Your liver Emotional well-being may be closely monitored because Cholesterol level and medication options can cause toxicity. Lveel Continue. These are derived from fish oils that are chemically changed and purified. Please understand that the American Heart Association is not recommending or endorsing any specific products.

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High Cholesterol - What All Patients Need to Know

Cholesterol level and medication options -

Other medicines may be used if statins do not work or you do not want to take statins. Heart UK: treatment for high cholesterol. Page last reviewed: 13 July Next review due: 13 July Home Health A to Z High cholesterol Back to High cholesterol.

Medicines for high cholesterol - High cholesterol Contents What is high cholesterol? Getting tested Cholesterol levels How to lower your cholesterol Medicines for high cholesterol.

Medicine to lower your cholesterol You might need medicine to lower your cholesterol if: your cholesterol level has not gone down after changing your diet and lifestyle you're at a high risk of having a heart attack or stroke Ask your doctor about the medicines you can take.

People with high triglyceride levels — Triglycerides, like cholesterol, are a type of lipid. High triglycerides called "hypertriglyceridemia" are also associated with an increased risk of heart disease. These need to be assessed on a fasting blood test because eating any food prior to the test will increase the levels.

Dietary interventions and exercise are usually effective in lowering triglycerides. The dietary interventions include limiting intake of refined carbohydrates, excess calories, and alcohol.

For reducing cardiovascular risk, the first step is to reduce the LDL to below the target level see 'Statins' below and then check the fasting triglyceride level. See 'Omega-3' below. People who have already had triglyceride-related pancreatitis may be treated at lower levels.

In these situations, a class of medication called fibrates are usually the first line of treatment. People with diabetes — People with diabetes type 1 or 2 are at high risk of heart disease. A moderate- or high-intensity statin is recommended in most adults with diabetes, regardless of their baseline LDL cholesterol level.

See "Patient education: Type 2 diabetes: Overview Beyond the Basics ". Older adults — The decision to treat high cholesterol levels in a person over the age of 75 depends upon the individual's "chronologic age" age in years as well as their "physiologic age" which takes into account their health and fitness level.

A person with a limited life span and underlying illness may not need to receive drug therapy. On the other hand, an otherwise healthy older adult should not be denied drug therapy simply on the basis of age alone.

In general, the treatment goals discussed above apply for people of all ages. These patients often have a genetic factor that leads to a change in how cholesterol is processed in the body, and they have high levels of cholesterol from birth. As such, their risk of developing heart disease is much higher.

These patients are recommended for treatment regardless of the risk score, with treatment often started in late teenage years. You can help lower your lipid levels with lifestyle changes, medications, or a combination of both.

In certain cases, a health care provider will recommend a trial of lifestyle changes before recommending a medication. The best approach for you will depend on your individual situation, including your lipid levels, health conditions, risk factors, medications, and lifestyle.

Lifestyle changes — If you have high low-density lipoprotein LDL cholesterol, you should try to make some changes in your day-to-day habits, including reducing the amount of total and saturated fat in your diet, losing weight if you are overweight or obese , getting regular aerobic exercise, and eating plenty of fruits and vegetables see "Patient education: Exercise Beyond the Basics " and "Patient education: Diet and health Beyond the Basics ".

A plant-based diet is an effective strategy to lowering LDL cholesterol. The benefits of these lifestyle changes usually become evident within 6 to 12 months. However, the success of lipid lowering with lifestyle modification varies widely, and health care providers sometimes recommend beginning medication sooner.

Medications — There are many medications available to help lower elevated levels of LDL cholesterol. Each category of medication varies in how it works, how effective it is, and how much it costs. Your health care provider will recommend a medication or combination of medications based on your blood lipid levels and other individual factors.

Statins — Statins are one of the best-studied classes of medications and the most commonly used drugs for lowering LDL cholesterol.

They are the most effective drugs for prevention of coronary heart disease, heart attack, stroke, and death. Available statins include atorvastatin former brand name: Lipitor , rosuvastatin former brand name: Crestor , and several other similar medications table 1.

