Therapeutic Uses of Cholesterol-lowering Medicines

Cholesterol-lowering medicines are used to treat:
• High levels of total cholesterol
• High levels of LDL cholesterol

How Cholesterol-lowering Medicines Work Statins (Advicor, Altoprev, Caduet, Crestor, Lescol/Lescol XL, Lipitor, Mevacor, Pravachol, Pravigard PAC, Vytorin, and Zocor) block an enzyme that helps make cholesterol. When cholesterol production is slowed, the liver makes more LDL receptors. The receptors attract LDL particles from the blood, reducing their level in the bloodstream. Statins are most effective at lowering LDL (“bad”) cholesterol levels, but they also help lower triglyceride levels and raise HDL (“good”) cholesterol levels.

Bile acid sequestrants (or resins) (Colestid, LoCholest, LoCholest Light, Prevalite, Questran, Questran Light, and WelChol) bind to bile, an acid used in the digestive process. The body uses cholesterol to make bile. When the bile acid sequestrants bind to the bile, it cannot be used in the digestive process, and the liver responds by making more bile. The more bile the liver makes, the more cholesterol it uses. Less cholesterol is left to circulate through the bloodstream.

Nicotinic acid, or niacin, (Advicor, Niacor, Niaspan, Nicolar, Slo-Niacin, and others) is a form of vitamin B. It appears to slow the liver’s production of the components that help make LDL (“bad”) cholesterol. Nicotinic acid has also been found to lower triglyceride levels and raise HDL (“good”) cholesterol levels. If taken for high cholesterol, it must be an FDA-monitored brand that is prescribed by a doctor (not a “dietary supplement”).

Fibric acid derivatives, or fibrates, (Antara, Atromid-S, Fenoglide, Lipofen, Lofibra, Lopid, Tricor, and Triglide) lower triglyceride levels by breaking down the particles that make triglycerides and using them in other ways. Lower triglyceride levels can lead to increased levels of HDL (“good”) cholesterol. These medicines are often used in conjunction with statins.

Cholesterol absorption inhibitors (Vytorin, Zetia) lower LDL (“bad”) cholesterol levels by reducing the amount of cholesterol that is absorbed in the digestive tract from food that has been eaten. This medicine can also be given in combination with a statin. It is important to stay on a cholesterol-lowering diet while taking this medicine.

Disclaimer
The information in this section is meant to provide a brief description of these medicines. It does not cover all of the possible uses, warnings, dosages, side effects, or interactions with other medicines and vitamin or herbal supplements. This information should not be used as medical advice for individual problems.


Resources

Texas Heart Institute www.texasheartinstitute.com/HIC/Topics/Meds/cholmed.cfm
American Heart Association www.americanheart.org/presenter.jhtml?identifier=163
Medline Plus www.nlm.nih.gov/medlineplus/druginfo/natural/patient-niacin.html


Updated December 2015