Tredaptive - Used alone or in combination with HMG CoA reductase inhibitors as an adjunct to diet to reduce LDL-C, TG, LDL-C:HDL-C ratio, non-HDL-C, apo B and increase HDL-C and apo A-1 in patients with primary hypercholesterolemia (Fredrickson type IIa, heterozygous familial & nonfamilial) or mixed dyslipidemia (Fredrickson type IIb). (See Classification of Hyperlipoproteinemias in Table 1.) In patients with a history of myocardial infarction (MI) or coronary artery disease (CAD), nicotinic acid is indicated to reduce the risk of a recurrent nonfatal MI. In patients with dyslipidemia, nicotinic acid with an HMG-CoA reductase inhibitor or bile acid sequestrant is indicated to slow progression or promote regression of atherosclerosis. Nicotinic acid, alone or in combination with a bile acid sequestrant, is indicated as an adjunct to diet for the reduction of elevated total and LDL cholesterol levels in patients with hypercholesterolemia (Types IIa and IIb) when the response to a diet restricted in saturated fat and cholesterol and other nonpharmacologic measures alone has been inadequate. As adjunctive therapy for the treatment of adult patients with very high serum TG levels (Types IV and V hyperlipidemia) who present a risk pancreatitis and who do not respond adequately to a determined dietary effort to control them. Such patients typically have serum triglyceride levels >2000 mg/dL and have elevations of VLDL cholesterol as well as fasting chylomicrons (type V hyperlipidemia). Subjects who consistently have total serum or plasma TG <1000 mg/dL are unlikely to develop pancreatitis. Therapy with nicotinic acid may be considered for those subjects with TG elevations between 1000 and 2000 mg/dL who have a history of pancreatitis or of recurrent abdominal pain typical of pancreatitis. Some Type IV patients with TG <1000 mg/dL may, through dietary or alcoholic indiscretion, convert to a Type V pattern with massive TG elevations accompanying fasting chylomicronemia, but the influence of nicotinic acid therapy on the risk of pancreatitis in such situations has not been adequately studied. Drug therapy is not indicated for patients with Type I hyperlipoproteinemia, who have elevations of chylomicrons and plasma TG, but who have normal levels of VLDL. Inspection of plasma refrigerated for 14 hrs is helpful in distinguishing Types I, IV and V hyperlipoproteinemia. (See Classification of Hyperlipoproteinemias in Table 1.) Click on icon to see table/diagram Treatment of dyslipidemia, particularly in patients with combined mixed dyslipidemia (characterized by elevated levels of low-density lipoprotein-cholesterol and triglycerides and low high-density lipoprotein-cholesterol) and in patients with primary hypercholesterolemia (heterozygous familial and non-familial). Tredaptive should be used in patients in combination with HMG-CoA reductase inhibitors (statins), when the cholesterol-lowering effect of HMG-CoA reductase inhibitor monotherapy is inadequate. It can be used as monotherapy only in patients in whom HMG-CoA reductase inhibitors are considered inappropriate or not tolerated. Diet and other non-pharmacological treatments (eg, exercise, weight reduction) should be continued during therapy with Tredaptive. Tredaptive is used for patients who cannot control the cholesterol levels by diet alone. It can be used alone or in combination with other medicines to treat cholesterol problems.