Statins – Statins are one of the more commonly perscribed medications to reduce cholesterol. These drugs inhibits the enzyme which the liver uses to produce cholesterol, thereby slowing the production of cholesterol in the body. People at risk for developing the plaques which line the arteries, or artherosclerosis, are usually given this medication. Statins not only slow the growth of plaques, but they also can shrink existing plaques and actually make them less likely to break apart, causing stroke or heart attack. Risk factors for artherosclerosis are:
High cholesterol levels;
Diabetes;
A family history of early-age heart attack or heart disease;
Advancing age.
There are several statins that are commonly perscribed. These medications have many differences, including their cholesterol-blocking ability, their side-effects, how they interact with other drugs, and their ability to reduce heart attack and stroke. Some common statins which are frequently perscribed include:
Atorvastatin (Lipitor);
Rosuvastatin (Crestor);
Fluvastatin (Lescol);
Simvastatin (Zocor);
Lovastatin (Mevacor);
Pravastatin (Pravachol).
Most side-effects of the statins are mild, like nausea and vomiting, but one major side-effect that is very rare, is rhabdomyolysis, which can cause muscle damage and eventually kidney failure. Any muscle or joint pain experienced while taking a statin should be reported immediately to your doctor.
Resins – Resins are another cholesterol-lowering medication. They bind with cholesterol-containing bile acids in the intestines and are then excreted. Resins actually reduce LDL cholesterol and are often perscribed with statins for a combined effect of lowered LDL cholesterol. Currently perscribed resins include:
Cholestyramine (Questran);
Colestipol (Colestid);
Colesevelam (WelChol).
Resins have few side-effects (gas, bloating, nausea and constipation); however, they may interfer with the absorption of other medications taken at the same time.
Nicotinic Acid – Nicotinic acid (niacin) is a common B vitamin, which, given in therapeutic doses, reduces LDL cholesterol and triglycerides. An over-the-counter niacin tablet as a dietary supplement would not produce the same effect, and could result in serious side-effects. Common trade names are:
Niacin;
Niacor;
Slo-Niacin.
Nicotinic acid interacts with other medications, including blood pressure medication, and your doctor should be consulted.
Gemfibrozil (Lopid) -- Gemfibrozil reduces triglycerides and increases HDL cholesterol, the good cholesterol, in the blood. It interacts with other medications, such as Coumidin, which could lead to increased bleeding, and glyburide, which could cause low blood sugar. The most serious, but rare, side-effect is rabdomyolysis, which could lead to kidney failure. Your doctor should be consulted and your current medications discussed before beginning therapy on gemfibrozil.
Clofibrate (Atromid-S) -- Clofibrate also acts by reducing LDL cholesterol levels; however, because of its many side-effects, it is usually perscribed only if all other methods of reducing cholesterol are ineffective. All current medications, including over-the-counter drugs, should be discussed with your doctor before using clofibrate.
Ursodiol (Actigall, Urso) – Ursodiol is made by the liver and reduces the production of cholesterol by the liver and absorption of cholesterol in the intestines. Side-effects are GI related, including nausea and vomiting, diarrhea, and constipation; and rash and back pain. Other medications may interfer with its function, reducing its effectiveness.
There are many more medications, including dietary supplements and over-the-counter medications that can help in reducing cholesterol levels. Before taking any medications, discuss them with your doctor and let your doctor know what medications you're taking already, to decide which may be best for you.
