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 namesBenefitsPossible 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.

Nov. 13, 2012