For most people, dietary and lifestyle changes are enough to lower cholesterol levels within a healthy range. However, your doctor may decide that drug therapy is necessary to increase the efficacy of your treatment plan. The type of cholesterol-lowering medication that is prescribed for you will depend on the type of cholesterol that requires treatment.
Statins
Statins slow the production of cholesterol in your liver. Drugs in this class include lovastatin, simvastatin, atorvastatin, pravastatin, fluvastatin and rosuvastatin. These medications also reabsorb cholesterol from your artery walls, which reduces plaque buildup and helps reduce your risk for heart disease. These are the most commonly prescribed cholesterol-reducing drugs, as they are the most effective for lowering your low-density lipoprotein, or LDL cholesterol, the type that poses the greatest health risk to you. Most patients experience a reduction between 20 and 60 percent, but it can take up to six weeks for the maximum effect to take place, according to the National Heart Lung and Blood Institute. Most people tolerate these drugs well, but a low risk of liver damage exists. Therefore, six weeks after you begin this medication, your doctor will likely perform a blood test to check your liver enzymes. Elevated enzymes indicate a possible risk, and may require a lower dosage or a change in medication.
Bile Acid Resins
Bile acid resins, also known as bile acid sequestrants, help lower your LDL between 15 and 30 percent, according to the National Heart Lung and Blood Institute. Bile acids are necessary for proper digestion and your liver uses cholesterol for this process. Medications in this class, such as cholestyramine, colesevelam and colestipol, bind to these bile acids, flushing them from your body through your bowel movements. This forces your liver to use more cholesterol for the digestion process, which lowers your cholesterol. Your doctor may combine these medications with a statin to increase the cholesterol lowering process.
Cholesterol Absorption Inhibitors
As of 2011, only one drug falls in this category -- ezetimibe. It helps lower your cholesterol by limiting the absorption of cholesterol from the food you eat. Its effectiveness ranges between 18 and 25 percent, but your doctor may combine it with any of the statins to increase the efficacy of either drug. One specific statin -- simvastatin -- is pharmacologically combined with ezetimibe. The result is Vytorin, a drug that decreases the absorption of dietary cholesterol while slowing cholesterol production. This may be more effective than combining ezetimibe with other statins, but doctors do not yet know if Vytorin is more effective than simvastatin alone in reducing your risk of heart disease.
Treating Children
High cholesterol affects children as well as adults, but the treatment causes a great deal of debate. The American Academy of Pediatrics states that children over the age of 8 with high levels of LDL cholesterol may take a cholesterol-lowering medication. This, however, is at the discretion of their doctors. A statin is the most common choice, even for a child. Those under the age of 8 need to receive nutrition counseling, increase physical activity and lose weight if they are obese.
References
- American Academy of Pediatrics; New AAP Policy on Lipid Screening and Heart Health in Children; July 7, 2008
- National Heart Lung and Blood Institute: Cholesterol Lowering Medicines
- MayoClinic.com; High Cholesterol Treatments and Drugs; June 24, 2010
- National Heart Lung and Blood Institute: Your Guide to Lowering Your Cholesterol With TLC