Statins decrease the body's production of cholesterol and increase removal of cholesterol by the liver, so they reduce LDL cholesterol levels by as much as 25 to 55 percent.

In addition, they can lower triglycerides. Statins may also reduce inflammation and may prevent heart attacks and strokes through this mechanism.

While most people tolerate statins well, there are some potential side effects, mainly muscle pain, aches, or weakness. Use of statins may also increase the risk of developing diabetes, although the risk is seen mostly in those with prediabetes, and the benefit in reduction on heart attack and stroke is about four times that of the risk of developing diabetes.

Changing statins and using low doses often can avoid these issues, but if not, non-statin medications can be used to lower LDL cholesterol. It is important to closely follow the dosing instructions for when to take statins; some are more effective when taken before bedtime while others should be taken with a meal.

In addition, some foods, such as grapefruit or grapefruit juice, can increase the risk of side effects of statins.

Most manufacturers recommend that people who take lovastatin, simvastatin, or atorvastatin consume no more than one-half of a grapefruit or 8 ounces of grapefruit juice per day. Ezetimibe — Ezetimibe brand name: Zetia blocks the body's ability to actively transport cholesterol from food as well as cholesterol that the body produces internally.

It lowers LDL cholesterol levels by 20 to 25 percent and has relatively few side effects. It is usually prescribed in combination with a statin but is also used alone in patients who cannot tolerate a statin. When used in combination with a statin after an acute coronary syndrome eg, heart attack , ezetimibe provides a small additional reduction in the risk of having another cardiovascular event.

PCSK9 inhibitors — PCSK9 monoclonal antibody inhibitors are another class of drugs that lower LDL cholesterol levels sample brand names: Praluent, Repatha table 1 ; they are given by injection under the skin every two to four weeks.

They reduce cardiovascular events such as heart attack or stroke and potentially death. Aside from mild skin reactions at the site of injection, they have few side effects. Inclisiran brand name Leqvio is a PCSK9 inhibitor that is given by injection once, 90 days later, and then every six months.

However, they are expensive and their use is limited to patients treated with maximal tolerated statins who have persistent elevations of LDL cholesterol.

Bile acid sequestrants — The bile acid sequestrants include colesevelam brand name: Welchol , colestipol brand name: Colestid , and cholestyramine sample brand names: Prevalite, Questran table 1. These medications bind to bile acids in the intestine, reducing the amount of cholesterol the body absorbs from foods.

They are used only occasionally. They lower LDL cholesterol only modestly 10 to 15 percent. Side effects can be bothersome and may include nausea, bloating, cramping, and liver damage. Taking psyllium a fiber supplement, such as Metamucil can sometimes reduce the dose required and the side effects.

Bile acid sequestrants can interact with some medications, including as digoxin brand name: Lanoxin and warfarin brand name: Jantoven , and with the absorption of fat-soluble vitamins including vitamins A, D, K, and E.

Taking these medications at different times of day can solve these problems in some cases. Bempedoic acid — Bempedoic acid brand name: Nexletol is the newest lipid-lowering agent, and it is approved for lowering LDL cholesterol. It works by inhibiting cholesterol synthesis at a step before the HMG-CoA reductase or the enzyme inhibited by statin therapy.

Bempedoic acid alone or in combination with a statin or ezetimibe brand name: Nexlizet lowers LDL cholesterol as well as other atherogenic proteins.

Bempedoic acid can reduce the risk of cardiovascular events such as heart attacks. Side effects include an increase in the incidence of gout, gallstones, kidney damage, and small increases in liver enzymes. Early studies reported Achilles tendon rupture as a rare side effect; however, this effect was not seen in a recent large trial.

Omega-3 — Oily fish, such as mackerel, herring, bluefish, sardines, salmon, and anchovies, contain two important fatty acids called docosahexaenoic acid DHA and eicosapentaenoic acid EPA.

Eating a diet that includes one to two servings of oily fish per week can lower triglyceride levels and reduce the risk of death from coronary heart disease. Fish oil supplements, supplements with low-dose mixed fish oils usually approximately 1 gram per day of combined DHA and EPA , had been thought to provide cardiac benefit, but large trials have found no significant benefit.

