Treatment to Lower Cholesterol.

If your high cholesterol has warranted treatment, it may be due to two reasons:

• You have not religiously followed the diet regimen for lowering cholesterol, and
• You have not brought in Lifestyle changes to lower cholesterol.

But if you have been faithfully following the advice given in the above two posts and yet have not been able to lower cholesterol level in 3 months, then you have a very “stubborn cholesterol”, which has then to be controlled through cholesterol medication. There are several cholesterol medicines and your doctor is the best person to choose which cholesterol drugs best suit you. Some information is given here in brief for your knowledge only.

However, after starting Cholesterol Treatment, it is still imperative that you follow the prescribed diet for lowering cholesterol and the lifestyle changes to lower cholesterol, in which exercise, especially aerobics forms a very important part. Both diet and lifestyle changes are to be considered as part of the treatment along with the cholesterol drugs to lower your cholesterol levels.

Lowering Cholesterol with Drugs.

1) Statins:

• Most preferred and effective of the cholesterol reducing medicines in reducing LDL cholesterol.
• Modestly reduce triglycerides and slightly increase HDL.
• Statins act by lowering cholesterol production in the liver and also stimulating the liver to remove the LDL cholesterol in the blood.
• Well tolerated – rarely side effects are seen.
• Reduction in cholesterol levels is seen in about two months time, when cholesterol levels are checked again for comparison with the previous report. This helps in two ways. It shows the amount of success with Statins and also enables your doctor to determine whether any change in dosage is required or not.
• Examples of Statins:–  Atorvastotin(Lupitor),  Fluvastatin(Lescol), Lovastatin(Mevacor), Pravastatin(Pravachol),  Simvastatin(Zocor),    Rosovastatin(Crestor).
• Side Effects of Statins: As mentioned above, side effects are rare and include generalized muscle pain, weakness, constipation, abdominal cramps, headache and interference with liver function causing a dark colored urine. On these side effects presenting themselves, you must stop Statins immediately and report to your doctor who will take the necessary action.

2) Bile acid Sequestrants or Resins.

• Resins lower LDL by binding themselves with bile acids which contain cholesterol. As explained in Benefits of Cholesterol, cholesterol plays an important part in production of bile acids. Resins promote excretion of these bile acids through the intestine, thereby helping in getting rid of cholesterol. As a result more cholesterol is used to make bile acids which again, resins help to excrete. This is how Resins help to reduce cholesterol.
• Cholesterol reducing action of Resins is not very strong and they are sometimes given in conjunction with Statins.
• Examples of Bile acid Sequestrants or Resins:– Cholestyramine(Questran), Colestipol(Colestid), Colesevalam(Welchol).

3) Cholesterol absorption inhibitors.

• As the name suggests, they act directly by reducing the absorption of cholesterol from the intestines, thereby lowering cholesterol blood levels.
• Not as effective as statins in reducing cholesterol but when administered along with them greatly enhance the action of Statins..
• Examples:– Ezetimibe(Zetia).
• Side Effects are rare and include edema or swelling of the tongue, which is called angioedema.

4) Fibrates (also called fibric acid derivatives).

• Fibrates act by stimulating extra production of an enzyme  which breaks down the fats in the blood.
• They mainly reduce the triglycerides level and marginally increase the HDL or the good cholesterol levels. They are not very useful in lowering LDL levels.
• Examples of Fibrates:– Gemfibrozil(Lopid), Fenofibrate (Tricor), Clofibrate (Atromid-S) .
• Side Effects include gastro intestinal symptoms like flatulence and nausea. Fibrates increase the likely hood of gall stone formation. If a patient is on anti coagulation therapy, fibrates increase the action of the anti coagulants causing thinning of the blood. Such combined therapy requires strict medical supervision as it can give rise to bleeding either in the gastro intestinal tract or the urinary tract or from an injury.

5) Niacin or Nicotinic acid. (Part of Vitamin B’complex).

• Niacin used for cholesterol treatment differs from the over the counter Niacin ( Nicotinamide) of  Vitamin B’ complex, which has no role in treating high cholesterol.

• Niacin lowers LDL or the bad cholesterol and the triglycerides and effectively raises HDL or the good cholesterol. However high doses are required.
• Available as short acting or immediate release and long acting or extended release.
• Examples : – Advicor is now available in combination of Niacin with Lovostatin.
• Side Effects include hot flushes, gastrointestinal symptoms like nausea, vomiting, diarrhea and indigestion. Long term treatment can cause peptic ulcer, liver toxicity, gout and increased blood sugar.

Action Step: As stated above, always consult your doctor on any issue regarding cholesterol treatment and do follow up with regular blood tests for cholesterol. It may sometimes be necessary for your doctor to alter the cholesterol medicines or their dosage.

Related posts:

1. Complications of High Cholesterol.
2. 7 Health Benefits of Cholesterol|Functions of Cholesterol.
3. Treatment of High Triglycerides.
4. How to Lower Cholesterol with Lifestyle Changes.
5. Cholesterol Levels.
6. Cholesterol Ratio.
7. Foods High in Triglycerides.
8. Cholesterol Foods.