Cholesterol Medicine: Types, Benefits, and Side Effects

This Supplement Can Help You Control Your Cholesterol Levels

Some people may benefit from lifestyle changes, such as eating a healthier diet and exercising more, to lower or prevent high cholesterol levels. There may also be a need for cholesterol medicine for others with high cholesterol levels.

Make sure you discuss your treatment plan with your doctor to devise a plan that works for you. If medication is required, make sure that you take it as prescribed. To get the most benefit from these medications, you should make them a regular part of your daily routine.

Cholesterol-lowering Drugs Types

Many medications can lower the level of cholesterol in the blood.

Statins are recommended for most patients, and there has been direct evidence that statins can significantly lower the risk of heart attacks and strokes among patients. Most of the time, statins continue to be the most effective lipid-lowering treatment available.

Those in any of these groups should discuss the risks and benefits of statin therapy with their doctor:

• It is recommended that people with a history of cardiovascular disease, including stroke, which is caused by atherosclerosis, be monitored
• The number of individuals whose LDL-C level exceeds 190 mg/dL is significant
• Diabetes in adults between the ages of 40 and 75
  are at risk of developing cardiovascular disease when their LDL-C level is 70 to 189 mg/dL, and the risk of developing the disease from atherosclerosis and risk-enhancing factors is 5% to 19.9%
• An adult who has an LDL-C value between 70 and 189 mg/dL and a 10-year risk of developing cardiovascular disease as a result of atherosclerosis of 20% or more significant as a result of the age group of 40-75 years of age
• It is also possible for people who don't fall into these categories to benefit from statin therapy.

Talking to your healthcare professional about your 10-year or lifetime risk is essential to make an informed decision. To determine your level of risk, they will assess your risk factors to determine the treatment that will meet your individual needs to reduce your risk.

This section will summarize some of the more significant cardiovascular medications commonly prescribed daily. To assist you in identifying what you may be taking, we have included generic names as well as trade names that are significant. The American Heart Association does not recommend or endorse any specific products. 

You should speak to your doctor or pharmacist if your prescription medication is not listed. Talk to your doctor about all the drugs you are taking, their intended effects, and potential side effects. Please do not stop taking a medication or change its dosage (or frequency) without consulting your doctor first. Some cholesterol-lowering medicines may interact with grapefruit, grapefruit juice, pomegranate, and juice. It would be best if you discussed any possible risks with your doctor before taking any medication.

The Statins

Known as HMG CoA reductase inhibitors, this class of drugs works in the liver to prevent cholesterol from forming by inhibiting this enzyme's production. As a result, the amount of cholesterol circulating in the blood is reduced. Statins are most effective at lowering LDL (bad) cholesterol. In addition to reducing triglycerides (blood fats), they also help raise HDL (good) cholesterol levels in the blood.

Please consult your doctor about statins' possible side effects before taking them. Most side effects are mild and disappear as your body adjusts to the medication. It is rare to have muscle problems or liver abnormalities, but your doctor may order regular liver function tests to check your liver health. If you are pregnant or have active or chronic liver disease, you should not take statins.

The Following Statins are Available in The U.S:

• Atorvastatin (Lipitor®)
• Fluvastatin (Lescol®)
• Lovastatin (Mevacor®, Altoprev™)
• Pravastatin (Pravachol®)
• Rosuvastatin Calcium (Crestor®)
• Simvastatin (Zocor®)
  Your doctor may recommend a different medication if statins do not help you enough or if you experience side effects.

There are also combination medications, such as Caduet® (atorvastatin + amlodipine) and Vytorin TM ( simvastatin and ezetimibe).

Keep in mind that if you already take the highest-tolerated statin and your LDL-C is still 70 or above, you may be prescribed one or more of the following drugs. Combining them with a statin to achieve the best results is possible.

Inhibitors of Cholesterol Absorption (Ezetimibe)

In the intestine, cholesterol is prevented from being absorbed into the body by blocking its absorption. Among the non-statin agents, it is the most commonly used.

