A patient who has primary hyperlipidemia and who takes atorvastatin (Lipitor)continues to have LDL cholesterol of 140 mg/dL after 3 months of therapy.The primary care NP increases the dose from 10 mg daily to 20 mg daily.The patient reports headache and dizziness a few weeks after the dose increase.The NP should:

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When used in combination with a low-dose statin,ezetimibe has been noted to produce an additional 18% reduction in LDL.Because this patient continues to have elevated LDL along with side effects of the statin,the NP should resume the lower dose of the statin and add ezetimibe.Atorvastatin is given once daily.Cholestyramine and omega-3 supplements are not indicated.

A Patient Who Has Primary Hyperlipidemia and Who Takes Atorvastatin