The effects are exponential so those 5 or 10 years are worth much more doing it now than later and even small changes make huge differences.
Ezetimibe won’t affect desmosterol, neither will bempedoic acid or PCKS9i.
Praluent can be had for $200 a month now at 150 mg one time a month.
I’ve posted some studies a while ago that showed that pulsed (once weekly dose) of statins is quite effective in reducing LDL-C and ApoB. If you add daily Ezetimibe or enough soluble fibers to your diet you can further reduce it.
Is Praluent better than Repatha? 150mg of Praluent once a month seems to be an off-label use, right? Does anyone have experience with whether the effectiveness declines too much during the last week? I’m personally interested in PCSK9 inhibitors because statins cause muscle symptoms for me, and Bempedoic Acid caused stomach pain. I’m currently only on Ezetimibe. I have high Lp(a), so in that sense, a PCSK9 inhibitor could be a good option. It might be difficult to get a prescription, and the cost is also a bit intimidating, which is why the 150mg per month option interests me
I have just attempted it and while l will put out the caveat that it could certainly be me… I failed miserably (2 injectors wasted). I had difficulty with the needle centering in the syringe(any suggestions would be welcomed). My next attempt will be into a 2 ml sterile vial.
Into a syringe or vial works fine. I’ve done is a dozen times plus - no issues. There is no possibility of wasting the drug if you go through the procedure correctly.
I showed the process of doing this on a video.
I don’t know where the link is now, but @RapAdmin can likely update on this as it was uploaded. Regardless of what autoinjector - if you need to split doses, if can be done.
I was looking for the video you posted too but my search skills are not as good as l had hoped. I found a couple of videos on YouTube and it seemed pretty straightforward… Obviously l was doing something wrong, just not sure what.
I’m 39 and take 5mg Rosuvastatin daily. My ApoB was usually 90 before I started both that and 10mg Ezetimibe. Now it’s 40 or less.
If your ApoB is 90, it doesn’t matter how old you are. You should get an early start on getting it under 60. I really don’t see any downside. I am generally all for having an aggressive approach.
It seems so, there was at least a post-hoc analysis detecting an improvement in ACM in its clinical trial compared to Repatha. I don’t remember the effect right before the next dose, but 150 mg Q4W (monthly), at least had at one point a potent effect, and yes it’d be off-label or something like that. Splitting the dosing as others explain could be an option if done sterile.
If I remember correctly studies were done with atorvastatin (10 and 20 mg) and rosuvastatin (5 and 10 mg) and reduction was about 15-20% with once weekly dose. Will try to find the studies and post them.
I just wanted to post an update on my limited experience with splitting the mounjaro auto injectors. Again with the caveat that it could always be user error, the type of syringe one injects into matters. I failed 4 times (100% failure rate) with the syringe on the right. I succeeded twice (100% success rate) with the syringe on the left.
I know most people would Intuit this but just in case, go with the a similar syringe to what @DrFraser uses in his video.
So long as you pull out the plunger all the way to 1 mL and you put the needle of the autoinjector into the opening to that syringe, it’s hard to fail.
Alternatively some people have found it simpler to inject into a sterile 2 mL vial (can put up to 4 autoinjectors into the 1 vial = 2 mL), however, withdraw 0.5 mL of air from the vial before using the autoinjector into the vial. Naturally, solid prep of the port with alcohol pad.
Here is an example of these vials, cheap and easy to get - use on Amazon. Then simply pull out the desired dose with an insulin syringe.