Cholesterol medications: Consider the options

By Mayo Clinic staff
A healthy lifestyle is the first defense against high cholesterol. But sometimes diet and exercise aren't enough, and you may need to take cholesterol medications. Cholesterol medications may help:

• Decrease your low-density lipoprotein (LDL) cholesterol, the "bad" cholesterol that increases the risk of heart disease
• Decrease your triglycerides, a type of fat in the blood that also increases the risk of heart disease
• Increase your high-density lipoprotein (HDL) cholesterol, the "good" cholesterol that offers protection from heart disease

Your doctor may suggest a single drug or a combination of cholesterol medications. Here's an overview of benefits, cautions and possible side effects for common classes of cholesterol medications.

Drug class and drug names	Benefits	Possible side effects and cautions
Statins Altoprev (lovastatin) Crestor (rosuvastatin) Lescol (fluvastatin) Lipitor (atorvastatin) Mevacor (lovastatin) Pravachol (pravastatin) Zocor (simvastatin)	Decrease LDL and triglycerides; slightly increase HDL	Constipation, nausea, diarrhea, stomach pain, cramps, muscle soreness, pain and weakness; possible interaction with grapefruit juice
Bile acid binding resins Colestid (colestipol) Questran (cholestyramine/ sucrose) Welchol (colesevelam)	Decrease LDL	Constipation, bloating, nausea, gas; may increase triglycerides
Cholesterol absorption inhibitor Zetia (ezetimibe)	Decreases LDL; slightly decrease triglycerides; slightly increase HDL	Stomach pain, fatigue, muscle soreness
Combination cholesterol absorption inhibitor and statin Vytorin (ezetimibe-simvastatin)	Decreases LDL and triglycerides; increases HDL	Stomach pain, fatigue, gas, constipation, abdominal pain, cramps, muscle soreness, pain and weakness; possible interaction with grapefruit juice
Fibrates Lofibra (fenofibrate) Lopid (gemfibrozil) TriCor (fenofibrate)	Decrease triglycerides; increase HDL	Nausea, stomach pain, gallstones
Niacin Niaspan (prescription niacin)	Decreases LDL and triglycerides; increases HDL	Facial and neck flushing, nausea, vomiting, diarrhea, gout, high blood sugar, peptic ulcers
Combination statin and niacin Advicor (niacin-lovastatin)	Decreases LDL and triglycerides; increases HDL	Facial and neck flushing, dizziness, heart palpitations, shortness of breath, sweating, chills; possible interaction with grapefruit juice
Omega-3 fatty acids Lovaza (prescription omega-3 fatty acid supplement) Vascepa (Icosapent ethyl)	Decrease triglycerides	Belching, fishy taste, increased infection risk

Most cholesterol medications lower cholesterol with few side effects, but effectiveness varies from person to person. If you decide to take cholesterol medication, your doctor may recommend periodic liver function tests to monitor the medication's effect on your liver. Also remember the importance of healthy lifestyle choices. Medication can help control your cholesterol — but lifestyle matters, too.

Flaxseed against cholesterol

Flax seed oil is a rich source of essential fatty acids, most notably omega-3 fatty acids. Also known as polyunsaturated fatty acids, these compounds are necessary for healthy growth and development. According to the University of Maryland Medical Center, they are also critical for proper brain function and cardiovascular health.

Various flaxseed preparations - including ground flaxseed, partially defatted flaxseed, and flaxseed bread and muffins - seem to significantly reduce total cholesterol and the “bad cholesterol,” low-density lipoprotein (LDL) cholesterol, in people with normal cholesterol levels and in men and pre-menopausal women with high cholesterol. But flaxseed doesn’t have much effect on “good cholesterol,” high-density lipoprotein (HDL) cholesterol. Most flaxseed preparations don’t affect triglyceride levels either, but unfortunately partially defatted flaxseed (flaxseed without as much alpha-linolenic acid content) can increase triglycerides by approximately 10%.

 

Flaxseed might slow blood clotting. Taking flaxseed along with medications that also slow clotting might increase the chances of bruising and bleeding.

Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.