The first choice of treatment when it comes to lowering cholesterol level is to change your diet and increase your exercise, according to the American Heart Association. These methods do not work for everyone, and if this is the case for you, your doctor may choose to prescribe a cholesterol-lowering medication for you. A variety exists, each with its own set of pros and cons.
Statins
Considered one of the most effective cholesterol medications when it comes to lowering high levels of bad cholesterol (LDL) according to the American Heart Association (AHA), this class of drugs offers a number of benefits, among which is decreasing a person's risk of developing cardiovascular disease.
The AHA states there are currently six statins available on the market, and while the main purpose of these drugs is to lower LDL levels, they are also to lower triglycerides and may slightly increase levels of good cholesterol (HDL). The difference among these six are the dosage and the number of times a day you need to take them.
The most common statins include atorvastatin (Lipitor), lovastatin (Mevacor), simvastatin (Zocor), pravastatin (Pravachol) and rosuvastatin calcium (Crestor).
The side effects are considered mild and typically subside as your body adjusts to them. These include upset stomach, gas, cramps, constipation and abdominal pain.
Bile Acid Sequestrants
Bile acid sequestrants, as explained by the National Institutes of Health (NIH), help lower LDL levels by 10 to 20 percent and work by binding to the bile acids in the intestines that contain cholesterol. The excess cholesterol is excreted through bowel movements, and these medications are sometimes prescribed in combination with statins for patients considered high risk, such as those with heart disease. When prescribed together, the NIH states, LDL levels may be reduced by as much as 40 percent.
The most common drugs prescribed in this class of drugs include cholestyramine (Questran, Prevalite, L-Cholest), colesevelam ( Welchol) and colestipol (Cholestid), all of which are available in either tablet or powder form.
The most common side effects associated with these medications include constipation, nausea, bloating and gas.
Fibrates
Fibrates are typically prescribed for those who need to lower triglyceride levels, as this is the type of cholesterol they work most effectively for. They are considered ineffective for lowering LDL levels and minimally effective for raising HDL, as explained by the NHI. Fibrates are considered a good medication for patients with heart disease whose triglycerides are elevated, but whose LDL levels are low--this helps decrease their risk of suffering a heart attack.
Typically prescribed to be taken twice a day, 30 minutes prior to meals, over time fibrates may decrease triglyceride levels by 20 to 50 percent. They may also increase HDL levels by 10 to 15 percent.
Drugs included in this class include bezabifrate (Bezalip), gemfibrozil (Lopid) and fenofibrate (Lofibra, Tricor).
The most commonly reported side effect is gastrointestinal problems, although many patients have no problems at all. Another side effect is an increased likelihood of developing gallstones. Close monitoring is need by the prescribing doctor if the patient is also taking a blood-thinning medication.
Nicotonic Acid
Nicotonic acid, known also as niacin, not only lowers LDL cholesterol levels and triglycerides, it also lowers total cholesterol while raising HDL. This medication works by affecting the blood fats in your system, thus effectively lowering and raising all of the types of cholesterol produced by your body.
Niacin is available over-the-counter, and is better known as the water-soluble vitamin B. This is a daily supplement; however, the AHA recommends that you not take it in place of the prescription, nicotonic acid, when attempting to lower your cholesterol. This is due in large part to the lack of regulation by the FDA, which means niacin in supplement form may contain either much more or less of the vitamin than the label claims.
When taken to lower your blood cholesterol, the NIH states it is safer to take the prescription form, Nicotonic Acid, which allows your doctor to monitor you for any complications. Three types of this prescription form are available: immediate release, timed release and extended release. Your doctor will discuss this with you, helping you decide which type is the best.
The NIH states that nicotonic acid helps reduce LDL levels by 10 to 20 percent, triglycerides by 20 to 50 percent and raise HDL by 15 to 35 percent. Some of its most common side effects include hot flashes, nausea, vomiting and diarrhea.
