Many people will be able to reduce their cholesterol levels by adopting the lifestyle changes of diet and exercise. For others drug treatments may be an additional requirement. Even so the combination of lifestyle change and medication means that the drugs will be kept down to the lowest possible dose.
There are a number of different types of drugs used to lower cholesterol levels and they work in various ways. Here are details of the main types:
Statins, which include lovastatin and pravastatin, to name but two, are the most effective cholesterol-lowering drugs which can reduce LDL levels by between 20-55 percent. Statins act by blocking an enzyme that controls the rate at which the body produces cholesterol. Some research suggests that if you are taking statin drugs, you should also take "Co-Enzyme Q-10" to avoid possible side effects.
Ezetimibe. This drug reduces the amount of cholesterol absorbed by the body. Ezetimibe can be combined with a statin to achieve a greater reduction of LDL. Ezetimibe lowers LDL by about 18–25 percent.
Bile acid sequestrates. Bile acids are secreted from the liver and gall bladder in the bile. These bind with cholesterol-containing bile acids in the intestines and are then eliminated from the body in the stool. They lower LDL cholesterol by about 15–30 percent. The only disadvantage of these drugs is malabsorption.
Fibric acids (also called "fibrates") work by cutting down the triglyceride production and removing it from circulation. These cholesterol lowering drugs also increase the level of HDL or "good" cholesterol. Fibrates contain gemfibrozil or lopid and fenofibrate (tricor). Fibrates are less effective in lowering LDL levels.
Nicotinic acid—also called niacin. This is a water-soluble B vitamin that should be taken only under your doctor's supervision. It improves all lipoproteins—total cholesterol, LDL, triglycerides, and HDL—when taken in doses well above the vitamin requirement. LDL levels are usually reduced by about 5–15 percent, and up to 25 percent in some patients.
When you talk with your doctor about taking a cholesterol-lowering drug, be sure to mention any other medicines you're taking—even over-the-counter remedies. And if you have any side effects from a medication, tell your doctor as soon as possible. Gastrointestinal (usually constipation, abdominal pains and cramps) are the most common side effects of cholesterol lowering drugs. Symptoms are usually mild to severe and tend to settle as the therapy continues. The amount or type of drug can be changed to reduce or stop bad side effects. If one drug does not lower your LDL enough, you may be given a second medication to take at the same time.
It should be stressed that this article is for information purposes only and none of these drugs should be taken unless they have been prescribed by your physician.