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Cholesterol lowering drugs Internal Medicine ,Pharmacology ,Prevention

Cholesterol treatment guidlines:

Current guidelines for cholesterol treatment: http://www.nhlbi.nih.gov/guidelines/cholesterol/profmats.htm

Drug Treatment:

There are four major classes of medications are used to treat hyperlipidemia:
o HMG-CoA reductase inhibitors (statins)
o Bile acid sequestrants (cholestyramine, cholestipol)
o Nicotinic acid
o Fibric acids


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o The statins can lower LDL levels by 18% to 55% and triglyceride levels by 7% to 30%. They also can raise HDL levels by 5% to 15%.Their major side effects include myopathy and an elevation of liver enzyme levels.


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o The bile acid resins (cholestyramine, cholestipol) lower LDL levels by 15% to 30%, and raise HDL levels by 3% to 5%. They have no effect on triglyceride levels. Their major side effects include gastrointestinal distress, constipation, and a decrease in the absorption of other drugs.


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o Nicotinic acid lowers LDL levels by 5% to 25% and triglyceride levels by 20% to 50%. Nicotinic acid also raises HDL levels by 15% to 35%. The major side effects of nicotinic acid include flushing, hyperglycemia, hyperuricemia, GI distress, and hepatotoxicity.



o Fibric acids lower LDL levels by 5% to 20% and triglyceride levels by 20% to 50%, and raise HDL levels by 10% to 20%. Their major side effects include dyspepsia, gallstones, myopathy, and unexplained noncardiac death.


August 11, 2006