily) nearly as effective as the full dose?

 

[Ghoul]

40mg daily or weekly total?

I recall reading 20mg+ rosuvastatin daily would develop protein in the urine, fuck with creatinine, etc.

Isn't a microdose (20mg weekly, meaning 2.8mg daily) nearly as effective as the full dose?

40mg daily. The standard dose based on my LDL at the time. They both go to 80mg.

2.5mg Rosu is surprisingly effective as a microdose, 35% LDL reduction, 50% with ezetimebe.

I was initially prescribed 10mg, when I complained about sides was told split to 5mg. Then 5mg eod. Finally I asked about Repatha and that was the end of Rosuvastatin.

Pitavastatin is even more of a no brainer vs Rosuvastatin used at low doses, since Rosu loses the one thing it has to offer, somewhat higher ldl reduction at 40mg.

 

[explodingHeart]

40mg daily. The standard dose based on my LDL at the time. They both go to 80mg.

2.5mg Rosu is surprisingly effective as a microdose, 35% LDL reduction, 50% with ezetimebe.

I was initially prescribed 10mg, when I complained about sides was told split to 5mg. Then 5mg eod. Finally I asked about Repatha and that was the end of Rosuvastatin.

Pitavastatin is even more of a no brainer vs Rosuvastatin used at low doses, since Rosu loses the one thing it has to offer, somewhat higher ldl reduction at 40mg.

Would you suggest I buy pitavastin and use a microdose from that instead of rosouva?

I don't see much point in reducing my LDL from its natural 30 range but maybe it has other benefits like inflammation reduction, plaque reduction, etc?

 

[Ghoul]

Would you suggest I buy pitavastin and use a microdose from that instead of rosouva?

I don't see much point in reducing my LDL from its natural 30 range but maybe it has other benefits like inflammation reduction, plaque reduction, etc?

I would choose 1mg Pita over microdose Rosu. With minimal LDL reduction, 1mg would still lower hsCRP inflammation, significantly reduce APOb 15-20% (which can be elevated even with low LDL increasing risk), boost quantity (5-7%) of HDL improve its *function* for better reverse cholesterol transport facilitating regression, improve endothelial function, with no adverse impact on insulin sensitivity and it's not oxidative like Rosu, slowing calcification.

1mg Pita tabs are available and pretty cheap too (I was quoted $75 for 600).

 

[Nidus]

Why wait?

Ezetimebe protects your long term vascular health without metabolic compromises or any significant risk of sides.

I think anyone on AAS should consider 5-10mg Ezemtibe daily. For me a must have and no-brainer not to have (unless youre blessed by the genetic gods)

 

[xrayphoton13]

I love ezetimibe. It's something I'll take now on cycle and it just works in the background unnoticeable. I am curious if there's a best time of day to take it as I usually take it before bed. Same with rosuvostatin. Is there a certain time that's best? I know BP meds are usually dosed at night but wasn't sure about these

I think if you're getting hemorrhoids from ezetimibe you may want to consider more fiber in your diet via fruits/veggies and metamucil.

 

[DugPrime]

90 on a 0-99 ref

Then you don't need ezetimibe.

 

[Ghoul]

I love ezetimibe. It's something I'll take now on cycle and it just works in the background unnoticeable. I am curious if there's a best time of day to take it as I usually take it before bed. Same with rosuvostatin. Is there a certain time that's best? I know BP meds are usually dosed at night but wasn't sure about these

I think if you're getting hemorrhoids from ezetimibe you may want to consider more fiber in your diet via fruits/veggies and metamucil.

The current medical consensus is that time of day for ezetimebe, statins, and (once a day) BP meds doesn't matter (outside of a few rare conditions requiring a different approach).

As long as sides aren't an issue (in which case a different med is probobly a better solution than timing), consistency is what matters most, so use the time that ensures you'll be most likely to actually take the meds every single day.

 

[Eddie.]

I love ezetimibe. It's something I'll take now on cycle and it just works in the background unnoticeable. I am curious if there's a best time of day to take it as I usually take it before bed. Same with rosuvostatin. Is there a certain time that's best? I know BP meds are usually dosed at night but wasn't sure about these

I think if you're getting hemorrhoids from ezetimibe you may want to consider more fiber in your diet via fruits/veggies and metamucil.

