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Lipid-lowering drugs

Lipid-lowering drugs are used to reduce the level of lipids (fats and related substances) in the blood.

Lipid-lowering drugs
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Lipid-lowering drugs reduce excessive levels of lipids, particularly cholesterol and triglycerides, in the bloodstream. Blood contains several types of lipids that are needed for normal body function. However, if lipids are present in excess, they can build up in the arteries (see Atherosclerosis), and can cause serious disorders such as coronary artery disease, heart attack (see Myocardial infarction), and stroke. In addition, high levels of triglycerides can sometimes result in inflammation of the pancreas (see Acute pancreatitis).

Elevated blood lipid levels can be reduced to some extent by weight loss, which will mean making changes to the diet (see Diet and health) and exercising. However, for some people, especially those with a family history of high blood lipid levels (see Inherited hyperlipidaemias), drug treatment is also needed to lower the lipid levels. Drugs to reduce lipid levels may also be given to people with angina to reduce the risk of having a heart attack, and after a heart attack to minimize the risk of further attacks.

Common drugs

Statins: Atorvastatin, Fluvastatin, Pravastatin, Simvastatin Anion-exchange resins: Colestyramine, Colestipol
Fibrates: Bezafibrate, Fenofibrate, Gemfibrozil Nicotinic acid:
Other lipid-lowering products: Fish oil, Ispaghula

What are the types of lipid-lowering drug?

The main types of lipid-lowering drug include statins, anion-exchange resins, fibrates, and nicotinic acid and its derivatives. These drugs work in different ways to lower the levels of lipids in the blood. In addition, the natural dietary products ispaghula, which is a soluble fibre, or fish oil may be recommended.

Your doctor's choice of drug treatment will depend on which type of lipid is causing your condition. In some instances, your doctor may prescribe a combination of drugs. Lipid-lowering drugs are taken orally on a daily basis, and most need to be taken long term.

Statins drugs

These drugs reduce the formation of cholesterol and triglycerides in the body. Side effects may include nausea, headaches, abdominal pain, and diarrhoea or constipation. Statins may also cause muscle inflammation; you should inform your doctor if you develop any unexplained muscle pain, tenderness, or weakness. Long-term use of statins can affect liver function, so you may need liver function tests every 4-6 months. You should also tell your doctor if you are planning a pregnancy, are pregnant, or are breast-feeding because statins can harm a fetus or baby.

Anion-exchange resins

These drugs lower blood cholesterol levels by reducing fat absorption from the intestines. Anion-exchange resins may be used in combination with other lipid-lowering drugs, such as fibrates and statins. You should take any other lipid-lowering drugs at least 1 hour before or 4-6 hours after taking an anion-exchange resin because the resin can interfere with the absorption of other drugs.

Anion-exchange resins have few side effects, although they sometimes cause nausea, abdominal discomfort, and constipation. Supplements of vitamins A, D, and K may be necessary in long-term treatment with anion-exchange resins because the drugs reduce the body's absorption of these vitamins.

Fibrates drugs

These drugs are effective in lowering levels of both cholesterol and triglycerides in the blood. Fibrates are unsuitable if you have a disorder of the kidneys, liver, or gallbladder. The drugs occasionally cause side effects, including muscle pain, nausea, headache, and erectile dysfunction. Muscle pain may be more common if you have a disorder of the kidneys or are also receiving a statin. Fibrates can harm a fetus or baby, and it is important to tell your doctor if you are planning a pregnancy, are pregnant, or are breast-feeding.

Nicotinic acid

Excessively high levels of cholesterol or triglycerides in the blood may be reduced by treatment with nicotinic acid. However, nicotinic acid often causes side effects and is generally used only when other drugs have proved ineffective. The side effects may include facial flushing, unsteadiness, headache, nausea and vomiting, and itching. Muscle pain may develop if this drug is used together with a statin. Women who are planning a pregnancy or who are pregnant or breast-feeding should avoid nicotinic acid because it may harm a fetus or baby.

Other lipid-lowering products

The natural products ispaghula and fish oil can reduce blood lipid levels when they are incorporated into the daily diet. Ispaghula is a nonabsorbable fibre that helps to reduce high blood cholesterol levels, although its effectiveness is small compared with that of other drugs. Fish oil helps to reduce the triglyceride levels in the blood. It occurs naturally in oily fish, such as mackerel, and is available as a dietary supplement.

Posted 09.09.2010

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