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High Cholesterol -- Medicines to Help You

April 2009

Cholesterol is a kind of fat in your blood. Your body makes its own cholesterol but you also get it from the foods you eat like meat, potato chips, cookies, and eggs. Some people have too much cholesterol in their blood.

Cholesterol can build up on the inside of the blood vessels of your heart. If too much cholesterol builds up, then the blood cannot flow through to your heart. This can cause a heart attack.

Most people do not show any signs of high cholesterol. The only way to know for sure is to go to the doctor and ask for a cholesterol test.

If your doctor tells you that you have high cholesterol, there are things you can do to lower your cholesterol. You can make changes to your diet and exercise at least 30 minutes most days. There are also medicines you can take to help lower your cholesterol.

Use this guide to help you talk to your doctor about how to best control your cholesterol. This guide lists the different kinds of medicines to control cholesterol. Ask your doctor to tell you about all of the risks and benefits of taking your cholesterol medicine.

Did you know?

  • High cholesterol can raise your chance of having heart attacks and heart disease.
  • Women over age 20 should have their cholesterol checked by a doctor.
  • Most people do not show any signs of having high cholesterol.
  • Sometimes cholesterol can build up in your heart and cause chest pains.
  • You can find out your cholesterol number by getting a simple blood test.
  • Your total cholesterol number should be under 200.

Good vs. Bad Cholesterol

Not all cholesterol in your blood is bad for you. There are three kinds of blood cholesterol that you should know about: HDL (good cholesterol), LDL, (bad cholesterol) and triglycerides.

  Good Cholesterol Bad Cholesterol
What is it called? HDL LDL
What does it do to your heart? Helps to keep the arteries from clogging up Protects against heart disease Builds up and blocks your arteriesHelps to cause heart disease
What should your cholesterol number be? Good level =
60mg/dL or Higher
Good level =
Less than 100mg/dL if you have high risk for heart diseaseLess than 130mg/dL if you are otherwise healthy

Triglycerides are another form of fat in your blood that can raise your risk for heart disease. You may need treatment if your triglycerides are:

  • Borderline High (150-199 mg/dL)
  • High (200 mg/dL or more)

Medicines to Control Cholesterol

There are different kinds of medicines to control cholesterol.

There are many different medicines in each group. These medicines are listed on the next few pages. You will also find some general information about the safety warnings and side effects for the different kinds of medicine to control cholesterol. This guide only talks about some of the risks of taking these medicines. Talk to your doctor or pharmacist about all of the risks of taking your medicine.

Write down the important facts about your medicine here.

 

HMG-CoA Reductase Inhibitors (also called Statins)

Brand Name Generic Name
Altoprev Lovastatin
Crestor Rosuvastatin
Lescol Fluvastatin
Lipitor Atorvastatin
Livalo Pitavastatin
Mevacor Lovastatin
Pravachol Pravastatin
Zocor Simvastatin

Statins: What You Should Know

Warnings

  • Do not use these medicines if you have liver disease.
  • Do not use these medicines if you are pregnant or nursing.
  • Use these medicines with caution if you are also taking Gemfibrozil, Amiodarone, Verapamil, or blood thinners (anticoagulants).
  • People who use some HIV medicines, birth control pills (oral contraceptives), Nefazodone, and niacin should talk to their doctor about the specific risks of using Statins.
  • Drinking a quart or more of grapefruit juice everyday may affect these "Statin" medicines.

Common Side Effects

  • Gas
  • Dizziness
  • Constipation
  • Headache
  • Diarrhea
  • Upset stomach

Warning Signs

Call your doctor if you have any of these signs:

  • Fever
  • Dark urine
  • Muscle pain or weakness that happens without a good reason (like exercise or injury)

For more information about the risks and side effects for each drug, check Drugs@FDA.

