Approved in January 2013, mipomersen (Kynamro™) is the first and only medication in this class. It is approved for a specific genetic high cholesterol disorder known as homozygous familial hypercholesterolemia (HoFH). It is given as an injection just under the skin (a subcutaneous injection) once a week and is intended for use in combination with other cholesterol medications. Like many other cholesterol medications, mipomersen can cause serious liver problems, and careful monitoring of the liver (using routine blood tests) is recommended.
In the past, when there was a large focus on LDL goals, if you did not reach your LDL goal after three months of taking a single cholesterol medication, your healthcare provider would consider starting a second medicine along with it. However, now that there is very little emphasis on the old LDL goals, it is unclear what role these other medications may have. One important role may be in people who cannot tolerate their recommended dose of statin due to side effects, since the use of low doses of each medicine may help reduce side effects.
Examples of cholesterol medications that have been combined into one form include:
- Ezetimibe/simvastatin (Vytorin®) or ezetimibe/atorvastatin (Liptruzet)
- Niacin extended-release/simvastatin (Simcor®).
If your doctor prescribes medications for cholesterol, you also will need to:
- Follow your a diet low in cholesterol
- Be more physically active
- Lose weight (if you are overweight)
- Control all of your other risk factors for heart disease (including smoking, high blood pressure, and diabetes).
Taking all these steps together may lessen the amount of cholesterol medication you need or make the medicine work better -- and that reduces your risk for a heart attack.