Your cholesterol includes two different types: Low-density lipoprotein, also called LDL or "bad" cholesterol and high-density lipoprotein, also called HDL or "good" cholesterol. LDL cholesterol is the type that can deposit in your arteries and put you at risk for heart disease and stroke. HDL cholesterol is responsible for transporting LDL back to the liver for disposal. Lifestyle changes, such as eating a healthy diet, managing your weight and participating in regular daily exercise, can go a long way in managing your cholesterol. In some cases, lifestyle change alone just isn't enough and medication may be required. Your doctor can prescribe a cholesterol treatment regimen that is appropriate for you.
Bile Acid-Binding Resins
One of the functions of cholesterol in your body is to help make bile, an acid produced in your liver and used during the digestion process. Resins are a type of medication that help lower LDL cholesterol by binding to bile. Once binding occurs, the bile is no longer useful and it signals the liver that there is a shortage. The liver responds by using more cholesterol to produce more bile, which reduces the amount of cholesterol in your bloodstream. Examples of this medication include cholestyramine, colestipol and colesevelam.
Cholesterol Absorption Inhibitors
When you eat, cholesterol is absorbed into your small intestine and then released into your bloodstream. This class of drug is effective in limiting the amount of dietary cholesterol that your small intestine can absorb. Cholesterol absorption inhibitors can lower LDL cholesterol as well as increase HDL cholesterol levels. Approved in 2002, ezetimibe is the first drug of this class.
Fibrates
This class of drug is not effective in lowering LDL cholesterol, but it can increase HDL levels. Prescribed when LDL levels are within a target goal and HDL levels are low, it is sometimes used as a combination therapy with statin drugs. Fibrate medications include gemfibrozil, fenofibrate and clofibrate.
Niacin
Niacin in the form of nicotinic acid can increase HDL cholesterol as well as lower LDL levels. It affects the liver and influences the production of blood fats. Although niacin is available in supplemental form, administration of niacin should only occur under the supervision of your doctor. Your doctor will prescribe niacin in prescription form and monitor you carefully for side effects including flushing, itching and stomach upset. Niacin may also cause liver toxicity and increase blood sugar levels in diabetics.
