Fibrates
These include bezafibrate (Bezalip®), fenofibrate (Lipidil®), gemfibrozil (Lopid®).
Fibrates lower triglycerides by 30-40% and are generally well tolerated.
Fibrates should be avoided if you have significant kidney disease. If you have an elevated triglyceride level and a low LDL-C level, your doctor may prescribe a triglyceride- lowering drug alone. But if your LDL-C level is high, it would usually be lowered with a statin and perhaps a second drug might be added (such as niacin or a fibrate). While these drug combinations are highly effective, side effects are possible and more careful follow-up with your physician is essential.
Omega-3 (fish oil) supplements
2 to 4 capsules of 1000 mg per day of Omega-3 supplements will lower triglycerides by about 30% and may be recommended by your doctor.
Niacin
Niacin lowers triglycerides by a similar amount, but its use may be limited by side effects and increases in blood sugar. Brand name extended release niacin (Niaspan®) is better tolerated. “No-flush niacin” (inositol hexanicotinate) is not effective. The most potent statin drugs can also lower triglycerides by 40%.