Cholesterol medications: Consider the options
Healthy lifestyle changes are the first defense against high cholesterol. But sometimes diet and exercise aren't enough. Enter cholesterol medications. These drugs may help:
- Decrease low-density lipoprotein (LDL), the "bad" cholesterol that increases the risk of heart disease
- Decrease triglycerides, a type of fat in the blood that also increases the risk of heart disease
- Increase high-density lipoprotein (HDL), the "good" cholesterol that offers protection from heart disease
Your doctor may suggest a single drug or a combination of cholesterol medications. Here's an overview of benefits, side effects and cautions for common classes of cholesterol medications.
| Drug class | Generic and brand names | Benefits | Side effects and cautions |
|---|---|---|---|
| Statins | Atorvastatin (Lipitor) Fluvastatin (Lescol) Lovastatin (Altocor, Mevacor) Pravastatin (Pravachol) Rosuvastatin (Crestor) Simvastatin (Zocor) | Decrease LDL and triglycerides, slightly increase HDL | Constipation, nausea, diarrhea, stomach pain, cramps, muscle soreness, pain and weakness, possible increased concentration when taken with grapefruit juice |
| Bile acid binding resins | Cholestyramine (Questran) Colesevelam (WelChol) Colestipol (Colestid) | Decrease LDL | Constipation, bloating, nausea, gas, may increase triglyceride levels |
| Cholesterol absorption inhibitors | Ezetimibe (Zetia) | Decrease LDL, slightly decrease triglycerides, slightly increase HDL | Stomach pain, fatigue, muscle soreness |
| Combination cholesterol absorption inhibitor and statin | Ezetimibe/simvastatin (Vytorin) | Decrease LDL and triglycerides, increase HDL | Stomach pain, fatigue, gas, constipation, abdominal pain, cramps, muscle soreness, pain and weakness, possible increased concentration when taken with grapefruit juice |
| Fibrates | Fenofibrate (Lofibra, TriCor) Gemfibrozil (Lopid) | Decrease triglycerides, increase HDL | Nausea, stomach pain, gallstones |
| Niacin (vitamin B-3, nicotinic acid) | Various prescription and over-the-counter preparations available, but prescription niacin preferred | Decrease LDL and triglycerides, increase HDL | Facial and neck flushing, nausea, vomiting, diarrhea, gout, high blood sugar, peptic ulcers |
Most of these medications are well tolerated, but effectiveness varies from person to person. If you decide to take cholesterol medication, your doctor may recommend periodic liver function tests to monitor the medication's effect on your liver. Also remember the importance of healthy lifestyle choices. Medication can help control your cholesterol — but lifestyle matters, too.
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