Medications
Main Page | Risk Factors | Symptoms | Diagnosis | Treatment | Screening | Reducing Your Risk | Talking to Your Doctor | Resource Guide
There is no treatment specifically for metabolic syndrome. The condition is treated by managing the underlying conditions and risk factors that are involved.
Weight-loss Drugs
There are some medications available that your doctor may prescribe for you to help you lose weight. These medications are part of a complete plan that also includes a healthy diet and physical activity.
The most commonly prescribed weight-loss medications are:
- Sibutramine (Meridia) —Sibutramine is a prescription medication that is used as an appetite suppressant. This medication, which is available in a pill, is usually only prescribed for you if you are very overweight. Sibutramine is believed to work by increasing the activity of certain chemicals, called norepinephrine and serotonin, in the brain to suppress your appetite.
- Orlistat (Xenical) —Orlistat works by preventing or blocking the fat you eat from being absorbed into your body. The undigested fat is removed in your bowel movements. Orlistat is taken as a pill up to three times a day with each main meal that contains fat. It is important to try to eat a low-calorie, low-fat diet while taking this medication.
- Phendimetrazine (Bontril) —Phendimetrazine is a prescription medication commonly used as an appetite suppressant. This medication comes as a pill. Phendimetrazine is believed to work to increase the activity of certain chemicals in your brain, serotonin, norepinephrine, epinephrine, and dopamine which suppress your appetite.
- Phentermine (Adipex) —Phentermine is a prescription medication commonly used as an appetite suppressant. This medication comes as either a pill or a capsule. Phentermine directly stimulates the satiety center in your brain so that you don’t feel hungry.
- Diethylpropion (Tenuate) —Diethylpropion is a prescription medication commonly used as an appetite suppressant. This medication comes as a pill. Diethylpropion is believed to work by changing the nerve impulses going to the appetite control center in your brain and suppresses hunger.
- Other Appetite Suppressants include:
- Bupropion (Wellbutrin)
- Fluoxetine (Prozac)
- Sertraline (Zoloft)
- Topiramate (Topamax)
- Zonisamide (Zonegran)
Medications to Control Cholesterol
Your doctor will test your cholesterol levels, and you can work together to choose the medications that will work best for you. The purpose of using cholesterol medications is to reduce your LDL cholesterol (the “bad” cholesterol) and increase your HDL (the “good” cholesterol). The medications also work to decrease the level of triglycerides (a kind of fat found in your blood and considered another type of “bad cholesterol”) in your blood.
Medications include:
- Exetimibe-Ezetimibe (Zetia )—Used alone or in combination with statins, this new class of drugs lowers cholesterol by blocking the absorption for the intestines. As in other cholesterol-lowering drugs, its use should be in conjunction with diet and exercise.
- Statins—Statins are used to reduce the amount of cholesterol in your blood. The medications, available in pill form, are usually taken right before bed. They block an enzyme (HMG-CoA reductase) that the body needs to produce cholesterol, so less cholesterol is produced and less cholesterol is in the blood. Medications include:
- Atorvastatin (Lipitor)
- Fluvastatin (Lescol)
- Lovastatin (Mevacor)
- Pravastatin (Pravachol)
- Rosuvastatin calcium (Crestor)
- Simvastatin (Zocor)
- Fibric Acid Derivatives—Fibric acid derivatives are also known as fibrates. They work by reducing the production of triglycerides and increasing HDL cholesterol (the “good” cholesterol). Medications include:
- Fenofibrate (Tricor)
- Gemfibrozil (Lopid)
- Clofibrate (Atromid)
- Niacin —Niacin has been found to lower triglyceride levels and LDL levels and raise HDL levels. The use of niacin to treat cholesterol requires careful monitoring because the medication may increase production of glucose (sugar in your blood). Medications include:
- Niaspan (niacin extended-release tablets): available by prescription
- Niacor or Nicolar (niacin): available over-the-counter
- Omega-3-Fish oil has been found to lower triglyceride by 20 to 50%. In some individuals, it may raise LDL cholesterol and also raise HDL cholesterol slightly. Medications include:
- Omega-3 fatty acid available over-the-counter
- Omacor, prescription omega-3 acid ethylesters
Medications to Lower Blood Pressure
The major types of medications used to control high blood pressure include:
- Angiotensin-converting Enzyme (ACE) Inhibitors—ACE inhibitors help relax and widen the blood vessels, making it easier and requiring less force (pressure) to let the blood flow through the blood vessels. This lowers your blood pressure. Medications include:
- Benazepril (Lotensin)
- Captopril (Capoten)
- Enalapril (Vasotec)
- Fosinopril (Monopril)
- Lisinopril (Prinivil, Zestril)
- Moexipril (Univasc)
- Perindopril (Aceon)
- Quinapril (Accupril)
- Ramipril (Altace)
- Trandolapril (Mavik)
- Calcium Channel Blockers—These work by decreasing the heart's pumping strength and relaxing blood vessels. Medications include:
- Amlodipine (Norvasc, Lotrel, Caduet)
- Bepridil (Vascor)
- Diltiazem (Cardizem, Dilacor)
- Felodipine (Plendil, Lexxel)
- Isradipine (DynaCirc)
- Nicardipine (Cardene)
- Nifedipine (Adalat, Procardia XL)
- Nisoldipine (Sular)
- Verapamil (Calan SR, Isoptin SR)
- Beta Blockers—Beta blockers work by limiting the activity of epinephrine, a hormone that increases blood pressure. Medications include:
- Acebutolol (Sectral)
- Atenolol (Tenormin)
- Betaxolol (Kerlone)
- Carvedilol (Coreg)
- Labetalol (Normodyne, Trandate)
- Metoprolol (Lopressor, Toprol XL)
- Nadolol (Corgard)
- Penbutolol (Levatol)
- Pindolol (Visken)
- Propranolol (Inderal)
- Timolol (Blocadren)
- Angiotensin II Receptor Blockers—These medications block the action of angiotensin II, a substance that causes the blood vessels in your body to constrict (or tighten), making it harder for blood to pump and flow through the vessels. Medications include:
- Candesartan cilexetil (Atacand)
- Eprosartan (Teveten)
- Irbesartan (Avapro)
- Losartan potassium (Cozaar)
- Olmesartan (Benicar)
- Telmisartan (Micardis)
- Valsartan (Diovan)
- Diuretics—These medications cause your kidneys to get rid of extra fluid and excess salt. This relaxes the blood vessels and reduces the strain on your circulation. Medications include:
- Amiloride (Midamor)
- Bumetanide (Bumex)
- Chlorothiazide (Diuril)
- Chlorthalidone (Hygroton)
- Furosemide (Lasix)
- Hydrochlorothiazide (Esidrix, Hydrodiuril)
- Indapamide (Lozol)
- Spironolactone (Aldactone)
Diabetes Medications
Doctors use medications to decrease insulin resistance in people with diabetes . These medications may also help improve insulin metabolism in people with metabolic syndrome.
