Common Medications Prescribed

Statins

Statins are the most prescribed medication for cholesterol. They significantly lower LDL cholesterol by inhibiting an enzyme that controls the rate of cholesterol production. Statins increase the liver's ability to remove LDL cholesterol in the blood. They can lower bad cholesterol by 20 percent to 60 percent, lower triglycerides and can help raise HDL cholesterol.

Rare side effects include problems with the liver and muscles, and are more likely to occur in people who are also taking fibrates (e.g. gemfibrozil or fenofibrate). Before beginning this medication, your doctor will do a liver test, also called a liver function test, to make sure the drug is safe for you. While you are on this medication, your doctor will test every so often how well your liver is working. Talk to your doctor about any muscle problems, such as pain in the calves and general muscle soreness. Also, tell your doctor if you see dark urine.

Bile acid sequestrants

These drugs bind with cholesterol-containing bile acids in the intestines and are then eliminated in the stool. Bile acid sequestrants lower LDL cholesterol by about 15 percent to 20 percent. Combined with a statin, these drugs can lower LDL by more than 40 percent. Side effects can include constipation, bloating, nausea and gas.

Nicotinic acid

Nicotinic acid, or niacin (a form of the water soluble B vitamin) improves all lipoproteins when given in high doses. Nicotinic acid reduces LDL cholesterol levels by 10 percent to 20 percent, reduces triglycerides by 20 percent to 50 percent and raises HDL cholesterol by 15 percent to 35 percent. Some forms are available over the counter, but do not take it without instructions from your doctor.

A common side effect is flushing or hot flashes, which are the result of blood vessels opening wide. Other side effects include nausea, indigestion, gas, vomiting, diarrhea and the activation of peptic ulcers. Your doctor may not prescribe this medicine if you have diabetes.

Fibrates

Fibrates are mostly effective in lowering triglycerides and, to a lesser extent, in increasing HDL cholesterol levels. Reductions in triglycerides generally are 20 percent to 50 percent with increases in HDL cholesterol of 10 percent to 15 percent. Fibrates are generally well-tolerated. The most common side effect is gastrointestinal discomfort, and they may increase the chances of developing gallstones. Although rare, serious problems with the liver and muscles can occur, especially in patients also taking statins.

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This article was reviewed and updated June 2007.