I take ezetimibe and rosuvostatin before bed too.

 

[Ghoul]

Then you don't need ezetimibe.

Unless you're pursuing longevity. 90 LDL is only ok because risk has been measured on the basis of the next 10 years.

Most cardiology risk calculators are starting to display "lifetime" risk of heart attack, stroke, or requiring a bypass.

A 95 LDL for a 25yo could show a 1% 10 year risk, not considered significant enough under treatment guidelines to warrant lipid lowering drugs. But the lifetime risk could easily be 60%, and the calculator will have an "informal" suggestion that using medication to bring LDL below 70 could drop lifetime risk to 25%.

 

[120nmol]

Add it bro don’t be shy
I used to be shy, now I’m an addict

 

[Ghoul]

Add it bro don’t be shy
I used to be shy, now I’m an addict
View attachment 334087

There's nothing to be gained by practicing "medicine minimalism" by avoiding certain drugs, and Ezetimebe is definately one of them.

 

[120nmol]

There's nothing to be gained by practicing "medicine minimalism" by avoiding certain drugs, and Ezetimebe is definately one of them.

I agree I personally take ezetimbie with rosuvastatin daily and it did wonders for my lipid profile

 

[Ghoul]

I agree I personally take ezetimbie with rosuvastatin daily and it did wonders for my lipid profile

Man I feel like rosuvastatin is another curse of "super cheap generics" and clinical inertia like amlodipine is for BP meds.

Good for you keeping lipids in check though. Only 1/3 of Americans who should be on lipid lowering meds are. 65% facing tremendously higher risk of the most likely cause of death and disability, CVD, for no good reason.

 

[120nmol]

Man I feel like rosuvastatin is another curse of "super cheap generics" and clinical inertia like amlodipine is for BP meds.

I agree and I wouldn’t change it for any other statin that came after rosuvastatin I’ve noticed with other statins cholesterol panel becomes a roller coaster for most and side effects hit almost everyone
I’ve tried repetha not long ago which works in a different way but the price.. I’d rather buy Pharma Hgh..

Good for you keeping lipids in check though. Only 1/3 of Americans who should be on lipid lowering meds are. 65% facing tremendously higher risk of the most likely cause of death and disability, CVD, for no good reason.

I’m not from the USA but I guess docs here follow same protocol the second total cholesterol is above 200 they give you the highest statin dose lol..
My doc wanted to put me on 40mg rosuvastatin I told him bra.. wait.. how about I do 10mg ezetimbe and 10mg rosuvastatin.. he was skeptical but agreed..
Nuked my cholesterol to 80 Hdl went up ldl went down I got no side effects so I just mono therapy it.

 

[Ouch]

I love ezetimibe. It's something I'll take now on cycle and it just works in the background unnoticeable. I am curious if there's a best time of day to take it as I usually take it before bed. Same with rosuvostatin. Is there a certain time that's best? I know BP meds are usually dosed at night but wasn't sure about these

I think if you're getting hemorrhoids from ezetimibe you may want to consider more fiber in your diet via fruits/veggies and metamucil.

With novel advice like that you could be an America doctor! Just like saying if a statin is causing severe muscle pain then don’t exercise so much, or eat a banana.

The truth is that there’s a fine line between medicine and poison. And the difference can often be each person’s personal body chemistry.

If Ez (or whatever meds) work for some - that’s awesome and god speed. But for many they come with legit side effects. Just look at the reviews for it on Drugs.com - 4 stars out of 10 due to side effects.

It sucks but that’s the way it works - poison for some, medicine for others.

 

[Ghoul]

I agree and I wouldn’t change it for any other statin that came after rosuvastatin I’ve noticed with other statins cholesterol panel becomes a roller coaster for most and side effects hit almost everyone
I’ve tried repetha not long ago which works in a different way but the price.. I’d rather buy Pharma Hgh..