As such, they are no longer recommended. A second study of a high-dose agent that had both EPA and DHA failed to provide benefit, suggesting that the EPA only preparation at the 4 g dose is important. However, the trials found that omega-3 fatty acid medications increase the risk of atrial fibrillation.

Therefore, a discussion with your cardiologist on the net benefit or harm from taking fish oil supplements including icosapent ethyl is needed before starting this treatment.

Nicotinic acid niacin — Nicotinic acid is a vitamin that is available in immediate-release, sustained-release, and extended-release formulations table 1. Nicotinic acid is rarely used for a high cholesterol. In most situations, ezetimibe or a PCSK9 inhibitor is tried before nicotinic acid.

Historically, this agent used to be used to raise HDL cholesterol levels, but that is no longer recommended. It is sometimes used for patients with high lipoprotein a levels and LDL cholesterol that is refractory to more effective and better-tolerated medications statins, ezetimibe and PCSK9 inhibitors.

Nicotinic acid is associated with many side effects, including flushing when the face or body turns red and becomes warm , itching, nausea, numbness and tingling, and worsening of gout.

This medication can also cause liver damage; people who use it require regular blood tests to monitor their liver function. Red yeast rice — Red yeast rice is a fermented rice product that can lower serum cholesterol. Red yeast rice contains naturally occurring substances called monacolins that act to reduce cholesterol by a mechanism similar to that of statins.

Although red yeast rice is effective for lowering total and LDL cholesterol, there is not evidence that it decreases rates of cardiovascular events or that it is safe to take long-term.

Moreover, red yeast rice supplements are not standardized in the United States. Different commercial preparations vary widely in the amount of the active ingredient, and some commercial preparations have been shown to contain potentially toxic substances or lovastatin, a statin medication.

Soy protein — Soy protein contains isoflavones, which mimic the action of estrogen. A diet high in soy protein can slightly lower levels of total cholesterol, LDL cholesterol, and triglycerides and raise levels of high-density lipoprotein HDL cholesterol.

However, normal protein should not be replaced with soy protein or isoflavone supplements in an effort to lower cholesterol levels. Soy foods and food products eg, tofu, soy butter, edamame, some soy burgers are likely to have beneficial effects on lipids and cardiovascular health because they are low in saturated fats and high in unsaturated fats.

Garlic — Garlic has not been proven to be effective in lowering cholesterol. Plant stanols and sterols — Plant stanols and sterols may act by blocking the absorption of cholesterol in the intestine. They are naturally found in some fruits, vegetables, vegetable oils, nuts, seeds, and legumes.

They are also available in commercially prepared products such as margarine Promise Active and Benecol , orange juice Minute Maid Premium Heart Wise , and rice milk Rice Dream Heart Wise as well as dietary supplements Benecol SoftGels and Cholest-Off.

Despite lowering cholesterol levels, there are no studies demonstrating a reduced risk of coronary heart disease in people who consume supplemental plant stanols and sterols.

These products need to be studied more before they can be recommended. Although medications can rapidly lower your levels within a week , it often takes 6 to 12 months before the effects of lifestyle modifications are noticeable.

Once you have an effective treatment plan and you begin to see results, it is important to stay committed to the plan. Stopping treatment usually allows lipid levels to rise again and increases your risk for heart attack, stroke, or other cardiovascular problems.

Even while taking medications, maintaining a healthy lifestyle is crucial to obtain the most benefit from these therapies. Most people who stop treatment do so because of perceived side effects.

Having high cholesterol means you have high Anx of LDL or oltions cholesterol, or both. These Emotional well-being risk factors for cardiovascular heart disease. Having high triglyceride levels is also a risk factor for cardiovascular disease. Healthy diet and exercise are the first line in managing high cholesterol. However, management depends on the person. Common cholesterol medication names in the Emotional well-being are statins such Emotional well-being Lipitor, Lescol, or Cholesrerol. However, there are a Cohlesterol of other options. Your liver produces all of the cholesterol your body needs. But there are some factors that can cause you to have too much cholesterol in your blood. The most common causes of high cholesterol include:.