Low-density lipoprotein, or LDL, cholesterol can be a serious health problem. LDL cholesterol is associated with an increased risk of developing heart disease. Changes in your diet, weight and physical activity habits can help to control your LDL cholesterol, but this may not always be enough. If your LDL becomes too high, your doctor may suggest taking a cholesterol-lowering medication. Ideally, your LDL cholesterol should be maintained at 100 mg/dL or less, but it is not considered high until it reaches 160 mg/dL.
Statin Drugs
According to the American Heart Association, statin drugs are the most commonly prescribed cholesterol-lowering medications. These drugs work by inhibiting the body's production of cholesterol as well as increasing cellular intake of LDL cholesterol. These medications are user-friendly in that there are few negative interactions with other drugs and they are widely accepted by those who receive them. The side effects of statin drugs are few and include stomach pain, cramping and constipation. Statin drugs include atorvastatin, fluvastatin, simvastatin, cerivastatin and pravastatin.
Niacin
Niacin is a B vitamin that can also be used as a means to help lower LDL cholesterol. Niacin both reduces your body's production of very-low-density lipoprotein, or VLDL, and LDL cholesterol as well as inhibits the release of fatty acids into your bloodstream. Since VLDL cholesterol can become LDL cholesterol, the fact that niacin works on both is very beneficial. Niacin, although available as a supplement, should not be taken in supplement form to help lower LDL cholesterol. The prescription form of niacin should only be taken to lower LDL when it is given to you by your doctor. The side effects of niacin include flushing, which is redness and heat of your skin. For many, this can be avoided by taking aspirin 30 minutes before you take niacin.
Resins
A class of drugs known as resins may also be known as bile acid sequestrants and are used to help lower LDL cholesterol. These types of medications work to excrete bile acids and increase the sensitivity of LDL receptors; both are mechanisms to decrease your LDL cholesterol. The side effects of resin medications are usually mild and include constipation and stomach discomfort. Some common resin medications include cholestyramine, colestipol and colesevelam.
Fibrates
Fibrate medications mainly work to reduce VLDL levels. This is beneficial for LDL cholesterol, though, because VLDL is turned into LDL when it is needed for use by cells. Fibrates decrease the production of VLDL and increase VLDL metabolism. Common fibrate medications include gemfibrozil and fenofibrate. Side effects of fibrate medications are a little more serious and include elevated liver function tests, flushing and pruritis, random hives, and itchiness of the skin.
References
- American Heart Association; Cholesterol-Lowering Drugs; 2011
- "Cecil Essentials of Medicine"; Thomas Andreoli, Charles Carpenter, Robert Griggs, Joseph Loscalzo, eds.; 2004
- National Heart Lung and Blood Institute; High Blood Cholesterol: What You Need to Know; June 2005
