Final answer:
Patients with familial combined hyperlipidemia who cannot tolerate niacin or statins have alternatives like fibrates, ezetimibe, and bile acid sequestrants, and can consider natural options such as plant sterol-containing products and fatty acids.
Step-by-step explanation:
For patients with familial combined hyperlipidemia who cannot tolerate niacin or statins, there are alternative medications available. Fibrates such as fenofibrate or gemfibrozil can be considered due to their effectiveness in lowering triglyceride levels. Additionally, ezetimibe may be used to help reduce cholesterol absorption from the intestine. Other potential options include bile acid sequestrants, which can also lower cholesterol levels. For a natural approach, plant sterol-containing products and fatty acids might offer some benefits. It is crucial for patients to work closely with their healthcare provider to monitor blood lipid profiles when using these medications.