Yeah most of the time, with high LDL, esp over 40, the guidelines call for "high dose statin" so that's what they give. Even though 10mg Rosu lowers it by 45%. 40mg only lowers by another 10%, but the side effects increase by 50%. Ezetimebe gives more of a benefit and no sides.



I’m not from the USA but I guess docs here follow same protocol the second total cholesterol is above 200 they give you the highest statin dose lol..
My doc wanted to put me on 40mg rosuvastatin I told him bra.. wait.. how about I do 10mg ezetimbe and 10mg rosuvastatin.. he was skeptical but agreed..
Nuked my cholesterol to 80 Hdl went up ldl went down I got no side effects so I just mono therapy it.

I have no doubt even meds with the safest track record will occasionally cause someone problem. But lipid related drugs seem to have a lot of baggage and "nocebo" effects because of the widespread bad reputation they have, mostly from older generation drugs. Even Repatha has a certain percentage of reported muscle effects that are exactly like statins, despite working nothing like a statin or affecting muscles at all. You know what's going on there. Someone pressured into using it, and doesn't believe their doc that Repatha won't cause muscle pain.

I had a look at those reviews, because all the trial and FDA surveillance data shows an extremely low rate of sides, and those that happen are often when used in conjunction with a statin that causes the same side, or effects that happen at the same or higher rate when the subject was given a placebo.

It's like reading reviews from a bunch of hypochondriacs with severe psychological problems.

There's no consistant pattern of side effects that would lend some credibility to a particular problem. They're all over the place.

Some of them "always have issues with statins and this statin was no different, just like they knew would happen". lol

Another got instant arthritis wrecking their back.

....immediately developed dementia

....started bleeding internally and their bladder sealed up.

 

[120nmol]

I have no doubt even meds with the safest track record will occasionally cause someone problem. But lipid related drugs seem to have a lot of baggage and "nocebo" effects because of the widespread bad reputation they have, mostly from older generation drugs. Even Repatha has a certain percentage of reported muscle effects that are exactly like statins, despite working nothing like a statin or affecting muscles at all. You know what's going on there. Someone pressured into using it, and doesn't believe their doc that Repatha won't cause muscle pain.

I had a look at those reviews, because all the trial and FDA surveillance data shows an extremely low rate of sides, and those that happen are often when used in conjunction with a statin that causes the same side, or effects that happen at the same or higher rate when the subject was given a placebo.

It's like reading reviews from a bunch of hypochondriacs with severe psychological problems.

There's no consistant pattern of side effects that would lend some credibility to a particular problem. They're all over the place.

Some of them "always have issues with statins and this statin was no different, just like they knew would happen". lol

Another got instant arthritis wrecking their back.

....immediately developed dementia

....started bleeding internally and their bladder sealed up.

I have a saying for that ..
If you can handle tren you’ll handle statins lol..
Either way I personally think when doing hrt cholesterol is not relevant and should be as low as possible therefore statins/ezetimbe is a must.

 

[explodingHeart]

I have no doubt even meds with the safest track record will occasionally cause someone problem. But lipid related drugs seem to have a lot of baggage and "nocebo" effects because of the widespread bad reputation they have, mostly from older generation drugs. Even Repatha has a certain percentage of reported muscle effects that are exactly like statins, despite working nothing like a statin or affecting muscles at all. You know what's going on there. Someone pressured into using it, and doesn't believe their doc that Repatha won't cause muscle pain.

I had a look at those reviews, because all the trial and FDA surveillance data shows an extremely low rate of sides, and those that happen are often when used in conjunction with a statin that causes the same side, or effects that happen at the same or higher rate when the subject was given a placebo.

It's like reading reviews from a bunch of hypochondriacs with severe psychological problems.

There's no consistant pattern of side effects that would lend some credibility to a particular problem. They're all over the place.

Some of them "always have issues with statins and this statin was no different, just like they knew would happen". lol

Another got instant arthritis wrecking their back.

....immediately developed dementia

....started bleeding internally and their bladder sealed up.

Do you think someone is completely immune to plaque accural if their LDL remains below 50 or so? Could I start smoking and using anadrol daily if my LDL stayed under 40?