Bile Acid Sequestrants

Brand Name Generic Name
Colestid Colestipol
LoCholest (oral powder) Cholestyramine
Prevalite (oral powder) Cholestyramine
Questran (oral powder) Cholestyramine
Welchol Colesevelam

Bile Acid Sequestrants: What You Should Know

Warnings

  • Do not use these drugs if you have problems with your liver or gallbladder.
  • People who have bleeding problems, heart disease, stomach ulcers, kidney disease, or an under-active thyroid should talk to their doctor about the risks of taking these medicines.
  • People who take Spironolactone should talk to their doctor before taking Colestipol (Colestid).

Common Side Effects

  • Heartburn
  • Constipation
  • Gas
  • Indigestion
  • Nausea

Warning Signs

Call your doctor if you have any of these signs:

  • Stomach pain
  • Vomiting
  • Sudden weight loss
  • Unusual bleeding from gums or rectum

For more information about the risks and side effects for each drug, check Drugs@FDA.

Fibrates

Brand Name Generic Name
Antara Fenofibrate
Fenoglide Fenofibrate
Lipofen Fenofibrate
Lopid Gemfibrozil
Tricor Fenofibrate
Triglide Fenofibrate
Trilipix Fenofibric Acid

Fibrates: What You Should Know

Warnings

  • People with kidney problems, gallbladder disease, or liver disease should not use these drugs.
  • Talk to your doctor before taking other medicines to control cholesterol called "Statins" (HMG-CoA Reductase Inhibitors).
  • Pregnant women or women who are breastfeeding should talk to their doctor about the risks of taking these drugs.
  • People who take diabetes medicines or blood thinners (anticoagulants) should talk to their doctor about the risks of taking these drugs.

Common Side Effects

  • Headache
  • Constipation or Diarrhea
  • Dizziness
  • Stomach pain

Warning Signs

Call your doctor if you have any of these signs:

  • Muscle pain
  • Weakness
  • Jaundice (skin or eyes look yellow)

For more information about the risks and side effects for each drug, check Drugs@FDA.

Niacin

Brand Name Generic Name
Niaspan

Niacin

Nicotinic Acid

Niacin: What You Should Know

Warnings

  • Do not use Niaspan if you have liver disease or if you are taking an immediate-release niacin pill.
  • Do not use Niaspan if you are pregnant or breastfeeding.
  • People who are taking aspirin, high blood pressure medicines, HMG CoA Reductase Inhibitors ("Statins"), or medicines to lower bile acid should talk to their doctor about the risks of taking Niacin (Niaspan).
  • People with kidney disease, peptic ulcer, diabetes, or chest pain should talk to their doctor about the risks of taking this drug.
  • People who have had a heart attack or gout should talk to their doctor about the risks of taking this drug.

Common Side Effects

  • Headache
  • Upset stomach
  • Heartburn
  • Diarrhea
  • Flushing (redness of the face or neck)

Warning Signs

Call your doctor if you have any of these signs:

  • Fast heartbeat
  • Fainting
  • Dizziness
  • Jaundice (skin or eyes look yellow)

For more information about the risks and side effects for each drug, check Drugs@FDA.

Cholesterol Absorption Inhibitors

Brand Name Generic Name
Zetia Ezetimibe

Cholesterol Absorption Inhibitors: What You Should Know

Warnings

  • Women who are pregnant or breastfeeding should not take Zetia with another cholesterol medicine.
  • People who have liver disease should not take Zetia with another cholesterol medicine.
  • Use caution if you are taking blood thinners (anticoagulants).

Common Side Effects

  • Feeling Tired
  • Stomach Pain

Warning Signs

Call your doctor if you have any of these signs:

  • Muscle Pain, Tenderness or Weakness
  • Stomach Pain
  • Swelling of the Face or Lips
  • Severe Itching

Omega-3 Fatty Acid

Brand Name Generic Name
Lovaza Omega-3 Acid Ethyl Esters

Omega-3 Fatty Acid: What You Should Know

Warnings

  • Women who are breastfeeding, pregnant, or planning to become pregnant should talk to their doctor before taking Lovaza.
  • Tell your doctor if you have diabetes or liver, thyroid or pancreas problems.
  • Tell your doctor if you are allergic to fish.
  • Tell your doctor if you drink more than 2 glasses of alcohol each day.
  • Tell your doctor if you take blood thinners or anticoagulants including aspirin, warfarin, coumarin, and clopidogrel (Plavix).

