If you have high cholesterol, you may have already tried diet and exercise to lower your LDL cholesterol and raise your HDL cholesterol. For some people, especially those with a family history of hypercholesterolemia, diet and exercise alone are not enough. You may need to begin taking one of the many cholesterol-lowering drugs on the market. While they're all effective, each is prescribed for a certain type of problem. Almost all of them have unwanted side effects, so you should only take them as a last resort. Cholesterol-lowering drugs come in four major classes: HMG-CoA reductase inhibitors (statins), fibric acid derivatives, nicotinic acid (niacin or vitamin B3) and bile-acid sequestrants.
HMG-CoA Reductase Inhibitors
HMG-CoA reductase inhibitors are the most popularly prescribed cholesterol drugs. They produce two effects in the liver--they interfere with the liver's ability to produce cholesterol, and they enhance the liver's ability to take cholesterol in from the blood. There are a number of different types, and they generally produce mild side effects, such as muscle tenderness and liver damage. Some patients report more serious side effects, such as heartburn, nausea, headaches and dizziness.
Fibric Acid Derivatives
Fibric acid derivatives are often prescribed for patients who need reductions in their LDL cholesterol and triglycerides but an increase in their HDL cholesterol. Side effects include gastrointestinal discomfort, bloating, skin rashes and sensitivity to sunlight.
Nicotinic Acid
Nicotinic acid is designed to lower a patient's LDL cholesterol while raising his HDL cholesterol. In some patients, this drug can also lower triglycerides. The worst side effects of nicotinic acid include itching and tingling of the skin, headaches, and flushing around the face and lower jaw.
Bile-Acid Sequestrants
Bile-acid sequestrants function primarily inside the intestine. Bile is made primarily from cholesterol, so bile-acid sequestrants bind to the bile, preventing the cholesterol from entering the bloodstream. The most common side effects include bloating and constipation. In some cases, patients report abdominal pain, vomiting, diarrhea, weight loss and flatulence.
