Cholesterol-lowering Medicines

Lowering your "bad" cholesterol (also called LDL, or low-density lipoprotein) can reduce your risk of having a heart attack or stroke. A number of lifestyle changes can help you improve your cholesterol level (see the box below). However, if these lifestyle changes don't help after about 6 months to 1 year, your doctor may suggest medicine to lower your cholesterol.

Even if you take cholesterol-lowering medicine, it's important to keep up with your lifestyle changes. Eating a healthy diet and being physically active can make your medicine more effective. Your doctor can give you tips on how to make healthy food choices and include physical activity in your daily routine.

Several types of medicine are used to treat high cholesterol levels. Your doctor will decide which type of medicine is right for you. He or she may prescribe more than 1 of these drugs at a time because combinations of these medicines can be more effective.

Statins (also called HMG-CoA reductase inhibitors) slow down your body's production of cholesterol. These drugs also remove cholesterol buildup from your arteries (blood vessels). Examples of statins include atorvastatin (brand name: Lipitor), fluvastatin (brand name: Lescol), lovastatin (brand names: Altocor, Mevacor), pravastatin (brand name: Pravachol), rosuvastatin (brand name: Crestor) and simvastatin (brand name: Zocor).

Resins (also called bile acid sequestrants) help lower your LDL cholesterol level. Some examples of bile acid sequestrants include cholestyramine (brand names: Prevalite, Questran), colesevelam (brand name: Welchol) and colestipol (brand name: Colestid).

Fibrates (also called fibric acid derivatives) help lower your cholesterol by reducing the amount of triglycerides (fats) in your body and by increasing your level of "good" cholesterol (also called HDL, or high-density lipoprotein). Some examples of fibrates include fenofibrate (brand names: Antara, Lofibra, Tricor) and gemfibrozil (brand name: Lopid).

Niacin (also called nicotinic acid) is a B vitamin. When given in large doses, it can lower your levels of triglycerides and LDL cholesterol, and increase your HDL cholesterol level. Even though you can buy niacin without a prescription, you should not take it to lower your cholesterol unless your doctor prescribes it for you. It can cause serious side effects.

Cholesterol absorption inhibitors help lower your cholesterol by reducing the amount that is absorbed by your intestines. Ezetimibe (brand name: Zetia) is a cholesterol absorption inhibitor. This type of medicine is often given in combination with a statin. The combination of ezetimibe and simvastatin (brand name: Vytorin) is an example.

Like all medicines, these drugs can cause side effects. However, the side effects usually are not severe and are not experienced very often.

Common side effects of cholesterol-lowering drugs include the following:

Tell your doctor as soon as possible if your side effects become severe.

If you take 2 or more medicines at the same time, the way your body processes each drug can change. When this happens, the risk of side effects from each drug increases and each drug may not work the way it should. This is called a "drug-drug interaction." Vitamins and herbal supplements can affect the way your body processes drugs too.

Certain foods or drinks can also prevent your medicine from working the way it should or make side effects worse. This is called a "drug-food interaction."

Drug-drug interactions and drug-food interactions can be dangerous. Be certain that your doctor knows all of the over-the-counter and prescription medicines, vitamins and herbal supplements that you are taking. Also, talk to your doctor before you take any new over-the-counter or prescription medicine, or use a vitamin or herbal supplement.

It's important to take medicines exactly as your doctor tells you to. Ask your doctor whether you need to avoid any foods or drinks while using your cholesterol-lowering medicine.