If you have high cholesterol, your doctor may recommend cholesterol medication in addition to a diet low in saturated fat, high in fiber, and low in refined carbohydrates.
Cholesterol is an important part of your cells and also serves as the building block of some hormones. The liver makes all the cholesterol the body needs. But cholesterol also enters your body from dietary sources, such as animal-based foods like milk, eggs, and meat. Too much cholesterol in your blood can increase the risk of coronary artery disease.
The first line of treatment for abnormal cholesterol is usually to eat a diet low in saturated and trans fats, and high in fruits and vegetables, nuts, and seeds, and to increase exercise. But for some, these changes alone are not enough to lower blood cholesterol levels; they also may need medicine to bring down their cholesterol to a safe level.
Cholesterol-lowering drugs include:
- Bile-acid resins
- Fibric acid derivatives
- Cholesterol absorption inhibitors
Cholesterol-lowering medicine is most effective when combined with a healthy diet and exercise.
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Statins block the production of cholesterol in the liver itself. They lower LDL, the “bad” cholesterol, and triglycerides, and have a mild effect in raising HDL, the “good” cholesterol. These drugs are the first line of treatment for most people with high cholesterol. Statins have been shown in multiple research studies to reduce the risk of cardiovascular events like heart attacks and death from heart disease. Side effects can include intestinal problems, liver damage, and muscle inflammation.
Statins also carry warnings that memory loss, mental confusion, high blood sugar, and type 2 diabetes are possible side effects. It’s important to remember that statins may also interact with other medications you take.
Examples of statins include:
- Atorvastatin (Lipitor)
- Fluvastatin (Lescol)
- Lovastatin (Mevacor)
- Pitavastatin (Livalo)
- Pravastatin (Pravachol)
- Rosuvastatin (Crestor)
- Simvastatin (Zocor)
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Nicotinic acid (niacin) is a B-complex vitamin. It’s found in food, but is also available at high doses by prescription. It lowers LDL cholesterol and raises HDL cholesterol. The main side effects are flushing, itching, tingling and headache. Research has not shown that adding nicotinic acid to statin therapy is associated with a lower risk of heart disease. Examples of nicotinic acid medication include:
[toggle title=”How Do Bile Acid Resins Work?”]
These drugs work inside the intestine, where they bind to bile from the liver and prevent it from being reabsorbed into the circulatory system. Bile is made largely from cholesterol, so these drugs work by depleting the body’s supply of cholesterol. The most common side effects are constipation, gas and upset stomach. Examples of bile acid resins include:
- Questran and Questran Light
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Fibrates reduce the production of triglycerides and can increase HDL cholesterol. Examples of fibrates include:
Ezetimibe (Zetia) lowers bad LDL cholesterol by blocking cholesterol absorption in the intestine. Research studies have not found that ezetimibe is associated with a lower risk of heart disease.
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Some people with high cholesterol, other cholesterol problems, or some other medical conditions, achieve the best results with combination drugs — pills that contain more than one medication. Some examples include:
Advicor: Lovastatin and niacin (nicotinic acid)
Caduet: Atorvastatin and amlodipine, a calcium channel blocker
Liptruzet: Atorvastatin and ezetimibe
Simcor: Simvastatin and niacin (nicotinic acid)
Vytorin: Simvastatin and ezetimibe, a cholesterol absorption inhibitor