Which medicine would be better for me? Rozat F or Lipaglyn 4 gm? - #9792

Patient Name: Suraj Age: 32 years Date: 12-04-2025 Chronic Illnesses: None Presenting Concern: Elevated Triglycerides and Mildly Raised Liver Enzymes (SGPT 88, SGOT 38) Clinical Summary: Suraj presents with borderline high triglyceride levels (197 mg/dL) and mildly elevated SGPT (88 U/L) with SGOT (38 U/L). No other abnormalities reported in the lipid or liver panel. The patient is currently seeking advice between Rozat F (Rosuvastatin + Fenofibrate) and Lipaglyn 4 mg (Saroglitazar) for lipid control and liver health. Medication Comparison: 1. Rozat F (Rosuvastatin + Fenofibrate) Indication: Primarily used to manage high cholesterol and triglycerides. Mechanism: Rosuvastatin reduces LDL cholesterol and slightly lowers triglycerides. Fenofibrate specifically targets high triglycerides. Side Effects: Muscle pain or cramps (rarely rhabdomyolysis) Mild liver enzyme elevation GI symptoms (nausea, abdominal discomfort) Slight increase in blood sugar in some cases Caution: Use carefully in those with existing liver abnormalities. 2. Lipaglyn (Saroglitazar 4 mg) Indication: Approved for hypertriglyceridemia with or without diabetes; also helps in improving liver enzyme levels in NAFLD/NASH. Mechanism: Dual PPAR alpha/gamma agonist – reduces triglycerides and improves insulin sensitivity. Side Effects: Mild gastric discomfort Occasional reports of increased creatinine Flatulence or bloating Usually well tolerated with fewer muscle-related side effects compared to statins Liver Friendly: Often chosen in patients with both high triglycerides and elevated liver enzymes. Recommendation: Considering: Your mildly raised SGPT, Triglycerides < 200, No diabetes, And that other parameters are normal — Lipaglyn (Saroglitazar 4 mg) may be a better initial choice, especially for patients with borderline triglycerides and concurrent liver enzyme elevation. It has a more favorable profile for liver health and is better tolerated in younger patients who are statin-naive or sensitive. However, if LDL cholesterol or total cholesterol were also elevated or if cardiovascular risk is higher, Rozat F could be considered (with liver monitoring). Additional Advice: Avoid alcohol Follow a low-carb, low-fat diet Exercise regularly (30–45 mins/day) Recheck liver function and lipid profile in 6–8 weeks after starting therapy Avoid fried or processed foods Next Steps: Start with Lipaglyn 4 mg once daily (after food), for 6–8 weeks Monitor LFTs and Lipid Profile after 2 months If no improvement or LDL remains high, consider adding a statin under physician guidance Please consult before starting or switching medications. Dr Shayeque Reza MD 9800280276