Hypertriglyceridemia Sample Clauses

Hypertriglyceridemia. For triglyceride levels >1200 mg/dL in asymptomatic participants, determine levels of plasma lipids after an overnight fast, then follow guidelines for lipase elevations (above). In participants with isolated hypertriglyceridemia and high LDL cholesterol, weight reduction should be strongly encouraged if obesity is present. Fat intake should be decreased, but the concomitant increase in carbohydrate intake may raise triglyceride and lower HDL levels. Severe hypertriglyceridemia and hyperchylomicronemia require very low fat diets, avoidance of free sugars, and decreased alcohol intake. Pharmacologic treatment of hypertriglyceridemia is dependent upon local availability of such treatment, and is at the discretion of the site investigator. Treatment should be documented as concomitant drugs on the CRFs. The preferred treatment is with gemfibrozil (600 mg q12h, 30 minutes prior to the morning and evening meals). Niacin (500 mg/day to start and increasing to 4 g/day) produces frequent cutaneous flushing, with or without pruritis. However the cutaneous symptoms tend to subside after several weeks and may be minimized by initiating therapy at low doses. Because of its propensity to worsen the control of blood sugar, niacin should be used with caution in participants with diabetes mellitus or a history of hyperglycemia. Bile sequestering resins are discouraged because their use is usually associated with increased triglyceride levels. HMG-CoA reductase inhibitors tend more to decrease cholesterol than triglycerides and are not recommended as first-line therapy for hypertriglyceridemia, and some have significant drug interactions with protease inhibitors.
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