What Are Cholesterol-Lowering Medications?
If your health care professional has decided you need to take medicine to reduce high cholesterol, it’s because you are at borderline to intermediate risk and have risk enhancing factors or are at high risk for heart disease or stroke. Usually, the treatment combines healthy lifestyle changes, including diet and physical activity, and medicine.
What type of medicine may I be prescribed?
Various medications can lower blood cholesterol levels. Statins are recommended for most patients and have been directly associated with reducing risk for heart attack and stroke. Statins continue to provide the most effective lipid-lowering treatment in most cases. Statins (HMG-CoA reductase inhibitors) prevent the production of cholesterol in the liver. Their major effect is to lower LDL cholesterol. Some names are lovastatin, pravastatin, simvastatin, fluvastatin and atorvastatin.
What other medications may be prescribed?
Your health care professional will monitor your progress with your statin therapy and recommended lifestyle changes. If you are having serious side effects or don’t have the desired response to statin therapy and lifestyle changes alone, they may change the dose or consider adding on other medications as well. If you have known CVD and are already taking the highest tolerated statin and your LDL-C is still 70 or above, one or more of the following medicines may be prescribed. They all can be taken in combination with a statin.
- Ezetimibe (cholesterol absorption inhibitors) works by preventing cholesterol from being absorbed in the intestine. It is the most commonly used non-statin agent.
- Bile acid sequesterants cause the intestine to get rid of more cholesterol. Some names are cholestyramine, cholestipol and colesevelam.
- PCSK9 Inhibitors are powerful LDL-lowering drugs. They bind to and inactivate a protein in liver to lower LDL (bad) cholesterol. Some names are alirocumab and evolocumab.
The following medicines are triglyceride-lowering drugs and have mild LDL- lowering action, but data does not support their use as an addon to statins.
- Fibrates are especially good for lowering triglyceride (blood fat) levels and have a mild LDL-lowering action. Some names are gemfibrozil, clofibrate and fenofibrate.
- Niacin (nicotinic acid) is a B vitamin that limits the production of blood fats in the liver. Take this only if your doctor has prescribed it. It lowers triglycerides and has mild LDL-lowering action.
Your doctor will work with you to decide which medicine, or combination of medicines, is best for you. Always follow your doctor’s instructions carefully, and let the doctor know if you have any side effects. Never stop taking your medicine on your own!
How do I know if my medicine is working?
Your doctor will test your blood cholesterol level when needed. Together with your doctor, set a goal and ask how long it may take to reach that goal.
Read full article HERE.
Sources:
American Heart Association
About Cholesterol
About High Blood Pressure
Cholesterol videos:
Understanding Familial Hypercholesterolemia (FH)
How to Manage High Cholesterol
Additional Resources*
The FH Foundation
Million Hearts
DASH Diet (Dietary Approaches to Stop Hypertension)