Statins (HMG CoA Reductase Inhibitors)

Common names include:

• Fluvastatin (Lescol)
• Atorvastatin (Lipitor)
• Lovastatin (Mevacor)
• Pravastatin (Pravachol)
• Simvastatin (Zocor)
• Rosuvastatin (Crestor)
• Pitavastatin (Livalo)

Statins lower total blood cholesterol, LDL cholesterol, and triglyceride levels. They also lower heart disease risks. The drugs are usually taken daily with dinner or in the evening. Your doctor may measure your blood cholesterol levels regularly while you are taking these drugs.

Even if you currently have no known coronary heart disease (CHD), you may benefit from taking statin (cholesterol-lowering) medications, particularly if your cholesterol levels are elevated. The medication may reduce the incidence of heart attack, stroke, and death.

Significant side effects that have been reported with the use of statin medications include:

• Headache
• Muscle pain and/or damage
• Liver damage (rare)
• Rash

Bile Acid Sequestrants

Common names include:

• Cholestyramine (Questran)
• Colestipol (Colestid)
• Colesevelam (Welchol)

Bile acid sequestrants lower cholesterol levels by changing the way that cholesterol is metabolized. The drugs are in powder form and are taken with meals to decrease side effects. They should not be taken within hours of any other medications. Usually you should take other medicines either one hour before or four hours after taking this medication.

Possible side effects include, but are not limited to:

• Heartburn
• Bloating
• Constipation

Niacin or Nicotinic Acid

Niacin is a B vitamin. At higher doses, it can lower cholesterol levels and triglycerides. It is not known how it works. Niacin should be taken with meals, two or three times per day, or once a day with the extended-release pill.

Possible side effects can include, but are not limited to:

• Flushing
• Itching
• Rash
• Digestive system distress

Fibric Acid Derivatives

Common names include:

• Gemfibrozil (Lopid)
• Fenofibrate (Lofibra, Tricor)

Fibric acid derivatives are usually taken to lower triglyceride levels and increase HDL (good) cholesterol. They may also help lower LDL cholesterol.

Possible side effects include, but are not limited to:

• Abdominal pain
• Nausea
• Diarrhea
• Rash
• Itching
• Gallstones
• Muscle pain or inflammation (especially if taken with a statin)

Selective Cholesterol Absorption Inhibitors

Zetia (Ezetimibe)

Ezetimibe lowers both total cholesterol and LDL (bad) cholesterol. It works by a different mechanism than the statins by decreasing the amount of cholesterol that your body absorbs.

Possible side effects include, but are not limited to:

• Abdominal pain
• Fatigue
• Allergic reaction (swelling of face, lips, tongue, or throat that may cause difficulty breathing)
• Joint aches