High blood cholesterol is a major cause of stroke and heart disease. According to the American Diabetes Association, those diagnosed with heart disease or have LDL or bad cholesterol level exceeding 200mg/dL should take cholesterol-lowering drugs in addition to exercising and eating healthily.
At present, there are a few groups of drugs to reduce blood cholesterol. These include statins, bile-acid-binding resins and cholesterol absorption inhibitors. And since many people with high blood cholesterol also have high triglycerides, medicines such as fibrates and niacin are also worthy of a mention here.
Statins
Medicines in this group are often the first drugs to be tried on a patient. Statins work by blocking a substance needed by the liver to produce cholesterol. As a result, there is less cholesterol in the blood. Side-effects of statins include muscle and stomach pains but these are often mild. Commonly prescribed statins are atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Altocor, Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor) and simvastatin (Zocor).
Bile-acid-binding Resins
If statins cannot be used or are ineffective, doctors may prescribe bile-acid-binding resins, often available as cholestyramine (Prevalite, Questran), colesevelam (Welchol) and colestipol (Colestid). The liver uses cholesterol to make bile acids. So when a bile-acid-binding resin is used, it causes the liver to use excess cholesterol to make more bile acids. This helps remove some cholesterol from the blood.
Side-effects of bile-acid-binding resins include stomach upset and constipation. In some patients, these drugs may interfere with the body’s ability to absorb other medications that the patients are taking.
Cholesterol Absorption Inhibitors
A relatively new drug in this group is ezetimibe (Zetia), which helps lower blood cholesterol by reducing the absorption of dietary cholesterol in the small intestine. It can be used alone or together with any statin drugs.
Fibrates
Fibrates or fibric acid derivatives are prescribed for people with extremely high triglyceride levels in addition to high LDL (bad) cholesterol levels. Common drugs in this group are fenofibrate (TriCor, Lofibra) and gemfibrozil (Lopid). Side-effects of using fibrates are heartburn, stomach pain, diarrhea, rashes and muscle pain.
Niacin
Another group of drugs to lower triglycerides is niacin or nicotinic acid. This medication is recommended for use at low doses because it can affect blood glucose control. Common brands are Niacor and Niaspan.
Some over-the-counter (OCT) preparation and dietary supplements containing niacin are also available. However, doctors from Mayo Clinic caution against using these OCT products because they have more side-effects and may cause damage to the liver.
Patients on cholesterol-lowering medications should take their medicines as prescribed. If a patient finds a certain medicine leaves very severe side-effects, he should let his doctor know as soon as possible. The doctor will then prescribe another medicine to suit his needs. Treatment compliance should be complemented with lifestyle changes, good eating habits and regular exercise to keep cholesterol at the ideal level.
Those who find this article useful may also be interested in reading Managing Diabetes by Caring for the Heart, Making Lifestyle Changes to Reduce Cholesterol and Cholesterol-lowering Foods.
References:
American Diabetes Association – Diabetes, Cholesterol and Heart Disease
Mayo Clinic – Treatments and Drugs for High Blood Cholesterol
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