Medications for Lipid Disorders
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The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included. Ask your doctor if you need to take any special precautions. Use each of these medications only as recommended by your doctor, and according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.
Note: Be sure to tell your doctor what other prescribed or over-the-counter medicines, supplements, or herbs you are taking; they could interact with your lipid medicine.
If your cholesterol level is elevated, your doctor may order medication to take in addition to recommending changes in your diet and lifestyle. The decision to start cholesterol-lowering drugs depends on your cholesterol level and your other heart-disease risk factors.
Prescription Medications
Statins (HMG CoA reductase inhibitors)
- Fluvastatin (Lescol)
- Atorvastatin (Lipitor)
- Lovastatin (Mevacor)
- Pravastatin (Pravachol)
- Simvastatin (Zocor)
- Rosuvastatin (Crestor)
- Cholestyramine (Questran)
- Colestipol (Colestid)
- Colesevelam (Welchol)
- Gemfibrozil (Lopid)
- Fenofibrate (Lofibra)
Selective Cholesterol Absorption Inhibitors
- Ezetimibe (Zetia)
Statins (HMG CoA Reductase Inhibitors)
Common names include:
- Fluvastatin (Lescol)
- Atorvastatin (Lipitor)
- Lovastatin (Mevacor)
- Pravastatin (Pravachol)
- Simvastatin (Zocor)
- Rosuvastatin (Crestor)
Statins lower total blood cholesterol, LDL cholesterol, and triglyceride levels. They also lower heart disease risks. The drugs are usually taken daily with dinner or in the evening. Your doctor will measure your blood cholesterol levels and liver function regularly while you are taking these drugs.
Even if you currently have no known coronary heart disease (CHD), you may benefit from taking statin (cholesterol-lowering) medications, particularly if your cholesterol levels are elevated. * 1,3 The medication may reduce the incidence of heart attack, stroke , and death.
Significant side effects that have been reported with the use of statin medications include:
- Liver damage
- Muscle pain and/or damage
- Rash
- Headache
However, a review found no evidence of an increased risk of muscle pain, muscle damage, or serious liver damage in people taking statins. * 2
Bile Acid Sequestrants
Common names include:
- Cholestyramine (Questran)
- Colestipol (Colestid)
- Colesevelam (Welchol)
Bile acid sequestrants lower cholesterol levels by changing the way that cholesterol is metabolized. The drugs are in powder form and are taken with meals to decrease side effects. They should not be taken within hours of any other medications. Usually this medication is taken either one hour before or four hours after any other medication.
Possible side effects include:
- Heartburn
- Bloating
- Constipation
Niacin or Nicotinic Acid
Niacin is a B vitamin. At higher doses, it can lower cholesterol levels and triglycerides. It is not known how it works. Niacin should be taken with meals, two or three times per day, or once a day with the extended release pill.
Possible side effects include:
- Flushing
- Itching
- Rash
- Digestive system distress
Fibric Acid Derivatives
Common names include:
- Gemfibrozil (Lopid)
- Fenofibrate (Lofibra)
Fibric acid derivatives are usually taken to lower triglyceride levels and increase HDL (good) cholesterol. They may also help lower LDL cholesterol.
Possible side effects include:
- Abdominal pain
- Nausea
- Diarrhea
- Rash
- Itching
- Gallstones
Selective Cholesterol Absorption Inhibitors
Common names include:
- Zetia (Ezetimibe)
Ezetimibe lowers both total cholesterol and LDL (bad) cholesterol. It works by a different mechanism than the statins by decreasing the amount of cholesterol that your body absorbs. Ezetimibe has been shown to reduce plague in arteries, but has not been shown to reduce mortality.
Possible side effects include:
- Abdominal pain
- Fatigue
- Allergic reaction (swelling of face, lips, tongue, or throat that may cause difficulty breathing)
- Rash
Special Considerations
Whenever you are taking a prescription medication, take the following precautions:
- Take your medication as directed. Do not change the amount or the schedule.
- Do not stop taking them without talking to your doctor.
- Do not share them.
- Know what the results and side effects may be. Report them to your doctor.
- Some drugs can be dangerous when mixed. Talk to a doctor or pharmacist if you are taking more than one drug. This includes over-the-counter medication and herb or dietary supplements.
- Plan ahead for refills so you don’t run out.
References:
American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=1200000 .
Lipid-lowering pharmacotherapy overview. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated September 2008. Accessed September 23, 2008.
National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/ .
Textbook of Primary Care Medicine. 3rd ed. Mosby, Inc; 2001.
USP DI. 21st ed. Micromedex; 2001.
* 1 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Thavendiranathan P, Bagai A, Brookhart MA, Choudhry NK. Primary prevention of cardiovascular diseases with statin therapy: a meta-analysis of randomized controlled trials. Arch Intern Med. 2006;166:2307-2313.
* 2 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Kashani A, Phillips CO, Foody JM, Wang Y, Mangalmurti S, Ko DT, et al. Risks associated with statin therapy: a systematic overview of randomized clinical trials. Circulation . 2006;114:2788-2797. Epub 2006 Dec 11.
*³1/30/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Mills EJ, Rachlis B, Wu P, Devereaux PJ, Arora P, Perri D. Primary prevention of cardiovascular mortality and events with statin treatments: a network meta-analysis involving more than 65,000 patients. J Am Coll Cardiol. 2008;52:1769-1781.
Last reviewed April 2009 by Rosalyn Carson-DeWitt, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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