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Cholesterol Medications

Your doctor has prescribed medication to help control your cholesterol. This sheet tells you how cholesterol affects your health. It also explains how medications can help improve your cholesterol levels.

Understanding Cholesterol

Older woman is talking with a female pharmacist about a bottle of pills.

Cholesterol is a type of fat (lipid) that’s carried in the blood. Your body makes cholesterol in the liver. You also get it from certain foods. The body needs some cholesterol to stay healthy. But high cholesterol increases buildup of plaque (a fatty substance) in the blood vessels. This reduces or blocks blood flow in these vessels and raises your risk of heart attack (also known as acute myocardial infarction, or AMI), stroke, and other health problems.

Types of Lipids

There are three key fats in the blood:

  • LDL (low-density lipoprotein) cholesterol. This is called “bad” because it can cause plaque buildup in the blood vessels.

  • HDL (high-density lipoprotein) cholesterol. This is called “good” because it helps remove harmful cholesterol from the bloodstream.

  • Triglycerides. These are a primary form of fat your body uses to store energy. Like LDL cholesterol, they can cause plaque buildup in the blood vessels.

Healthy Cholesterol Levels

The American Heart Association provides standards for healthy cholesterol levels. These general standards are:

  • Total cholesterol: Lower than 200

  • HDL cholesterol: 40 or higher for men, 50 or higher for women

  • LDL cholesterol: Lower than 100 and even as low as 70 in some people (check with your doctor). From 100 - 129 is considered near or above optimal for most people.

  • Triglycerides: Lower than 150

You can find out your levels by having a blood test. Talk to your doctor about what levels are best for you. To find out more about cholesterol levels, visit www.heart.org/cholesterol.

Types of Cholesterol Medications

Medications can help control the amount of cholesterol in the blood. There are several types. Each controls cholesterol in a different way. They also have different effects in terms of how well they work to lower cholesterol and reduce death rates. Discuss these effects with your doctor. Your doctor will prescribe the type of medicine that is best for you. They may be used alone or combined. The main types are:

  • Statins (HMG-CoA reductase inhibitors). Statins are thought to be the best at lowering cholesterol. They do this by keeping the body from making cholesterol. Benefits: Statins lower LDL cholesterol. They also slightly raise HDL cholesterol and lower triglycerides.

  • Selective cholesterol absorption inhibitors. These prevent the body from taking cholesterol from food. They may be prescribed for use alone or with a statin. Benefits: These medications lower LDL cholesterol. They also slightly raise HDL cholesterol and lower triglycerides.

  • Resins (also called bile acid sequestrants or bile acid-binding drugs). Resins promote increased disposal of cholesterol through the intestines. They work by binding to bile (a substance that helps the body digest food). The body uses cholesterol to make bile. Normally, most bile is absorbed by the body during digestion. But when bile is bound to resin, it is excreted from the body. So, the body must make more bile. To do this, the body takes up more cholesterol from the blood. Benefits: Resins lower LDL cholesterol.

  • Fibrates (fibric acid derivatives). These are best  at reducing  the amount of triglycerides the body makes. They are not very effective lowering LDL. Benefits: Fibrates lower triglycerides. They also raise HDL cholesterol.

  • Niacin (nicotinic acid). Niacin (vitamin B3) affects how the liver makes blood fats. (Note: Non-prescription niacin should not be used to treat cholesterol problems as it is not regulated by the U.S. Food and Drug Administration.) Benefits: Niacin raises HDL cholesterol. It also lowers triglycerides and LDL cholesterol.

  • Omega-3 fatty acids. These reduce the amount of triglycerides the body makes. They also help to clear these lipids from the blood. Omega-3 fatty acids are found in many foods. These include salmon and other oily fish, and walnuts. Your doctor may prescribe these fatty acids in capsule form. Benefits: Omega-3s lower triglycerides. (Note: They may increase LDL cholesterol in some patients.) 

Taking Cholesterol Medications

Take your medication exactly as your doctor instructs. This will help it work best. Here are tips for taking cholesterol medications:

  • Know when and how to take your medications. Some may need to be taken with food. Others may need to be taken on an empty stomach or at a certain time of day.

  • Stick to a schedule. Try the following:

    • Don’t skip doses or stop taking your medication. This is important even if you feel better or if your cholesterol numbers improve.

    • Set things up to help you remember. For instance, work taking your medications into your routine. You could plan to take them when you get up in the morning or when you go to bed at night.

    • Keep track of what you take. You may take a few different medications. If so, a list or chart can help you take the right pills at the right time. A pillbox with days of the week or times of day is also a good tool for keeping track.

  • Prevent drug interactions. Some medications and supplements can interact with one another (affect how other drugs work when taken together). Be sure to tell your doctor about all other medications you take. This includes vitamins, herbs, and over-the-counter medications.

  • Know how to deal with side effects. Many people have side effects when they first start taking a medication. These are things like headache and stomach upset. Side effects should go away in a few weeks. Tell your doctor about any side effects you have. Certain side effects should be reported to your doctor right away. These include yellowing of the eyes and blurred vision. Also report muscle aches and breathing problems.

Note: If you are pregnant or breastfeeding, tell your doctor before taking any cholesterol medications.

A Healthy Lifestyle

In addition to medications, your doctor will likely suggest lifestyle changes. These are essential to improve your cholesterol levels and your overall health. Your doctor may advise lifestyle changes first before a cholesterol medication is determined necessary. Your doctor can tell you more about these changes. And he or she can help you create a plan to make them part of your routine. Changes may include:

  • Healthy eating. Certain changes in eating patterns can help you lower LDL and triglyceride levels. Start by choosing healthy fats (such as olive oil) and adding fiber through whole grains and fresh fruits and vegetables. Also, reduce the number of calories you eat.

  • Exercise. Daily exercise can help raise HDL levels.

  • Keeping a healthy weight. Being at a healthy weight can help raise HDL levels. It can also lower triglycerides.

  • Quitting smoking. Being smoke-free can improve your lipid levels.

 

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