Reducing high cholesterol levels is an important way to protect the heart against coronary atery disease, heart attack and other serious medical conditions. While some people may benefit from more exercise and a more healthful diet, others need medication to reduce their cholesterol levels. The types of cholesterol lowering drugs available include statins, niacin, selective cholesterol absorption inhibitors, fibrates and resins.
Statins
Statin drugs work by blocking a liver enzyme that increases cholesterol production. While statins can reduce total cholesterol, they are most effective at reducing levels of low-density lipoprotein (bad cholesterol) in the blood. Before prescribing a statin drug, a medical professional will usually recommend lifestyle changes such as diet modification and increased physical activity. If these do not help to lower cholesterol levels, a statin drug may be prescribed. Because these drugs can cause liver problems, people who take statins need to get regular liver function tests. Pregnant women and people with liver disease should not take this type of drug. Side effects of statin drugs include muscle pain, flushing, rash and digestive problems. Examples of statin drugs include atorvastatin, lovastatin, simvastatin, rosuvastatin calcium, pravastatin and fluvastatin.
Niacin
Niacin, also known as nicotinic acid, is one of the B vitamins. It is responsible for helping the body use carbohydrates for energy. It can also be used to raise levels of good cholesterol in the blood. When niacin is used for this purpose, it is prescribed in high doses by a physician. This drug is sold under the brand names of Niacor, Niaspan and Slo-Niacin. One of the most common side effects of niacin is flushing of the skin. Other minor side effects include dizziness, itching, sweating, nausea, belching, diarrhea, and muscle pain and cramps.
Selective Cholesterol Absorption Inhibitors
Selective cholesterol absorption inhibitors work to reduce cholesterol by preventing cholesterol absorption in the intestinal tract. These drugs are best at lowering the levels of bad cholesterol in the blood, but they can also reduce triglycerides and increase levels of good cholesterol. Side effects of this type of drug can include numbness, fatigue, headache, dizziness, runny nose, cough, joint pain, tingly feelings, stomach pain, diarrhea and back pain. Seek medical attention if more serious side effects occur. Serious side effects include chest pain, unusual muscle pain or weakness, jaundice and loss of appetite. Zetia was the first approved selective cholesterol absorption inhibitor.
Fibrates
Fibrates, also known as fibric acid derivatives, reduce cholesterol by decreasing the production of triglycerides and increasing the speed of triglyceride removal from the bloodstream. These drugs are usually prescribed for people who have high triglyceride levels. Side effects of fibrates include a decrease in liver function, indigestion, and abdominal pain. These drugs should be taken with meals to avoid digestive system side effects. Examples of fibrate medications include Tricor, Atromid-S and Lopid.
Resins
Resins work to reduce cholesterol levels by working in the intestines. They bind to bile so that is is unavailable for digestion. The liver responds by producing more bile, which is made with cholesterol. The more bile that is produced, the more cholesterol the liver uses. This means that there is less cholesterol left in the bloodstream. These drugs are also known as bile acid-binding drugs or bile acid sequestrant. Examples of resins include colestipol, colesevelam Hcl and cholestyramine. Side effects of resin drugs include constipation, belching, diarrhea, bloating, weight loss, stomach pain, nausea, headache and vomiting.
