Table 3.
Lipid-lowering and anti-hypertensive drugs that elevate homocysteine
| Drug | Effect on homocysteine | Suggested mechanisms | Evidence from |
|---|---|---|---|
| Fibric acid derivatives | increase of homocysteine: | reduction of glomerular function | Human studies, cross-sectional and clinical trials mechanistic studies in rodents |
| + 40% fenofibrate | increased creatin/creatinine | ||
| +20% bezafibrate | metabolism | ||
| + 20% gemfibrozil | PPARα-activation | ||
| Niacin | increase of fasting | ||
| homocysteine, amount unclear | effect on vitamin B6 metabolism increased methylation demand | Human studies, mechanistic studies in rodents | |
| Diuretics | increase of fasting homocysteine +20% hydrochlorothiazide | decreased glomerular filtration rate | Human studies, cross-sectional and one clinical trial |