The body naturally makes cholesterol, a soft, waxy substance, which aids in the production of certain hormones and cell formation. However, high cholesterol levels can be dangerous because they contribute to heart disease. To reduce these numbers to healthy levels, your doctor may prescribe medication or a combination of medications if your cholesterol remains high even after you change your lifestyle.
Statins
Statins help lower cholesterol, primarily low-density lipoproteins (LDLs), also known as bad cholesterol, by preventing its production in the liver.
Drugs in this class typically lower LDL levels between 20 and 60 percent, and it takes four to six weeks to see maximum results. The dosage is convenient: one pill in the evening when cholesterol production is at its highest, and then another pill at mealtime or bedtime.
Six statins are currently available: atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin calcium and simvastatin.
Bile Acid Resins
Known also as bile acid sequestrants, bile acid resins lower levels of LDL cholesterol by binding to the bile the intestines produce, excreting it through stool. Because bile is a necessary acid in the digestive process, the bile acid resins cause the liver to produce more bile as it binds to cholesterol. The more bile the liver produces, the more cholesterol it uses, thus leaving very little cholesterol to travel through the bloodstream.
Bile acid resins lower LDL levels approximately 10 to 20 percent, according to the National Heart Lung and Blood Institute, and are sometimes used in combination with statins for patients with heart disease. This combination lowers LDL by over 40 percent.
These drugs are available in powder form and tablets. If you are taking it in powder form, mix it with water or fruit juice and take once or twice a day. Take the tablets with large amounts of liquid to reduce the risk of gastrointestinal problems, such as constipation or bloating.
Drugs in this class include cholestyramine, colesevelam Hcl and colestipol.
Fibrates
Fibrates are the best option for those with high triglycerides and low levels of high-density lipoproteins (HDLs), also known as good cholesterol. People whose triglycerides are high or whose HDL is low, after reaching LDL goal, use fibrates, according to the American Heart Association.
Fibrates generally lower triglycerides by 20 to 50 percent and raise levels of HDL by 10 to 15 percent. The usual dose is twice a day, 30 minutes prior to breakfast and dinner.
The most commonly prescribed fibrate in the United States is gemfibrozil, although fenofibrate and clofibrate are also available.
Nicotinic Acid
Nicotinic acid, also known as niacin, is a water-soluble B vitamin that is available in over-the-counter and prescription forms. Effective for all three lipids, the National Heart Lung and Blood Institute recommends using it only under the supervision of a doctor due to its possible side effects. These include high blood pressure, peptic ulcers and gout. The American Heart Association adds that diabetics should take caution when using, as this medication can raise blood sugar levels.
