About Cholesterol-Lowering Drugs

Some people have a genetic predisposition to high blood cholesterol levels. These people may need drug therapy in addition to diet to bring their cholesterol down to a safe level.

Niacin (nicotinic acid) is a B-complex vitamin. The main side effects are flushing, itching, tingling, and headache.

Bile-acid sequestrants, such as Questran, work inside the intestine, where they bind to bile from the liver and prevent it from being reabsorbed into the circulation. Bile is made largely from cholesterol, so these drugs deplete the body’s supply of cholesterol. The most common side effects from these drugs are constipation, gas, and upset stomach.

HMG-CoA reductase inhibitors, such as Mevacor and Pravachol, block production of cholesterol in the liver itself. These drugs can also produce intestinal side effects, as well as damage to the liver itself, and in a few patients, muscle tenderness.

These drugs will be more effective if you continue to follow a low cholesterol diet. Your doctor may be able to refer you to a dietitian for help in designing a diet especially for you and encouraging you to stay with it.

The chart and text below presents a brief summary of some drugs of the representative classes of available cholesterol-lowering drugs.

Atromid-S (clofibrate)

• Description: Orange, clear gelatin capsule (500 mg).
• Purpose: Atromid-S helps to lower levels of cholesterol and triglycerides (blood fats).
• Usual Dosage: One pill three to four times a day is the usual schedule.
• Possible side effects: Nausea, diarrhea, abdominal discomfort, drowsiness, weakness and headache occur occasionally. Skin rash and muscle cramps or stiffness are rare complications.
• Remarks: Keep all appointments with your doctor. Extra care in monitoring blood sugars is needed in diabetics. Periodic blood tests may be required while on this medication. This medication is only a supplement to a low-cholesterol and low-fat diet; therefore, you must continue to follow your doctor’s diet recommendations.

Colestid (colestipol granules)

• Description: Colestid is available in 5-gram packets, 300-gram and 500 gram canisters, and as a 1 gram yellow, elliptical-shaped tablet.
• Purpose: Colestid is a bile acid sequestrant used to lower high cholesterol levels. It works by binding to certain substances in the intestine.
• Usual dosage: One to three packets (5 to 15 grams) one to two times a day. May start with one packet daily and gradually increase dose. If using tablets, usual dose is 2 to 16 grams/day as a single dose or in divided doses.
• Possible side effects: Constipation, weight loss, belching, bloating, diarrhea, nausea, vomiting and stomach pain. Rarely, black tarry stools.
• Remarks: The powder should never be taken in its dry form; it should always be mixed with at least three to four ounces of water, milk, flavored drink, juice, or carbonated drink. Other medications should be taken one hour before or four hours after taking the Colestid. This medication is only a supplement to a low-cholesterol diet; therefore, you must continue to follow your doctor’s diet recommendations.