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NBME 22 Answers

nbme22/Block 4/Question#17

A 62-year-old man with dyslipidemia is brought to ...


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submitted by luckeroo(3),

why was this gemfibrozil and not niacin? I was lucky and guessed, but I thought niacin combined could also trigger myopathy?

.ooo.   Gemfibrozil is a CYP450 inhibitor causing an increase drug concentration of statin which would lead to the adverse side effect of myopathy. Not sure about niacin in combination with statin but believe this would be more likely to occur. Hope this helps! +  
yb_26  yes, it can be seen with niacin and esetemibe as well, according to UWorld. But first choice in such questions is always fibrates. +  
nor16  number one no-go combi is statin+fibrate here +