Cholesterol Lowering Drugs

By: R Heavner



The first line of treatment in lowering cholesterol levels are lifestyle changes such as proper diet, weight loss, and exercise. Along with lifestyle change, your doctor is also likely to prescribe medication to help in lowering and maintaining your cholesterol levels. A number of prescription drugs to lower cholesterol are available on the market, with a number of them (statins in particular) advertised very heavily in the media.

The statin class of drugs is quite popular as the cholesterol lowering drug of choice. It is sometimes difficult to judge whether this is due to their effectiveness or to the massive marketing campaigns from the pharmaceutical industry. Either way, as the top selling drugs in the nation, there are a tremendous number of prescriptions written for statin drugs.

Statins are known as HMG CoA reductase inhibitors, and work in the liver to slow the development of cholesterol. Studies have indicated that statin drugs tend to work best at lowering LDL, or bad cholesterol, but tend to not be as effective at reducing triglyceride levels. A few of the current statin drugs on the market are: atorvastatin (Lipitor) , fluvastatin (Lescol), lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor), and rosuvastatin (Crestor). Another, Vytorin, is a combination of Zetia (ezetimibe) and the statin drug Zocor (simvastatin). In an unsettling FDA report in January 2008, it was noted that Vytorin did not reduce atherosclerotic plaque any better that simvastin given alone, and in some cases actually resulted in an increase in plaque. Beyond common side effects such as headaches and nausea, the more serious side effects of statins include extreme muscle pain and muscle disease (statin induced myopathy), as well as serious liver problems.

Beyond statins, there are other classes of drugs which may be prescribed to help in lowering cholesterol levels. While not hyped with as much fanfare as statins, they have been shown to be effective for many patients.

One such class of drugs are resins, also known as bile acid-binding drugs. The resins basically work in the intestines to help increase elimination of LDL cholesterol. As the body digests food, it uses cholesterol to make bile. Resin type drugs bind themselves to bile. As the liver increases the production of bile, the body will use up more cholesterol. A few of the resin type drugs on the market are Cholestyramine (Questran®, Questran® Light, Prevalite®, Locholest®, Locholest® Light), Colesevelam Hcl (WelChol®), and Colestipol (Colestid®).

Fibrates are termed fibric acid derivatives and tend to be best at lowering triglycerides. In some cases they also have been known to raise levels of HDL. They are usually prescribed for patients with high triglyceride levels and low HDL levels and may be used in conjunction with statins. A few of the fibrate drugs on the market are: Gemfibrozil (Lopid®), Clofibrate (Atromid-S), and Fenofibrate (Antara®, Lofibra®, Tricor®, and Triglide™).

Niacin in the form of nicotinic acid works by affecting the production of blood fats in the liver. In prescription form niacin is used to help lower LDL cholesterol levels and triglycerides. A few of the prescription niacin preparations on the market are Niaspan® and Slo-Niacin®.

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