Cholesterol Lowering Medication
Will you need to take medication?
The research (CARDS 2004, Heart Protection Study 2002) shows that people with type 2 diabetes lower their risk of developing coronary heart disease by using the tablets known as statins. If you have type 1 diabetes your health care team will discuss cholesterol lowering therapy with you either when you reach the age of 40 years, or if other complications arise such as microproteinuria.
Cholesterol-lowering medicines are a long-term and effective treatment. However, it is important to lower your overall risk of coronary heart disease as much as possible by your food choices especially fat intakes, lifestyle such as keeping active and stopping smoking and taking the medication prescribed.
The medications used to treat cholesterol
Statins
These work by reducing the production of cholesterol from the liver, drawing ‘bad’ cholesterol out of the bloodstream and hence lowering cholesterol levels. Statins are not suitable for people who have liver disease or for women who are pregnant or breastfeeding.
Most statins should be taken in the evening, because our bodies make most of our cholesterol at night. However, you can take atorvastatin and rosuvastatin at any time. If you are taking the statin drug simvastatin, you should avoid drinking grapefruit juice or eating grapefruit. However, if you’re taking another statin, such as atorvastatin, you could have small quantities of grapefruit juice (or the grapefruit). If you have any questions about statins and grapefruit, talk to your doctor or pharmacist.
Possible side effects of statins: Feeling sick, being sick, diarrhoea and headaches. A rare side effect of statins is inflammation of the muscles (myositis). If you have any unexpected muscle pain, tenderness or weakness, you should tell your doctor. He or she may change the type of statin you are taking, or the dose.
Drugs in this group: Simvastatin, Atorvastatin, Pravastatin, Rosuvastatin Fluvostatin
Fibrates
Fibrates are useful for people who have a high level of both blood cholesterol and triglycerides. You will not usually be given fibrates if you are also taking statins, except under strict medical supervision. You should not use fibrates during pregnancy, or if you have liver or kidney disease.
Drugs in this group: Bezafibrate, Ciprofibrate,Fenofibrate, Gemfibrozil
Nicotinic acid
Nicotinic acid and acipimox are drugs that help to lower LDL levels and increase the level of ‘good’ HDL cholesterol.
Possible side effects: Flushing is a very common side-effect with this medication
Drugs in this group: Niaspan, Olbetam
Ezetimibe
Ezetimibe is another type of cholesterol-lowering drug. It can be used along with a statin, or people who cannot take statins can take ezetimibe on its own. Ezetimibe helps to lower blood cholesterol levels by preventing the small intestine from absorbing cholesterol. Ezetimibe can help reduce LDL cholesterol by about 18%, and if it is combined with low-dose statins it can be even more effective. More research is needed to confirm the long-term benefits of this drug.
Possible side effects: Headaches, pain in the abdomen and diarrhoea.
Drugs in this group: Ezetrol