Cholesterol (cont.)
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Cholesterol Levels facts
- What is cholesterol?
- What are LDL and HDL cholesterol?
- What determines the level of LDL cholesterol in the blood?
- Does lowering LDL cholesterol prevent heart attacks and strokes?
- How can LDL cholesterol levels be lowered?
- What are the current NCEP cholesterol treatment guidelines?
- Why is HDL the good cholesterol?
- What are triglycerides and VLDL?
- What medications are available to lower cholesterol, lipids, and triglycerides?
- Is lowering LDL cholesterol enough?
- Pictures of Cholesterol Levels - Slideshow
- Take the Cholesterol Quiz
- Lowering Cholesterol 15 Tips Slideshow Pictures
- High Cholesterol (Hyperlipidemia) FAQs
- Find a local Internist in your town
What medications are available to lower cholesterol, lipids, and triglycerides?
Lipid altering medications are used in lowering blood levels of undesirable lipids such as LDL cholesterol and triglycerides and increasing blood levels of desirable lipids such as HDL cholesterol. Several classes of medications are available in the United States, including HMG CoA reductase inhibitors (statins), nicotinic acid, fibric acid derivatives, and medications that decrease intestinal cholesterol absorption (bile acid sequestrants and cholesterol absorption inhibitors). Some of these medications are primarily useful in lowering LDL cholesterol, others in lowering triglycerides, and some in elevating HDL cholesterol. Medications also can be combined to more aggressively lower LDL, as well as in lowering LDL and increasing HDL at the same time.
Note: Dosing guidelines change. The US Food and Drug Administration (FDA) issued a guideline concerning the potential dangers of taking the 80mg dose of simvastatin (Zocor).
Lipid altering medications commonly used in the United States
| Medication class | Medication examples | Effects on blood lipids |
| Statins | pravastatin sodium (Pravachol), lovastatin (Mevacor), atorvastatin calcium (Lipitor), fluvastatin sodium (Lescol), rosuvastatin (Crestor), simvastatin (Zocor) | Most effective in lowering LDL, mildly effective in increasing HDL, mildly effective in lowering triglycerides |
| Fibric acid | Lopid, Tricor | Most effective in lowering triglycerides, effective in increasing HDL, minimally effective in lowering LDL |
| Bile acid sequestrants | cholestyramine (Questran), colestipol (Colestid), and colesevelam (Welchol) | Mildly to modestly effective in lowering LDL, no effect on HDL and triglycerides |
| Cholesterol absorption inhibitors | ezetimibe (Zetia) | Mildly to modestly effective in lowering LDL, no effect on HDL and triglycerides |
| Combining nicotinic acid with statin | lovastatin+niaspan (Advicor) | Effective in lowering LDL and triglycerides and increasing HDL |
Historically, niacin has been a one of the medications used to lower cholesterol and decrease the risk of heart attack and stroke. Its usefulness has been called into question by studies conducted in 2011 by the National Institutes of Health. Patients who are taking niacin should not stop using it without discussing treatment options for cholesterol control with their health care provider.
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