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When diet and exercise aren't enough, there are medications that can help you control your high cholesterol.

High cholesterol is usually treatable by making some dietary changes, as well as turning to regular exercises to keep the heart healthy, but also help you lose a few extra pounds and lower your HDL cholesterol levels. However, there are cases where cholesterol levels are abnormally high, in which case medication may be required.

Your doctor will carefully analyze your cholesterol levels before deciding which of the following classes of drugs may work efficiently towards helping you have good cholesterol readings.

1. Statins

HMG CoA reductase inhibitors is their other name, and they are medications that act upon the liver, causing it to produce less cholesterol, therefore preventing high amounts of cholesterol circulating through the bloodstream.

Statins normally work by influencing all three components of the total cholesterol in a person’s body, but they are most efficient in helping lower bad cholesterol levels. They also have quite a series of side effects, so you will have to talk to your doctor if they persist and are extremely disturbing.

Some level of discomfort is somewhat normal, since it takes time for the body to adjust to this medication. However, side effects of statins are usually easy to cope with, and will disappear after a few uses.

Statins aren’t just prescribed for people with high cholesterol, but they are also part of the treatment for people who are obese, have high blood pressure, diabetes, or a family history of heart attacks. Some of the most common types of statins include pitavastatin, rosuvastatin, pravastatin, lovastatin, atorvastatin, and fluvastatin.

2. Fibrates

In many cases, people that have high cholesterol levels may experience a high number of triglycerides as well. One of the medications that doctors prescribe to patients with high cholesterol and high triglyceride levels are fibrates.

Fibrates impact the level of triglycerides in the body by making sure that the liver produces less VLDL, which is a particle that travels in the bloodstream and carries the triglycerides. The way these meds work is by lowering triglycerides and increasing HDL levels, but they do not lower LDL cholesterol. That’s why they are given to patients in order to improve their bad-to-good cholesterol ratio.

Fibrates also come with their own potential side effects, such as an upset stomach or nausea. There were also situations where fibrates lead to liver inflammation, but this problem can be reversed, although it sometimes implies stopping the drug administration altogether. Gemfibrozil and fenofibrate are the most commonly-prescribed fibrates.

3. Niacin

Niacin is commonly referred to as vitamin B3, and it’s something that your body needs to stay healthy. Niacin drugs are prescribed to people who have a niacin deficiency, and for conditions which include high cholesterol. Niacin works to reduce levels of bad cholesterol and triglycerides.

Like other high cholesterol medication, niacin also comes with a few side effects, which include nausea and vomiting, flushing, an upset stomach, itching, and reduced blood pressure. There are also certain foods that you can consume to naturally increase your niacin levels, such as green vegetables, nuts, fish, liver, or potatoes.

4. Bile acid binding resins

This type of cholesterol medication goes by many different names, such as "resins" or "bile acid sequestrants". These drugs work by binding to bile acids that are found in your intestines, and eliminating them. This causes the liver to make more bile acids, which means that it uses more cholesterol, thus eliminating the one found in your bloodstream.

However, resins aren’t as efficient as statins in terms of how much they can reduce bad cholesterol levels. Even higher doses can only decrease bad cholesterol levels by a maximum of 25 percent. Even so, doctors choose to prescribe them because they are indeed efficient when combined with other high cholesterol meds, such as niacin or statins. When two of these drugs work together, they can decrease LDL levels with up to 50 percent.

These bile acid sequestrants also have some side effects, which may include constipation, bloating, vomiting, heartburn, gallstones, or weight loss. However, since they aren’t actually absorbed by the body, they will not affect other organs, as most of their side effects are gastrointestinal. Some common bile acid sequestrants are colesevelam, colestipol, and cholestyramine.

5. Cholesterol absorption inhibitors

This particular class of drugs works by preventing the intestines from absorbing cholesterol, and thus lowering LDL cholesterol levels. The most common inhibitor is ezetimibe, which was approved by the FDA back in 2002, and can be prescribed alone or together with statins.

This drug can reduce bad cholesterol levels by about 18 to 25 percent. It’s commonly prescribed for people who have familial hypercholesterolemia, a gene mutation that causes them to have high levels of cholesterol by default, in spite of them leading a healthy lifestyle.

These cholesterol absorption inhibitors are also prescribed to people who don’t respond well to a statins-based treatment, either because they can’t tolerate the drugs, or because statins alone have proven inefficient.

6. Omega-3 fatty acid supplements

The best way to get omega-3 fatty acids into your body is to consume fish meat. Alternatively, doctors can choose to prescribe supplements that will give your body the omega-3 acids it needs, in order to make your triglyceride levels go down.

These supplements are not without side effects, as they can cause people to have an upset stomach. They should also be avoided by people who take blood thinners or painkillers for inflammation. If your doctor is aware of any potential blood-thinning medication that you’re currently taking, they won’t prescribe omega-3 supplements.

Conclusion

Every high cholesterol treatment starts with making a change in the way you eat. Since fat is the number one enemy of high cholesterol, getting rid of fat from your diet will also improve cholesterol levels.

Even so, there are situations where cholesterol levels are too high, or dietary measurements aren’t helping (like in the case of people with familial hypercholesterolemia, which is an inherited form of high cholesterol). In that case, doctors turn to different meds that control high cholesterol, either by lowering LDL or triglyceride levels, or by improving the levels of HDL. 

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