Your doctor may try to control your cholesterol level first with diet and exercise. If that doesn't work, you may need medication to keep cholesterol levels in check. There are many on the market in several different categories sold under a variety of brand names. Here are some of the drugs available as generic medications.
Statins
Statins are used to control cholesterol because they can prevent your body from making it and may help remove blockages in blood vessels. Statins include simvastatin (Zocor), lovastatin (sold as Altoprev and Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor), fluvastatin (Lescol and Lescol XL) and atorvastatin (Lipitor). These drugs lower the "bad" cholesterol (low-density lipoprotein or LDL) and raise the "good" cholesterol (high-density lipoprotein or HDL). They also decrease triglycerides. Side effects may include pain in the muscles, damage to the liver, constipation, diarrhea and nausea.
Bile Acid Binding Resins
These medications lower the LDL or "bad" cholesterol. They include colesevelam (Welchol), colestipol (Colestid) and cholestyramine (sold as Questran, Prevalite and Questran Light in the United States). Side effects may include anxiety, dizziness, fever, rapid heartbeat, diarrhea, congestion, confusion, blurry vision, nausea, seizures, nightmares, headaches and coma.
Fibrates
Fibrates increase HDL cholesterol while lowering triglycerides. They may be prescribed as fenofibrate (under brand names such as Lofibra, Antara, TriCor, Triglide, Fenoglide and Lipofen) or gemfibrozil (Lopid). They are available as tablets or capsules. Possible side effects include a rash, continual indigestion, nausea, infections, chills, sore throat, cramps, breathing difficulties, headaches, stomach aches, constipation and back pain.
Niacin
Prescription-strength niacin---which is nicotinic acid and vitamin B3---is marketed under such names as Niaspan, Niacinol, Nicotinex and Niacor. Niacin can decrease both triglycerides and LDL, while raising the HDL level. Side effects may include stomach pain, headaches, a rash, diarrhea, dizziness, pain in the joints, cramps, sneezing and weakness. Some side effects require immediate medical attention. These include yellowness in the skin or eyes, severe abdominal pain, appetite loss and dark urination.
Cholesterol Absorption Inhibitors
Ezetimibe, sold as Zetia, raises HDL and lowers triglycerides and LDL. It is in pill form. Side effects may include indigestion, cramps, fever, nausea, skin spotting, vomiting, pain throughout the body, diarrhea, congestion, dizziness and swollen glands.
Combination Drugs
Two types of drug combinations may be used to fight high cholesterol. These include ezetimibe and simvastatin (marketed as Vytorin), and lovastatin and niacin, (marketed as Advicor). Both types decrease triglycerides and LDL and increase HDL. Side effects from the ezetimibe/simvastatin combination include bloating, hives, irritation, itching, severe nausea, skin redness, facial swelling, rapid heartbeat, difficulty swallowing or breathing, stiffness, difficulty moving, diarrhea and congestion in the ears. The lovastatin and niacin combination may produce such side effects as infections, body pain, diarrhea, dizziness, confusion, fainting, headaches and chills.
