Cholesterol Absorption Inhibitors

A newer drug group is cholesterol absorption inhibitors. Zetia was approved by the FDA in 2002.  It can reduce LDL by 18% to 20%. It also slightly reduces triglycerides. Zetia and other drugs within this group decrease cholesterol absorption.

When your doctor prescribes a cholesterol inhibitor in addition to a statin you can expect cholesterol to be reduced with even greater efficiency as much as 2 to 3 times what statins can do alone. That makes this group of drugs quite useful for people who cannot take statins. Or it may be used if patients have side effects when statin drugs are increased.  Remember your physician needs a total list of every medication you are taking whether it is prescribed or not. This is to prevent interactions with other drugs.

Nicotinic Acid Agents

Some brand names for nicotinic acid agents are Niacor, Niacin, or Slo-Niacin. Nicotinic acid is also known as niacin. Niacin is water soluble. It is one of the B vitamins. With high dosages it can improve all lipoprotein levels.

Nicotinic acid reduces LDL (the bad cholesterol) by 10% to 20%. At the same time it can reduce total cholesterol and triglycerides. It can raise HDL (the good cholesterol) by 15 to 35%.  It reduces triglycerides by 20 to 50%.

Nicotinamide is a byproduct of niacin when it is processed in your body.  Nicotinamide does not lower cholesterol and is not a substitute for nicotinic acid.  Several groups of people should not use nicotinic acid agents, including those who:

• have liver disease.
• are allergic to nicotinic acid.
• have arterial bleeding.
• have an active peptic ulcer.

Nicotinic acid is available in two forms. The primary difference is in delivery one is immediate and the other is delayed and extended. The immediate release type is inexpensive and can be purchased without a prescription. Nonetheless, it is not wise to reduce cholesterol without consulting and maintaining contact with your doctor because of its potential side effects.

Extended release niacin is often tolerated more readily than niacin in its rapid release crystalline form.  However, the extended release type has a higher risk of causing liver damage.

Niacin may increase your blood pressure when you are already on medication for high blood pressure.  When you are starting a niacin protocol be sure to keep an eye on your blood pressure.

Combining niacin with medications or foods may cause side effects. You must tell your doctor about all medications or supplements you are taking.

Fibrates

Fibrates are effective at reducing triglycerides.  They have minimal effect on raising HDL levels. Side effects might be serious. Discuss this with your physician. If you have kidney disease or liver disease do not take fibrates. If you have a known allergy to fibrates you should not take them.

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