Triglycerides are fats that circulate in the blood and are available for conversion to energy. Levels above 150 mg/dL, or milligrams per deciliter, are considered elevated, and may increase the risk for a heart attack or stroke. High triglycerides may be associated with obesity, type 2 diabetes, metabolic syndrome, hypothyroidism or drugs such as birth control pills, beta blockers, steroids or tamoxifen. If lifestyle choices such as eating a diet low in fats and simple sugars and exercising regularly do not bring triglyceride levels down to the goal, prescription drugs may be indicated.
Fibrates
Gemfibrozil and fenofibrate are examples of drugs in this class. They work in the liver and other organs and have been shown to lower triglyceride levels by 20 to 50 percent. In addition, they elevate HDL, also known as good cholesterol. The most common side effects are stomach upset and diarrhea. These drugs may increase the "blood-thinning" effects of warfarin and other drugs. When combined with statin drugs, they increase the risk of muscle damage.
Niacin
Niacin is a B vitamin that has beneficial effects on triglycerides and cholesterol. While some forms are available over the counter, monitoring by a health care professional is recommended both for side effects and for efficacy. Triglyceride levels may be lowered by 20 to 50 percent with niacin, according to the National Heart Lung and Blood Institute. A warm flushing reaction is common when taking niacin and may be minimized by taking aspirin before the dose. Liver damage and elevated blood sugar may also result. Drug interactions may occur with medicines taken to treat high blood pressure.
Statins
Statin drugs include atorvastatin, lovastatin, pravastatin, rosuvastatin and simvastatin. They inhibit an enzyme responsible for the manufacture of cholesterol. They also have the ability to lower triglycerides. Abnormal liver tests, muscle aches and gastrointestinal upset are the most common side effects. Statins may be prescribed in combination with fibrates or niacin, but must be monitored closely for side effects.
Bile Acid Sequestrants
Cholestyramine is an example of a bile acid sequestrant that works inside the intestine and is not absorbed. It is FDA approved for the treatment of elevated triglycerides. It may cause stomach and intestinal upset and constipation. It may interfere with the absorption of some medicines and vitamins A, D and K, according to Monthly Prescribing Reference.
Omega-3 Fatty Acids
Omega-3 fatty acid supplements are available over the counter. There is also a prescription version available by the brand name Lovaza. Side effects may include infection, flu symptoms or a rash. It should be avoided in those with an allergy to fish. Drug interactions may occur with anticoagulants. A health care professional should be involved with omega-3 fatty acid therapy whether it is obtained by a prescription or not.
