Control High Cholesterol

The following is an Editorial Resource from YourTotalHealth.

A Primer on Cholesterol-Lowering Medications

Reviewed by: Abdou Elhendy, M.D., PhD, FACC, FAHA

Improving your diet, increasing your exercise, quitting smoking and reducing your stress level may be enough to get your cholesterol levels into a healthy range without medication. But if those changes alone don’t work, or if you have a genetic tendency toward cholesterol problems, it’s good to know that there are some very effective cholesterol-lowering drugs available.

Most people tolerate these drugs with no problems, but all medications have side effects, so those are listed here as well. Here’s what they are, what they do and what you should watch out for:

• Statins (including fluvastatin, atorvastatin, lovastatin, pravastatin, rosuvastatin and simvastatin) slow the body’s production of cholesterol and reduce cholesterol build-up from the arteries. Side effects vary depending on which statin you take, but may include headache, nausea, vomiting, constipation, diarrhea, skin rashes and muscle pain. In rare cases, there may be liver failure or muscle damage leading to kidney failure — which could be fatal.
• 
  
• Cholesterol absorption inhibitors (such as ezetimibe) diminish the absorption of dietary cholesterol through the intestines. Ezetimibe is sometimes combined with a statin in the same pill. When used alone, side effects may include abdominal pain, back pain, diarrhea, joint pain and sinusitis. When combined with a statin, side effects may include chest pain, dizziness, headache, muscle pain and upper respiratory infection.
• 
  
• Fibrates (also called fibric acid derivatives and known by the generic names fenofibrate and gemfibrozil) reduce triglycerides in the blood and increase HDL. Mild side effects may include headache, abdominal pain and back pain, and respiratory problems. More serious problems may include vomiting and muscle pain, and increased risk for gallstones and gall bladder disease, kidney problems and liver malfunction. Some of the more serious side effects may occur when fibrates are combined with another cholesterol-reducing drug.
• 
  
• Bile acid resins (also called bile acid sequestrants and known by the names cholestyramine, colesevelam and colestipol) lower LDL cholesterol. Side effects may include constipation and worsening of hemorrhoids, indigestion, muscle aches, sore throat, weakness and increased bleeding because resins interfere with the body’s absorption of vitamin K, which aids in blood clotting. Taking a vitamin K supplement can lessen this problem.
• 
  
• Niacin (also called nicotinic acid) is a B vitamin (B₃) that lowers triglycerides and LDL and increases HDL when given in large doses. Possible side effects can include flushing, fast or irregular heartbeat, nausea, vomiting, loss of appetite, stomach pain, unusual bleeding and bruising, weakness, fatigue, fever, yellow skin or eyes, dark-colored urine and pale bowel movements.
• 
  

What's Next:  Food & Drug Interactions

• Understanding Your Cholesterol Report
  
• Are You at Risk for Heart Disease?
  
• Why Triglycerides Matter
  
• News You Need To Know
  
• The Gender Gap

Review date: 06-25-2008