Cholesterol medications: When diet and exercise aren't enough

Cholesterol medications: When diet and exercise aren't enough

If diet and lifestyle changes aren't enough to bring down your blood cholesterol to healthy levels, your doctor may recommend a cholesterol-lowering drug. Knowing the pros and cons of the dissimilar types of medications used to lower cholesterol can lead to more informed decisions about your options.

Statins

These drugs, such as atorvastatin (Lipitor), rosuvastatin (Crestor) And simvastatin (Zocor), work by inhibiting the activity of an enzyme that controls cholesterol production.

Benefits. Statins lower low-density lipoprotein (LDL), or "spoilt," cholesterol by 20 to 55 percent — more than any other drug. They also raise high-density lipoprotein (HDL), or "good," cholesterol. LDL clogs the arteries, while HDL prevents cholesterol buildup in the arteries.Possible side effects. In rare cases, muscle pain and changes in liver enzyme levels may occur. People using statins have reported joint pain as well. Don't take statins if you're pregnant or have liver disease.Ezetimibe (Zetia)

This drug lowers the quantity of cholesterol absorbed by the body.

Benefits. Ezetimibe lowers bad cholesterol by 18 to 25 percentage. It can be studied in combination with statins to lower LDL levels even further. It can also produce good cholesterol.Possible side effects. Ezetimibe may cause diarrhea, joint pain and tiredness.Bile acid resins

These drugs, such as cholestyramine (Prevalite), colestipol (Colestid) And colesevelam (Welchol), bind to bile acids in the bowel. These acids contain cholesterol, which are then ruled out from the body.

Benefits. Bile acid resins can bring down LDL cholesterol by 15 to 30 percent.Possible side effects. Bile acid resins may need to be taken in combination with other cholesterol-lowering drugs to effectively lower LDL levels. They may cause stomach and intestinal issues such as irregularity.

Nicotinic acid

Nicotinic acid (Niacin) Is a water-soluble B vitamin that takes down bad cholesterol and increases good cholesterol.

Benefits. Nicotinic acid reduces LDL levels by 5 to 15 percent, and up to 25 percent in some people.Possible side effects. Nicotinic acid may induce flushing, itchiness and upset stomach. Your doctor must monitor your liver function if you're calling for this drug. Don't apply it if you have diabetes because it can raise blood sugar levels.

Fibrates

Fibrates, such as gemfibrozil (Lopid) And fenofibrate (Tricor), can elevate good cholesterol if you have low HDL levels.

Benefits. Fibrates can improve HDL levels.Possible side effects. Among all cholesterol-lowering medications, fibrates are the least efficient at lowering bad cholesterol. They can also cause muscle pain when prescribed with statins, as well as digestive problems.Injectable medications

A novel class of drugs can help the liver absorb more LDL cholesterol — which lowers the amount of cholesterol circulating in your blood. Alirocumab (Praluent) and evolocumab (Repatha) Are approved for people who hold a genetic condition that causes very high levels of LDL. The drug also may be used if you have caused heart attacks or strokes and need additional lowering of your LDL levels. The drug is administered by injection at home one or two times a month.

Benefits. When submitted with a statin, this drug may further reduce LDL cholesterol.Possible side effects. Common side effects include itching, swelling, pain or bruising at the injection site. Back pain, rash, hives, swelling of the nasal passages and flu also may come.

Your doctor will urge a specific choice of medication or combination of medications based on a variety of factors, such as your individual risk factors, your age, your current health and possible side effects. Your doc will also monitor your medication regularly and recommend lifestyle changes that will allow you to take less medication and lower your risk of heart disease.