Dear patient,
I agree it is quite a cumbersome and conflicting regimen. In terms of the muscle aches, all pitavastatin,
fenofibrate, cholesevelam (Welchol) and
cholestyramine can give muscle aches, and even more if you combine them. It is paramount for your doctors to decide which lipid (fat in your blood) they should be targeting first, since Welchol and cholestyramine can actually elevate tryglicerides, which is what they are presumably trying to decrease with fenofibrate. The only statin you are taking is
Livalo of pitavastatin. This one mainly targets bad
cholesterol, which is very important. There are several types of statins, and if that is the main fat that is wrong with you, then your doctors could switch you to another member of that class. Welchol and cholestyramine act the same way, so I really see no point on being on both.
As with the second question, probably none of this medications is raising your blood pressure, that is just the way your body is now, and if so, you probably need medication to regulate it; that being said, losing 8-10% of body weight, decreasing salt and alcohol intake and regular physical activity can all lower your blood pressure and might "spare" the need for medications.
On the other hand, in diabetic patients the main driver of abnormal lipid levels are not the medications, but the
diabetes itself, that impairs normal
metabolism of fats. This is particularly true for tryglicerides and good cholesterol, or
HDL. So, control of your diabetes is paramount
Hope all of that is helpful,
Dr Brenes-Salazar
Mayo Clinic Rochester