Cholesterol- lowering Medicines

Why did my family doctor prescribe cholesterol- lowering medicine for me?
Lowering your "bad" cholesterol (also called LDL, or low-density lipoprotein) can reduce your risk of having a heart attack or stroke. A number of lifestyle changes can help you improve your cholesterol level (see the box below). However, if these lifestyle changes don't help after about 6 months to 1 year, your family doctor may suggest medicine to lower your cholesterol.
Even if you take cholesterol- lowering medicine, it's important to keep up with your lifestyle changes. Eating a healthy diet and being physically active can make your medicine more effective. Your family doctor can give you tips on how to make healthy food choices and include physical activity in your daily routine.

Lifestyle changes
* Avoid smoking cigarettes or using any other tobacco product.
* Get regular physical activity.

Eat a healthy low-fat diet that includes lots of fruits and vegetables.
* Limit how much alcohol you drink.

What are some common cholesterol- lowering medicines?
Several types of medicine are used to treat high cholesterol levels. Your family doctor will decide which type of medicine is right for you. He or she may prescribe more than 1 of these drugs at a time because combinations of these medicines can be more effective.
Statins (also called HMG-CoA reductase inhibitors) slow down your body's production of cholesterol. These drugs also remove cholesterol buildup from your arteries (blood vessels). Examples of statins include atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin and simvastatin.
Resins (also called bile acid sequestrants) help lower your LDL cholesterol level. Some examples of bile acid sequestrants include cholestyramine, colesevelam and colestipol.
Fibrates (also called fibric acid derivatives) help lower your cholesterol by reducing the amount of triglycerides (fats) in your body and by increasing your level of "good" cholesterol (also called HDL, or high-density lipoprotein) . Some examples of fibrates include fenofibrate and gemfibrozil.
Niacin (also called nicotinic acid) is a B vitamin. When given in large doses, it can lower your levels of triglycerides and LDL cholesterol, and increase your HDL cholesterol level. Even though you can buy niacin without a prescription, you should not take it to lower your cholesterol unless your family doctor prescribes it for you. It can cause serious side effects.
Cholesterol absorption inhibitors help lower your cholesterol by reducing the amount that is absorbed by your intestines. Ezetimibe is a cholesterol absorption inhibitor. This type of medicine is often given in combination with a statin. The combination of ezetimibe and simvastatin is an example.

Do cholesterol- lowering medicines have any side effects?
Like all medicines, these drugs can cause side effects. However, the side effects usually are not severe and are not experienced very often. Common side effects of cholesterol- lowering drugs include the following:
* Diarrhea or constipation
* Abdominal pain, cramps, bloating or gas
* Nausea and/or vomiting

Headache
* Drowsiness or dizziness
* Muscle aches or weakness
* Flushing (skin turning red and warm)
* Sleep problems

Tell your family doctor as soon as possible if your side effects become severe.

What is a drug interaction?
If you take 2 or more medicines at the same time, the way your body processes each drug can change. When this happens, the risk of side effects from each drug increases and each drug may not work the way it should. This is called a "drug-drug interaction. " Vitamins and herbal supplements can affect the way your body processes drugs too.
Certain foods or drinks can also prevent your medicine from working the way it should or make side effects worse. This is called a "drug-food interaction. "
Drug-drug interactions and drug-food interactions can be dangerous. Be certain that your family doctor knows all of the over-the-counter and prescription medicines, vitamins and herbal supplements that you are taking.
Also, talk to your family doctor before you take any new over-the-counter or prescription medicine, or use a vitamin or herbal supplement.
It's important to take medicines exactly as your family doctor tells you to. Ask your family doctor whether you need to avoid any foods or drinks while using your cholesterol- lowering medicine.
[AAFP]