Having high cholesterol can be a health risk for heart disease. While diet, exercise and lifestyle changes such as quitting smoking and keeping blood sugar levels under control if you're diabetic can help lower cholesterol, your doctor may prescribe medications to decrease cholesterol levels. Cholesterol-lowering medications work either by decreasing cholesterol production or by decreasing absorption and increasing excretion of cholesterol. Several categories of medications treat low-density lipoprotein levels, the "bad" cholesterol. High-density cholesterol is helpful and high levels are desirable.
Statins
Statins, the best-tolerated and safest of the cholesterol medications, according to Harvard Health Publications, block cholesterol production in the liver. Statins are medically known as HMG-CoA reductase inhibitors. Statins also increase LDL removal from your blood and raise HDL levels slightly. Statin drugs on the market as of 2010 include atorvastatin, sold as Lipitor; fluvastatin, sold as Lescol; lovastatin, sold as Altoprev and Mevacor; pravastatin, sold as Pravachol; rosuvastatin, sold as Crestor; and simvastatin, sold as Zocor. Vytorin combines a statin with a cholesterol absorption inhibitor, while Advicor combines a statin with niacin. Abdominal symptoms such as bloating, nausea and diarrhea or constipation are the most common side effects of statins.
Niacin
Niacin, sold as Niaspan, is a lipoprotein synthesis inhibitor that lowers triglyceride levels and slows removal of HDL, the "good" cholesterol, from your body. In high doses, niacin decreases production of very low-density lipoprotein, or VLDL, which converts into LDL, thereby lowering LDL levels. Side effects of niacin include flushing and stomach symptoms such as nausea, vomiting or diarrhea. Niacin may also increase the risk of gout.
Fibrates
Fibrates, also called fibric acid derivatives, increase the breakdown of lipids, decrease VLDL production and increase VLDL removal from the bloodstream. Fibrates also decrease triglyceride levels. Fibrate drugs include fenofibrate, sold as Lofibra and Tricor, and gemfibrozil, sold as Lopid.
Bile Acid Binders
Bile acid binders lower cholesterol levels by increasing bile acid excretion. Since bile acids are needed to manufacture bile, this removes LDL from the bloodstream to make more bile. Colestipol, sold as Colestid; cholestyramine sucrose, sold as Questran; and colesevelam, sold as Welchol are all bile acid binders. Bile acid binders may increase triglyceride levels, MayoClinic.com warns. Side effects of these drugs, like other cholesterol-lowering medications, include stomach symptoms such as nausea, diarrhea and gas.
Cholesterol Absorption Inhibitors
Ezetimibe, sold as Zetia, decreases cholesterol absorption in the gastrointestinal tract, lowering LDL levels. Side effects include abdominal pain, diarrhea and muscle aches.
Omega-3 Fatty Acids
Omega-3 fatty acids, sold as Lovaza, lower triglyceride and LDL levels. Lovaza may increase the risk of infection and increases burping, imparting a fishy taste to burps.
