Whenever there is a problem that needs to be fixed we all want a fast and easy solution. If the problem is high cholesterol then the fast and easy fix would be prescription medication for cholesterol control. However, is this really the solution that you want? Let’s examine what positives and negatives a person may encounter when using the most popular drugs to reduce cholesterol.
The first thing we need to do is to take a look at what medication your doctor may prescribe you. Most people have heard of statins, but there are three other groups of cholesterol lowering drugs.
Statin Drugs – Lescol (fluvastatin), Crestor (rosuvastatin), Lipitor (atorvastatin), Pravachol (pravastatin), and Zocor (simvastatin)
Bile Acid Sequestrants – Prevlite and Questran (cholestyramine), Colestid and Lestid (colestipol), and Welchol (colesevelam)
Natural Cholesterol Blockers – Cholestin (red yeast rice), sterols and stanols
Triglyceride Inhibitors – Atromid-S (clofibrate), Tricor (fenofibrate), Lopid (gemfibrozil), niacin (brand names include Niacor, Nicolar, Slo-Niacin, Advicor, and Niaspan)
All of this may seem completely foreign to you. In fact, most of those drug names just look like a foreign language. Your doctor will likely have a preferred medication plan for you, but it is best if you have a better understanding of each type of drug available to help control cholesterol. The following are some pros and cons for each of these four groups of drugs.
These drugs help reduce the production of cholesterol within your body. Statins are most effective for patients that already have a history of cardiovascular disease. They have become very popular in recent years and many doctors now believe statins are over-prescribed.
- Reduces total amount of cholesterol.
- Reduces LDL levels.
- Raises HDL levels.
- Decreases your risk of a heart attack, whether you have already had one or not.
- Risk of a stroke is decreased.
- Reduces the amount of plaque in your arteries.
- C-reative protein levels are reduced.
- May help prevent heart attacks and strokes in patients that do not have high cholesterol.
- Rhabdomyolysis – a condition where muscle breaks down and that theoretically can cause kidney failure. While only one statin drug, Baycol (cerivastatin), has ever shown statistical significance in regards to fatal kidney failure cases, though all statins are thought to cause this condition.
- Muscle aches and pain.
- Other common side effects – nausea, low blood pressure, fatigue, headache, sexual dysfunction and a possible allergic rash.
- Statins can also interact with fibrates and niacin, drugs that are meant to block the livers ability to remove statins from the blood. This interaction can cause statins to rise to a damaging level, which makes it more likely for rhabdomyolysis to occur.
- Grapefruit juice can block the effectiveness of statins.
Bile Acid Sequestrants
Bile acids break down fat into usable substances that the body can use. One of these substances is cholesterol. Bile acid sequestrants help the body rid itself of bile acids before they can break down fats, thus decreasing the production of cholesterol. In addition, cholesterol is a building block of bile acids so as the body recognizes that there is a deficiency of bile acids it will use up some cholesterol to create more. This leads to a decrease in cholesterol levels.
- Reduces total amount of cholesterol and specifically LDL levels.
- Used for other ailments, such as chronic diarrhea due to the improper absorption of bile acid.
- Few serious side effects.
- Weight loss.
- Gastrointestinal tract issues, such as nausea and gas.
- Muscle soreness and aching.
Natural Cholesterol Blockers
The most common cholesterol blockers contain the compounds stanol and sterol. Both of these help to reduce the amount of cholesterol that is absorbed through the body. While you can increase the amount of stanols and sterols your body receives by adjusting your diet since these compounds are found naturally in many foods, you can take supplements that contain these compounds. Prescriptions are not needed, but if your cholesterol is not at a dangerous level, your doctor may suggest that you either adjust your diet or take supplements to increase the amount of sterols and stanols your body receives. Sterols may help reduce bad cholesterol levels by up to 10%.
- Some foods are naturally high in sterols, such as almonds and apples.
- Many foods contain added plant sterols and stanols, such as some margarines and orange juice.
- Serious side effects are not common unless you take a supplement that contains other ingredients.
- Over-the-counter supplements are available to easily reach your recommended dosage.
- Mild and rare side effects – constipation, heartburn, nausea.
- Not nearly as effective as statins or other prescription drugs.
- Some supplements contain ingredients that have more serious and common side effects.
Fibrates and niacin are the most common triglyceride inhibitors. Triglycerides are involved in the production of lipoprotein from dietary fats. Triglyceride inhibitors decrease the production of triglycerides so the amount of lipoprotein produced also decreases, leading to lower LDL numbers. HDL is also increased with the use of triglyceride inhibitors. While not as effective as statins, total cholesterol can be lowered by as much as 10% and LDL levels can decrease by as much as 14%.
- Few serious side effects.
- Can lower cholesterol by 10% and LDLs by 14%.
- Side effects include allergic reactions, fatigue, nausea, diarrhea, headache, muscle pain.
- Not shown to effectively reduce heart attack risk.
- May raise blood sugar so should not be prescribed for diabetics.
Using medication for cholesterol control is very common and can be very effective. As seen here, there are many options that are available. All of these options should be discussed with your doctor so you can come up with the best plan to control your high cholesterol.