Medications include:
- Thiazolidinediones—These drugs help your body to better use insulin, a protein hormone that lets your body metabolize and use glucose. It also reduces glucose production in the liver. Medications include:
- Pioglitazone (ACTOS)
- Rosiglitazone (Avandia)
- Toglitazone (Rezulin)
- Biguanides
—These medications lower blood glucose levels by decreasing the amount of glucose produced by the liver. Medications include:
- Metformin (Glucophage, Glucophage XR)—Studies have found that metformin can reduce metabolic syndrome in people with high blood sugar.
- Sulfonylureas—These medications make the pancreas, a gland that plays a role in digestion, release more insulin. The only medication currently available is chlorpropamide (Diabinese).
- Meglitinides—These medications stimulate cells that make insulin to release insulin and are taken before each meal. Medications include:
- Nateglinide (Starlix)
- Repaglinide (Prandin)
- Alpha-glucosidase Inhibitors —These medications lower blood glucose by blocking breakdown of starchy foods; they need to be taken at the start of a meal. Medications include:
- Dipeptidyl peptidase-4 (DPP-4) Inhibitors—These medications lower blood glucose by slowing down the inactivation of glucagon-like peptide-1(GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). This allows better glucose control. Medications include:
- Sitagliptin ( Januva)
- Vildagliptin (Glavus)
- Proinflammatory and Prothrombotic State—The American Heart Association recommendation is that those patients with a 10-year risk for cardiovascular diase of 10% or greater should be treated with low-dose aspirin .
References:
Berger JS, Roncaglioni MC, Avanzini F et al: Aspirin for the primary prevention of cardiovascular events in women and men: a sex-specific meta-analysis of randomized controlled trials. JAMA. 2006;295:306-13.
Beta blockers for heart problems. FamilyDoctor.org, American Academy of Family Physicians website. Available at: http://familydoctor.org/633.xml . Accessed August 2, 2005.
Blood pressure lowering drugs. American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=159 . Accessed August 2, 2005.
Brazg R, Xu L, Dalla Man C et al: Effect of adding sitagliptin, a dipeptidyl peptidase-4 inhibitor, to metformin on 24-h glycaemic control and beta-cell function in patients with type 2 diabetes. Diabetes Obes Metab. 2007;9:186-93.
Calcium channel blockers. American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=4460 . Accessed August 2, 2005.
Cornier MA, Dabelea D, Hernandez TL et al: The metabolic syndrome. Endocr Rev. 2008;29:777-822.
Despres JP, Golay A, Sjostrom L, et al. Effects of rimonabant on metabolic risk factors in overweight patients with hyslipidemia. N Engl J Med. 2005;353:2121-2134.
Freemark M. Pharmacotherapy of childhood obesity. Diabetes Care. 2007;30:395-402.
Getting tough with metabolic syndrome. Post Grad Med. Available at: http://www.postgradmed.com/issues/2004/01_04/metabolic_foldout.pdf . Accessed July 28, 2005.
Li Z, Maglione M, Tu W, et al. Meta-analysis: pharmacologic treatment of obesity. Ann Intern Med. 2005;142:532-546.
Metabolic syndrome. The Mayo Clinic website. Available at: http://www.mayoclinic.com/invoke.cfm?id=DS00522 . Accessed July 28, 2005.
Orchar TJ, Temprosa M, Goldberg R, et al. The effect of diet and exercise or metformin on the metabolic syndrome: The diabetes prevention program randomized trial. Annals of Internal Medicine. 2005;142:611-619.
Other diabetes medications. American Diabetes Association website. Available at: http://www.diabetes.org/type-2-diabetes/oral-medications.jsp . Accessed August 2, 2005.
Rosenstock J, Fitchet M: Vildagliptin: clinical trials programme in monotherapy and combination therapy for type 2 diabetes. Int J Clin Pract Suppl. 2008;Mar;159:15-23.
Steinberger J, Daniels SR, Eckel RH et al: AHA Scienfic Statement: Progress and Challenges in Metabolic Syndrome in children and Adolescents. Circulation. 2009;118:628-647.
Skulas-Ray AC, West SG, Davidson MH, Kris-Etherton PM: Omega-3 fatty acid concentrates in the treatment of moderate hypertriglyceridemia. Expert Opin harmacother. 2008; 9:1237-48.
Last reviewed February 2009 by David Juan, 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.
Copyright © 2007 EBSCO Publishing All rights reserved.