You have more than one type of cholesterol, each requiring a different medication, or combination of medications, to effectively lower your cholesterol levels. It is never a "one size fits all" situation, and in some cases, your doctor may need to try more than one medication from each class before you find the best drug to meet your needs.
Statins
The National Heart Lung and Blood Institute reports people with a low-density lipoprotein, "bad" cholesterol, level of 130 mg/dL or higher typically require a cholesterol-lowering medication. Statins are the most commonly prescribed for elevated LDL cholesterol; they have the fewest drug interactions and have the fewest side effects. Most patients experience a 20 to 60 percent drop in their LDL levels, however, these drugs provide only a slight increase in your high-density lipoprotein, good cholesterol, levels. Statins may also decrease your triglycerides. Drugs in this class include lovastatin, fluvastatin, rosuvastatin, atorvastatin, pravastatin and simvastatin.
Fibrates
The fibrates class of drugs are effective for treating high triglycerides. On average, patients experience between a 20 and 50 percent decrease, the NHLBI says. Fibrates may also increase your HDL cholesterol between 10 and 15 percent. Drugs in this class include fenofibrate, gemfibrozil and clofibrate. MayoClinic.com warns the combination of statins with gemfibrozil increases your risk of elevated liver enzymes, a side effect of statins that can lead to permanent liver damage if not detected and treated in a timely manner.
Bile Acid Binding Resins
Also known as a bile acid sequestrant, bile acid binding resins are another drug your doctor may prescribe to lower your LDL cholesterol. Alone it may reduce your cholesterol between 10 and 20 percent. However, you physician may combine it with a statin to increase results. Together you may experience a reduction of 40 percent. Common resins include colestipol, colesevelam and cholestyramine sucrose.
Cholesterol Absorption Inhibitors
Cholesterol absorption inhibitors are most effective for lowering your LDL cholesterol and have a modest effect on both your triglycerides and HDL cholesterol. Only one drug exists in this class -- ezetimibe. This can be taken alone or with a statin to help achieve your cholesterol-lowering goals. A separate combination drug -- ezetimibe-simvastatin -- is available, and may be more effective.
Niacin
An over-the-counter, soluble vitamin B supplement, niacin can help improve all cholesterol levels. Although inexpensive when you purchase the supplement form, you must take large doses for it to be effective. The supplement form can also produce serious side effects. A prescription form, Niaspan, is available, and is recommended when trying to improve your cholesterol levels. Its side effects are less severe and your doctor is able to monitor you while you take it. It can reduce your LDL by 10 to 20 percent, your triglycerides by 20 to 50 percent and increase your HDL by 15 to 35 percent, according to the NHLBI.
