If you have unhealthy cholesterol levels, chances are your doctor has talked with you about ways to improve your numbers. Changes in lifestyle, such as diet and exercise, are instrumental when it comes to improving your cholesterol, but in some cases, the addition of medication is necessary. After reviewing your cholesterol results and medical history, your doctor can determine the best cholesterol medication for you. Since medications work differently, don't be alarmed if your doctor prescribes more than one. Combination drug therapy is common and sometimes necessary to bring levels into a healthy range.
"Types" of Cholesterol
Cholesterol travels through your bloodstream with proteins in "packages" or "complexes." Low-density lipoprotein, or LDL, is known as the "bad" cholesterol, as it can build up in your arteries, restricting the flow of blood to your heart and brain and increasing your risk of heart disease and stroke. High-density lipoprotein, also called HDL or "good" cholesterol, transports LDL to your liver for disposal.
Statins
Statins, or HMG CoA reductase inhibitors, are a class of medication that can slow down cholesterol production by blocking a substance your liver requires to manufacture cholesterol. It can also remove cholesterol deposits from your arteries and reverse coronary artery disease. Statins are one of the most commonly prescribed cholesterol-lowering medications and include drugs such as atorvastatin, simvastatin, pravastatin, rosuvastatin, fluvastatin and lovastatin. Although statins are most effective at lowering LDL cholesterol, they can also increase HDL levels.
Bile Acid Sequestrants
Your liver uses cholesterol to make bile, an acid used during the digestive process. Bile acid sequestrants lower LDL levels by binding to bile acids, which render them useless, causing the body to dispose of them. When this occurs, your body signals the liver to produce more bile acids, which uses up excess cholesterol. Examples of this medication, also called a resin include colestipol, colesevelam and cholestyramine.
Fibric Acid Derivatives
Fibric acid derivatives, also called fibrates, are not very effective when it comes to lowering LDL cholesterol, but they can increase HDL levels. This drug works in your liver by influencing the production of blood fats. Examples of this drug include clofibrate, fenofibrate, gemfibrozil, and niacin in the form of nicotinic acid.
Ezetimibe
When you consume dietary cholesterol, it is first absorbed into your small intestine and then released into your bloodstream. Ezetimibe is classified as a selective cholesterol absorption inhibitor that lowers your cholesterol by limiting your absorption of dietary cholesterol. Approved as a cholesterol-lowering medication in 2002, ezetimibe is most effective in lowering LDL levels, but can also positively affect HDL cholesterol.
Side Effects
Cholesterol medications may cause side effects, although many resolve after a period of adjustment. Side effects may include muscle pain, constipation, diarrhea, nausea and stomach pain. Niacin may also cause skin flushing and liver toxicity. Ask your doctor what to expect and report anything that concerns you.
