The University of Maryland Medical Center (UMMC) refers to high cholesterol and high triglycerides as lipid disorders, conditions characterized by an excess amount of fat in the blood. Lipid disorders increase the risk of heart disease, stroke and high blood pressure. Lifestyle interventions such as diet, exercise, weight management and smoking cessation are used to lower triglycerides and cholesterol in addition to drug therapy.
Statins
Statins, also known as HMG CoA reductase inhibitors, are the most common drug used to treat high cholesterol, according to the Mayo Clinic. Statins interfere with the liver's production of cholesterol. Statins are extremely effective at lowering LDL cholesterol, a type of cholesterol often referred to as "bad cholesterol" that causes fatty buildup in arteries. Statins are not for use by pregnant women, individuals with liver disease and those who are allergic to statins. Possible side effects of statins include diarrhea, heartburn, constipation, stomach pain or cramps, muscle or joint pain, fatigue, headache, rash, blurry vision and problems sleeping.
Common statins are lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor), fluvastatin (Lescol), torvastatin (Lipitor) and rosuvastatin (Crestor).
Bile Acid Sequestering Resins
Bile acid sequestering resins (BASRs) lower cholesterol indirectly. The liver uses cholesterol to make bile, a digestive fluid. BASRs bind to bile which makes bile useless. As a result the liver has to produce more bile. The more bile the liver produces, the more cholesterol is pulled from the blood which lowers blood cholesterol. Side effects of BASRs include constipation, bloating, fullness, nausea, and gas. The American Heart Association says BASRs are not appropriate for individuals with high triglycerides because they can raise triglycerides.
Common BASRs are cholestyramine (Questran), colesevelam (Welchol) and colestipol hydrochloride (Colestid).
Cholesterol Absorption Inhibitors
Cholesterol absorption inhibitors limit the amount of dietary cholesterol that is absorbed from the small intestine and released into the blood. An example of a cholesterol absorption inhibitor is ezetimibe (Zetia). Cholesterol absorption inhibitors can cause stomach pain and fatigue.
Fibrates
The Mayo Clinic says fibrates like fenofibrate (Lofibra, TriCor) and gemfibrozil (Lopid) speed up the removal of triglycerides from the blood. Fibrates can also lower the production of VLDL, a type of cholesterol that contains triglycerides. Side effects of fibrates are upset stomach and stomach pain, vomiting, gas, headache, dizziness, fatigue, muscle pain and weakness, rash, hair loss and abnormal heart rhythms.
Niacin
Niacin, also known as nicotinic acid, lowers triglycerides by limiting LDL and VLDL production and is administered to patients with very high triglycerides. Niacin is available in over-the-counter (OTC) and prescription forms but the Mayo Clinic says that prescription versions tend to have fewer side effects. The AHA warns that supplemental OTC niacin is not regulated by the U.S. Food and Drug Administration and therefore should not be substituted for prescription niacin. Side effects of niacin include flushing, dry skin, rash, upset stomach, vomiting, diarrhea, high blood sugar, headache and abnormal heart rhythms.
Combination Drugs
Ezetimibe-simvastatin (vytorin) combines a cholesterol absorption inhibitor and statin. This type of drug lowers the production of cholesterol and prevents its absorption into the blood. Drugs that combine niacin and statins are also available. According to the Mayo Clinic, taking a combination drug can reduce the number of pills an individual has to take but there is no evidence that combination drugs are more effective than taking drugs separately.
