High Cholesterol
Medications
Statins are the most effective and widely used medicines to treat high cholesterol. Evidence shows that statins can reduce the risk for heart attack, stroke, and death.9 Other medicines also lower cholesterol, and some may be used to lower triglycerides or raise HDL.
- Some people can try diet and exercise for at least 3 months before medicines are started. However, people who have coronary artery disease (CAD) should start taking medicines immediately.1, 13
- Other people who may need to start taking medicine as soon as possible include those who have a strong family history of early CAD, those who have inherited forms of high cholesterol, and those who have peripheral arterial disease or diabetes or who have had a previous heart attack or stroke.
Your doctor will follow the Canadian Working Group on Hypercholesterolemia and Other Dyslipidemias (WGHOD) medicine guidelines in deciding whether you should take medicine to lower your cholesterol. The guidelines base treatment on your LDL level and your risk for CAD. Many doctors also use the U.S. National Cholesterol Education Panel (NCEP) and American Heart Association medicine guidelines.
Cholesterol treatment guidelines will continue to evolve as experts learn more about how best to treat heart disease. However, everyone can benefit from eating a balanced low-fat diet, getting regular exercise, and reducing other heart disease risks, such as smoking.
Medication Choices
The following medicines can be used to lower LDL and triglyceride levels in the blood and to raise HDL:
Statin medicines Brand names* Generic names How they work Lipitor, Mevacor, Pravachol, Zocor, Lescol, Crestor, Altocor
atorvastatin, lovastatin, pravastatin, simvastatin, fluvastatin, rosuvastatin Reduce how much cholesterol your liver makes *Your doctor may prescribe a generic version of the medication instead of a brand-name version.
Your doctor may prescribe other medicines. Some are used with a statin.
Drugs combined with or used with a statin Brand names Generic names How they work Advicor niacin with lovastatin Raise good HDL cholesterol and lower bad LDL cholesterol Caduet atorvastatin with amlodipine Lower how much cholesterol your liver makes and lower blood pressure Your doctor may prescribe other medicines. Some are used with a statin.
Drugs that may be used with a statin Brand names Generic names How they work Ezetrol ezetimibe Lower the amount of cholesterol your body can absorb Colestid cholestyramine, colestipol Affect how your body removes cholesterol Lopid, Lipidil gemfibrozil, fenofibrate Raise HDL, lower triglycerides Niaspan niacin Affect how the liver makes cholesterol What to Think About
- Men younger than 35 and women who have not reached menopause are at lower risk for heart disease and often can try lifestyle changes before medicines.
- Medicine is always added to a diet and exercise plan (Therapeutic Lifestyle Changes), not substituted for it.
- Side effects are more likely and may be more severe when higher doses of statins are used.
- Doctors may also prescribe ASA therapy if you have had a heart attack or have a high risk for heart attack.
To help you decide whether medicine to lower cholesterol is right for you, see:
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| Author: | Douglas Dana Ralph Poore | Last Updated: November 13, 2006 |
| Medical Review: | Caroline S. Rhoads, MD - Internal Medicine Tom Bailey, MD - Family Medicine Neil J. Stone, MD, FACC, FACP - Internal Medicine, Cardiology | |
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