Cholesterol medications

Medications to lower total cholesterol, LDL, and/or triglycerides may be added when diet, exercise, weight management and quitting smoking do not result in desirable cholesterol levels. Medications are used in addition to, not instead of, diet, exercise, weight management and smoking cessation.

There are several different types of medications that work in different ways. Some can be used in combination with others. The timing of some of these medications in relation to food or other medications is very important. Please talk with your provider or pharmacist before starting them. Rhabdomyolysis is a rare, but serious, adverse reaction – report any unexplained muscle pain, tenderness, weakness to your provider. The following chart summarizes these drugs, but is not intended as medical advice. Please see your primary provider for more detailed information.

Drug type Examples Drug action Possible Side Effects Do not take if…
HMG-CoA Reductase Inhibitors or “Statins” Atorvastatin (Lipitor)
Fluvastatin (Lescol)Lovastatin (Mevacor)
Pravastati (Pravachol)
Simvastatin (Zocor)
Decrease total cholesterol and LDL by inhibiting synthesis and promoting breakdown of cholesterol in the liver Usually mild and transient, if at all: headache, flatulence, abdominal pain, cramps, constipation, nausea. You have liver dysfunction. You are pregnant or lactating.
Fibric Acid Derivatives Clofibrate (Atromid-S)


 

Fenofibrate (Tricor)


Gemfibrozil (Lopid)

 

Increases breakdown of VLDL to LDL, decreases synthesis of VLDL, inhibits cholesterol formation.

Decreases triglycerides and cholesterol.

Increases excretion of cholesterol in feces; reduces production of triglycerides in liver.

Nausea, vomiting, impotence, myalgia, increased or decreased angina, arrhythmias, fatigue, rash.

Nausea, constipation, diarrhea, abdominal pain, back pain, respiratory problems, abnormal liver function tests. Dyspepsia, abdominal pain, diarrhea, nausea, vomiting, rash, headache, vertigo.

You have known hypersensitivity to these drugs. You have kidney or liver dysfunction. You have primary biliary cirrhosis.
Bile Acid Sequestrants Cholestyramine (LoCholest, Prevalite, Questran, Questran Light)

Colestipol HCl (Colestid)

Colesevelam HCl (Welchol)

 

Decreases total and LDL cholesterol by blocking reabsorption of bile (needed in intestinal track for absorption of fats). More bile is excreted in feces; liver forced to make more bile from cholesterol, lowering the amount in blood. Constipation, exacerbation of hemorrhoids, abdominal pain, distention, cramping, nausea, increased bleeding due to vitamin K malabsorption, vitamin A and vitamin D deficiencies. You have known hypersensitivity to the drug. You have biliary obstruction.
Miscellaneous Niacin, nicotinic acid (Niaspan)


Ezetimibe (Zetia)

 

Lowers blood lipids, but mechanism of action unknown.

Inhibits absorption of cholesterol from intestines.

 

Generalized flushing, itching, tingling, nausea, vomiting, abdominal pain.

Fever, headache, runny nose, sore throat.

 

You have known hypersensitivity to niacin. You have a peptic ulcer. You have liver dysfunction. You have arterial bleeding.