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If blood triglycerides 600 mg/dl or greater:

• Try Low Fat Diet (20% or less of total calories from fat)
• Also consider drug therapy:

• Niacin as initial agent

• Followed by fenofibrate or gemfibrozil
• Fish Oil-the last resort!

If blood triglycerides <600 mg/dl:

• Step I or Step II diet (as tolerated)
• Gemfibrozil, fenofibrate or niacin as initial agent
• Followed by alternative agent

Once TG corrected, evaluate and treat LDL, if elevated.

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