Know your medications: anti-cholesterol drugs

It’s Cholesterol Awareness Month.

So I think it’s only right that I tackle the topic of drugs used in controlling our cholesterol levels. For a review of the basics of cholesterol and what out cholesterol numbers mean, check out this resource post. In the same post, I have tackled lifestyle changes strategies that can help lower and control cholesterol levels. In today’s post, let us take a look at the pharmacological therapies for high cholesterol levels.

The main types of cholesterol-lowering drugs are summarized below.

Statins 

Statins also known as HMG CoA reductase inhibitors, are the most popular of currently available anti-cholesterol drugs. They act on the enzyme that regulates the rate at which our body produces cholesterol. They are known to be most effective in lowering LDL levels (20 to 55%) and triglycerides to a lesser extent.

Statins currently available in the U.S.include:

• Atorvastatin (Lipitor®)
• Fluvastatin (Lescol®)
• Lovastatin (Mevacor®, Altoprev^TM)
• Pravastatin (Pravachol®)
• Rosuvastatin Calcium (Crestor®)
• Simvastatin (Zocor®)

Statins are also available in combination with other classes of drugs, namely Advicor® (lovastatin + niacin), Caduet® (atorvastatin + amlodipine), and Vytorin^TM (simvastatin + ezetimibe).

Ezetimibe

Selective cholesterol absorption inhibitors reduce the amount of cholesterol absorbed in the intestine. Ezetimibe (Zetia®) is the first inhibitor to be approved. It has been shown to lower LDL levels by about 18 to 25%., moderately lowers triglycerides, and increases HDL levels.

Resins

Resins (also known as sequestrant or bile acid-binding drugs) bind with cholesterol-containing bile acids in the intestines and facilitate their elimination in the stool. These class of drugs can lower LDL levels by about 15 to 30%.

Resins currently available in the U.S. include:

• Cholestyramine (Questran®, Questran® Light, Prevalite®, Locholest®,  Locholest® Light)
• Colestipol (Colestid®)
• Colesevelam HCl (WelChol®)

Niacin

Nicotinic acid also known as niacin is actually a water-soluble B vitamin that can lower LDL levels (5 to 15%) and triglycerides and increase HDL levels. However, its positive effect on out lipid profiles is only achieved in doses higher than when taken as just vitamin supplement. For cholesterol control, niacin should only be taken upon doctor’s orders.

Fibrates

Fibrates or fibric acid derivatives are mostly effective in lowering triglycerides and moderately increase HDL levels. However, they don’t effectively lower LDL levels.

Fibrates currently available in the U.S.include:

• Gemfibrozil (Lopid®)
• Fenofibrate (Antara®, Lofibra®, Tricor®, and Triglide^TM)
• Clofibrate (Atromid-S)

[Sources: The National Heart, Lung, and Blood Institute (NHLBI); American Heart Association (AHA)]

As with almost all medications, these drugs should only be taken after discussion with your doctor. Currently, there are no avalaible OTC drugs to control cholesterol levels. There may be drugs sold over the Internet but these offers should be approached with extreme caution (see previous post on this). However, aside from taking medications, lifestyle changes are also necessary in the fight against cholesterol and heart disease.

Coming soon: alternative products and supplements against cholesterol.

Photo credit: drugs by sarej at stock.xchng