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Lowering Your Blood Cholesterol

Medications To Lower Blood Cholesterol

Last modified: 
19/04/2012 - 10:35

Contributing Author: Guy Slowik FRCS

If your blood cholesterol level is higher than it should be, your doctor will probably advise you to try to bring it down with diet and exercise first. For many people, diet and exercise changes can cause their cholesterol level to begin dropping after two to three weeks and to fall 30 to 55 points over three months.

If, after three months of healthy eating and regular exercise, your cholesterol level is still too high, your physician may suggest additional changes to help you lower the fat and cholesterol in your diet even more. If these changes in diet and exercise do not bring your blood cholesterol level down to a healthy level within six months, your physician may prescribe a cholesterol-lowering medication.

Many excellent medications have been developed in recent years. These medications work by different means:

  • Some reduce the amount of cholesterol the liver makes.
  • Some reduce the amount of dietary cholesterol that is absorbed from food.

Need To Know:

Whatever cholesterol-lowering medication you use, have regular blood tests to make sure the medication is working and not causing side effects. In addition, keep up the changes in diet, exercise, and lifestyle. These will help keep your cholesterol levels down and reduce your risk of heart disease and chronic diseases in other ways.

Types of medication that may be prescribed to lower cholesterol include:

  • Niacin. This B vitamin is found in foods and in multi-vitamin supplements. In high doses, available by prescription, niacin lowers LDL (the bad cholesterol) and raises HDL (the good cholesterol). Minor side effects are flushing or tingling skin, itching, and headache.
  • Bile-acid sequestrants. These medications help to limit the liver's production of cholesterol. Common bile-acid sequestrants include colestipol (Colestid) and cholestyramine (Questran). The most common side effects include digestive problems such as constipation, gas, and upset stomach.
  • HMG-CoA reductase inhibitors, also called statins, which are the newest medications available to lower cholesterol.

Statins (HMG-CoA reductase inhibitors)

The statins are a powerful group of drugs used to lower cholesterol. They work by interrupting the final step in the chemical pathway that creates cholesterol in the liver.

Research shows that statins can dramatically reduce the risk for a heart attack, stroke, or death, even in people who have normal cholesterol levels and do not have heart disease. In people with heart disease, statins prevent a first or second heart attack.

Statins are considered safe and well tolerated. Their mild side effects include headaches, abdominal pain, constipation, diarrhea, and gas. They occasionally can cause muscle or joint pain. In rare cases, they can cause liver damage, which is why it's important to see your doctor regularly if you take a statin.

Common statins are:

  • Atorvastatin (Lipitor)
  • Fluvastatin (Lescol)
  • Lovastatin (Mevacor)
  • Pravastatin (Pravachol)
  • Simvastatin (Zocor)

The Newest Medication to Lower Cholesterol

The latest drug recently released to lower cholesterol is called Zetia (generic name-ezetimibe). Zetia works by lessening the amount of cholesterol absorbed through the intestines following meals, unlike the commonly used ‘statins’, which reduces cholesterol by restricting its production in the liver.

Zetia appears to effect both the bad LDL type cholesterol as well as the good HDL cholesterol by lowering the bad cholesterol and raising the good cholesterol. The total body cholesterol is also lowered, as are the level of circulating fats (triglycerides) in the blood.

Zetia is commonly prescribed together with one of the statin cholesterol lowering drugs because this combination has a more powerful impact on lowering the cholesterol.

Side effects, which are not particularly common and usually mild, include muscle discomfort felt in the abdomen or back, diarrhea, or discomfort in the joints.

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Lowering Your Blood Cholesterol

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From Andrew Maynard - Chair of the University of Michigan Department of Environmental Health Sciences, with help from David Faulkner - 2013 Master of Public Health graduate.