Cholesterol Medications

According to National Cholesterol Education Program (NCEP) guidelines endorsed by the American Heart Association, everyone after age of 20 should have a fasting “lipoprotein profile" every five years. Test readings of lipoprotein profile along with other risk factors of heart diseases will aid in determining the appropriate treatment for you. Your doctor is the best person to decide suitable treatment plan for you.

Different kinds of cholesterol lowering drugs 

Fibrates raise HDL concentrations and are good in lowering triglyceride levels.

Commonly available fibrates are:

1. Gemfibrozil
2. Fenofibrate
3. Clofibrate
4. Bezafibrate
5. Liprofibrate

Gemfibrozil has to be demonstrated to reduce the incidence of cardiovascular events. Clofibrate is rarely used & is associated with an increased incidence of gall stones. Fibrates are not very effective in controlling LDL cholesterol. So, they may be used along with statins.

These drugs are not indicated in liver & kidney disorder, gall bladder disease & pregnancy.

 
Cholesterol binding resins are used to reduce LDL cholesterol. They have no effect on HDL cholesterol, but known to raise triglyceride concentration. Resins combine with bile, an acid secreted by liver used in digestion, which makes it not possible to digest the food. To compensate, liver secretes more bile. Since, cholesterol is needed for formation of bile, more cholesterol is utilized from the body. In general, these bile acid binding resins promote excess disposal of cholesterol. These are useful in women of child bearing age.

Some varieties of resins available include:

1. Cholestyramine
2. Colestipol
3. Colesevelum HCL

Statins These drugs prevent the formation of cholesterol in the liver. Effective at lowering LDL cholesterol with limited effects on HDL & triglycerides.

These drugs should not be taken in active liver disease, pregnancy & breast feeding.

Examples for statins are:

1. Simvasatatin,
2. Pravastatin,
3. Atorvastatin,
4. Cerivastatin,
5. Fluvastatin,
6. Lovastatin etc.

Selective cholesterol absorption inhibitors These are new the new group of drugs that works by preventing the absorption of cholesterol from the intestine. Very effective in lowering LDL cholesterol. Ezetimibe is the first medicine of this class advocated for the treatment of high cholesterol & certain hereditary lipid disorders.

Niacin (Nicotinic acid) Its action is unclear. Niacin probably inhibits production of lipids in the liver and breaks down the lipid from fat depots. Its frequent side effects limit its value. Side effects are itching, flushing & nausea & stomach upset.

Moreover, medications should be begun only when weight control, healthy life style, fat-lowering diet, sufficient physical activities are not enough to maintain a normal lipid level. They may be prescribed individually or in combination.
 

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