Cholesterol High Medications

Using Cholesterol Medications

For some people, changing diet patterns and adopting an effective exercise program are not enough to reduce LDL levels to normal. Some cases may require the use of statins, beta-blockers and aspirin, or vitamins such as niacin.

The use of medicines and vitamin supplements should always be approached with caution. The consumption of excessive quantities of vitamins or the side effects of medications can lead to serious consequences. Medications that have been deemed safe for others may not be safe for you, so avoid taking any substance prescribed for someone else. Drug interaction effects can be serious. Always inform your doctor of any herbal remedies, vitamins or other medications you’re taking.

Cholesterol MedicationsWhat Are Statins?

Statins are drugs that slow down the production of cholesterol and increase the liver’s ability to remove it from the blood. Commonly prescribed statin drugs are Zocor®, Lipitor®, Pravachol®, Mevacor®, and Lecol®.

Before starting a new prescription, read the accompanying literature to find out about potential side effects. While most people experience no discomfort with most statins, side effects of statin drugs can include indigestion, constipation and muscle pain. Close monitoring is necessary when statins are taken in conjunction with the antibiotic erythromycin or the heart drug digoxin. When taken with other cholesterol lowering drugs, statins have an additive effect. Plan to discuss side effects and contraindications with your doctor.

Lopid

Lopid, a commonly prescribed non-statin drug, inhibits the formation of blood fats. Typically, triglycerides and cholesterol are reduced within three months of starting the drug. The most common side effect is indigestion. If any other symptoms occur, such as chest pain, shortness of breath, irregular heartbeat, or nausea, inform your doctor immediately. A double dose of Lopid should never be taken to compensate for a missed dose.

Niacin

Besides lowering triglycerides and LDL cholesterol, niacin benefits include enhancing the effect of some statins, raising HDL, and lowering fibrinogen levels. Fibrinogen contributes to plaque formation.

One of the benefits of taking niacin is that it can slow the signs of aging. Check interaction effects, though, as some drugs or supplements can negate the benefits of niacin.

Common side effects of niacin include an upset stomach, flushing or itching soon after ingestion. Some doctors recommend taking aspirin to counteract the flushing effect. In some cases, liver enzymes may rise to abnormally high levels. Niacin may cause an increase in blood glucose levels, so niacin is generally not recommended for diabetics. Individuals with gout risk painful arthritis. Check with you physician before taking niacin supplements.

Agent or Drug Impact on Blood Triglycerides Impact on LDL Level Impact on LDL Particle Size Impact on HDL Level
Lopid decrease slight decrease increase increase
Niacin decrease slight decrease increase increase
Statins slight decrease decrease little or no increase slight increase

Drug Effectiveness

The information in the following table is based on two major studies of statin drugs: the Scandinavian 4S study of simvastatin and the five-year CARE study of pravastatin conducted jointly by American and Canadian researchers.

Medication Effect on Cholesterol Level* Additional Benefits Possible Side Effects
Bile acid resins: e.g., cholestyramine, colestipol Lowers LDL cholesterol 10% to 20%

 

Constipation, nausea and intestinal gas
Fibrates Raises HDL 10% to 15% Lowers triglycerides 20% to 50% Generally well tolerated; gastrointestinal problems possible
Niacin Lowers total cholesterol; lowers LDL 10% to 20%; raises HDL 15% to 35% Lowers triglycerides 20% to 50% Hot flashes, nausea, indigestion, vomiting possible; liver problems, gout, high blood sugar possible
Reproductive hormones In post-menopausal women, raises HDL and lowers LDL cholesterol

 

Raises triglyceride levels
Statins: e.g., Zocor (simvastatin); Lipitor (atorvastatin) Lowers LDL levels 20%
to 60%; lowers total cholesterol; raises HDL by 8%
Lowers triglycerides Well tolerated; upset stomach, constipation, gas, abdominal pain, weakness possible; liver and muscle problems rare

*This percentage is based on the number of patients showing a positive effect compared with the total number of patients taking the medication in the Scandinavian 4S and CARE studies.

Although they don’t have a direct impact on cholesterol levels, aspirin and beta blockers are common drugs used in treatment. Aspirin helps to prevent blood clotting after surgery, thereby reducing the frequency of heart attacks. Beta-blockers slow heart rate and lower blood pressure.

Resources

Lee, D. (ed). (2002). Cholesterol and the heart. MedicineNet, Inc.

National Heart, Lung, and Blood Institute. (nd). The benefits of cholesterol lowering.

National Heart, Lung, and Blood Institute. (2001). Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult treatment Panel III) [NIH Publication No. 01-3670].