Comparing and Contrasting Statins and Fibrates

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Statins and fibrates are two classes of lipid-regulating drugs. The statins competitively inhibit 3-hydroxy-3-methylglutaryl coenzyme A, HMG-CoA, reductase, an enzyme involved in cholesterol synthesis, especially in the liver. While fibrates, fibric acid derivatives, are a class of amphipathic carboxylic acids. Clinical trials reveal that statins reduce cardiovascular event rate and all-cause mortality in a broad range of demographic and risk populations. Furthermore, six statins are available in the united states; cerivastatin, a type of statin, was withdrawn from the market due to excess rates of morbidity. Moreover, statins include various drugs that differ in low-density lipoprotein, LDL, lowering efficacy and metabolic rates, thus they differ in their potential for drug and disease interactions. These drugs include atorvastatin, fluvastatin, pravastatin sodium, rosuvastatin, and simvastatin. On the other hand, fibrates, such as benzafibrate, ciprofibrate, fenofibrate, and gemfibrozil, are used for patients who cannot tolerate statin. Statins and fibrates can be further compared and contrasted according to their clinical uses, side effects, contraindications, and interactions. The clinical uses of both statins and fibrates are mostly similar. Both classes lower the LDL concentration; however, Statins lower it more than the fibrates. Also, they increase the HDL, high-density lipoprotein, and decrease the triglyceride concentration, which is more in fibrates than in statins. On the other hand, statins reduce coronary events and mortality in patients with ischemic heart disease. Moreover, they lower the risk of ischemic stroke and treat hyperlipidemia. In contrast, fibrates activate peroxisome proliferator-activated receptor alpha, PPAR-alpha, this protein activates enzyme lipoprotein lipase that leads to decrease the formation of the very low-density lipoprotein (VLDL), which is converted into LDLs, and triglycerides. Also, this activation increase the HDL concentration. Statins and fibrates side effects are somewhat similar. Patients with both diseases suffer from muscular side effects. Both statins and fibrates consumption cause myopathy, such as rhabdomyolysis. However, with statins intake, myalgia and myositis may occur. Also, hepatic side effects can be a result of statins and fibrates, such as hepatitis, which is acute and rare accompanying the former and mild with the latter. In addition, jaundice is another hepatic side effect of statins intake. Similarly, the two types of drugs can cause gastro-intestinal disturbance, such as diarrhea, abdominal pain, bloating, nausea, and stomach upset.

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