Common Side Effects

  • Burping
  • Infection
  • Feeling like you have the flu
  • Upset stomach
  • Change in your sense of taste
  • Back pain
  • Skin rash

Other Side Effects

Lovaza may affect certain blood tests.

  • Test to check your liver (ALT)
  • Test to check your cholesterol (LDL-C)

Combination Medicines

Brand Name Generic Name
Advicor Niacin and Lovastatin
Simcor Niacin and Simvastatin
Vytorin Ezetimibe and Simvastatin

Combination Drugs: What You Should Know

Warnings

  • Do not take Vytorin or Advicor if you are pregnant or breastfeeding.
  • Do not take Vytorin if you have liver disease.
  • People taking Gemfibrozil (Lopid), Fenofibrate (Tricor), high blood pressure medicines, Protease Inhibitors (medicines to treat HIV) or blood thinners (anticoagulants) should use caution when taking these drugs.
  • Drinking a quart or more of grapefruit juice everyday may affect these drugs.

Common Side Effects

  • Headache
  • Flushing (redness of the face or neck)
  • Upset stomach

Warning Signs

Call your doctor if you have any of these signs:

  • Dark urine
  • Stomach pain
  • Muscle pain, tenderness or weakness that happens without a good reason (like exercise or injury)
  • Jaundice (skin or eyes look yellow)

For more information about the risks and side effects for each drug, check Drugs@FDA.

Other Combination Medicines

Brand Name Generic Name
Caduet Amlodipine and Atorvastatin

Caduet is used to treat people who have both high blood pressure and high cholesterol.

Warnings

  • Do not take Caduet if you are pregnant or planning to become pregnant.
  • Do not take Caduet if you are breastfeeding.
  • Do not take Caduet if you have liver problems.

Common Side Effects

  • Swelling of the Legs or Ankles (edema)
  • Muscle or Joint Pain
  • Headache
  • Diarrhea or Constipation
  • Feeling Dizzy
  • Feeling Tired or Sleepy
  • Gas
  • Rash
  • Nausea
  • Stomach Pain
  • Fast or Irregular Heartbeat
  • Face feels Hot or Warm (flushing)

Warning Signs

Call your doctor if you have any of these signs:

  • Muscle problems like weakness, tenderness, or pain that happens without a good reason (like exercise or injury)
  • Brown or Dark-colored Urine
  • Skin or Eyes look yellow (jaundice)
  • Feel more tired than usual

Questions To Ask Your Doctor

  • What drugs am I taking?
  • What are the side effects?
  • What other prescription drugs should I avoid while taking my medicines?
  • What foods, herbs, or over-the-counter medicines should I avoid?
  • When should I take each drug? How many times per day do I take each drug?
  • Can I take my medicines if I am pregnant or nursing?

For more information about the risks and side effects for each drug, check Drugs@FDA.

To Learn More

National Heart, Lung, and Blood Institute
Health Information Center
Phone: 301-592-8573
Web: www.nhlbi.nih.gov/health/infoctr/index.htm

The National Women's Health Information Center
Phone: 1-800-994-WOMAN (1-800-994-9662)
1-888-220-5446 for the hearing impaired
Web: www.4women.gov/faq/cholesterol.htm

This information reflects FDA's current analysis of data available to FDA concerning these products. FDA intends to update this sheet when additional information or analyses become available.

Check the following website for the most recent information about each drug: www.accessdata.fda.gov/scripts/cder/drugsatfda/.



  
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This article was provided by U.S. Food and Drug Administration. Visit the FDA's website to find out more about their activities and publications.
 
See Also
An HIVer's Guide to Metabolic Complications
HIV and Cardiovascular Disease
High Blood Cholesterol: What You Need to Know
Quiz: Are You at Risk for HIV?
10 Common Fears About HIV Transmission
More on Heart Disease Prevention

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