The Curbsiders Internal Medicine Podcast #407 DIGEST: Bempedoic acid and cardiac risk, Alpha-Gal Syndrome, Orforglipron, Zuranolone, DOACs for VTE of Malignancy, mAbs for Dementia, New Med for Smoking Cessation, Kiwis and Constipation
Sep 11, 2023
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Prescribing Precautions For Bempedoic Acid
- Avoid combining bempedoic acid with high-dose simvastatin (>20 mg) or lovastatin due to increased statin levels and risk.
- Monitor uric acid, LFTs, and creatinine; consider gout history before prescribing.
DOACs Practical For Cancer VTE
- DOACs are noninferior to LMWH for cancer-associated VTE in pragmatic settings and improve adherence.
- Apixaban dominated DOAC use and may explain lower major bleeding vs other DOACs.
Anticoagulant Selection In Cancer VTE
- Choose anticoagulant considering cancer type, bleeding risk, and patient preference; DOACs are reasonable first-line if no high GI bleed risk.
- Use twice-daily or weight-based LMWH carefully and expect adherence barriers with injectables.