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Cholesterol (cont.)

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What medications are available to lower cholesterol, lipids, and triglycerides?

Lipid-altering medications are used to lower blood levels of undesirable lipids such as LDL cholesterol and triglycerides and increase 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 lower LDL and increase HDL at the same time.

Note: Dosing guidelines change. The U.S. Food and Drug Administration (FDA) issued a guideline concerning the potential dangers of taking the 80 mg 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 gemfibrozil (Lopid), fenofibrate (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 professional.

Research to date suggests that only statin medications are effective in lowering the risk of developing heart disease.

Medically Reviewed by a Doctor on 3/13/2014

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