Sequestrants for Bile Acid

They cause the intestines to get rid of more cholesterol by binding to the bile acids in the bile.

The Following are Available in The U.S:

• Cholesterylamine (Questran®, Questran® Light, Prevalite®, Locholest®  Locholest® Light)
• Colestipol (Colestid®)
• Colesevelam Hcl (WelChol®)

Inhibitors of PCSK9

The PCSK9 inhibitors are potent drugs that can lower the body's LDL cholesterol level. As a result, they bind to and inactivate a protein found in liver cells to reduce LDL (bad) cholesterol levels. It is also known as alirocumab and evolocumab, among other names.

Citrate Lyase (ACL) Inhibitors

Inhibitors of the ACL work in the liver by preventing the production of cholesterol in that organ. Often, these medications are combined with lifestyle changes and statins in patients with familial heterozygous hypercholesterolemia and cardiovascular disease.

• Acid bempedoic (Nexletol)
• Ezetimibe and bempedoic acid (Nexlizet)

As a reminder, Adenosine triphosphate-citrate lyase (ACL) inhibitors are not included in the current guideline for managing blood cholesterol, as the FDA approved them in 2020. ACL inhibitors are discussed in more detail at the National Library of Medicine with the link, which opens a new window for you.

It has been shown that the following triglyceride-lowering drugs have a mild effect on LDL cholesterol levels; however, the evidence does not support their use as an addition to statin therapy.

Fibrates

In addition to lowering triglyceride levels (blood fat), fibrates also have a mild effect on reducing LDL levels.

The Following are Some of The Fibrates Available in The U.S:

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

Nicotinic Acid (Niacin)

As a B vitamin, niacin has been shown to reduce the production of blood fats in the liver, which is a significant health benefit. If you have not been prescribed this medicine by your doctor, you should not take it. In addition to lowering the level of triglycerides, it also mildly reduces the level of LDL cholesterol at the same time.

Several side effects are associated with niacin, such as flushing, itching, and upset stomach. Because niacin can cause toxicity to your liver, your liver functions may need to be closely monitored. There are usually more side effects associated with nonprescription immediate-release forms of niacin, especially when the dose is high. Because niacin is capable of causing an increase in blood sugar levels, niacin has to be used cautiously in diabetic patients.

There is a prescription form of niacin and a dietary supplement containing niacin. Due to serious side effects, You should not substitute supplements containing niacin for prescription niacin due to the risk of severe side effects. The Food and Drug Administration does not regulate dietary supplements containing niacin, so their amounts can vary widely - from zero to much more than advertised. The amount of niacin in nutritional supplements may vary even within the same brand. Before starting, you should discuss any niacin treatment with your doctor.

The Omega-3 Fatty Acid Ethyl Esters

These are derived from fish oils that have been chemically changed and purified to obtain them. These drugs and dietary changes are used to help people with high levels of triglycerides.

In The U.S., Omega-3 Fatty AAcid Ethyl Esters Include:

• Lovaza®
• Vascepa™
• Epanova®
• Omtryg®

Marine Sources of Omega-3 Polyunsaturated Fatty Acids (PUFA)

They are generally known as omega-3 fish oils; omega-3 fatty acids lower high blood triglyceride levels when taken in large doses. Triglyceride secretion is decreased due to its presence, and triglycerides are cleared as a result. A limited amount of marine-derived omega-3 PUFAs can be obtained through a daily diet alone to significantly lower triglycerides (between 2 and 4 grams), which is why supplementing with capsules may be necessary.

You should only use these cholesterol medicine under the supervision and care of your doctor because large doses of these supplements can cause serious side effects. Thus, there is an increased risk of bleeding, hemorrhagic strokes, and reduced blood sugar control in people with diabetes. Other medications, herbal preparations, and nutritional supplements may also have harmful interactions with this medication. Using these supplements may cause severe adverse reactions in people with allergies to fish, shellfish, or both of these ingredients.