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Efficacy and safety profile of different anti-cholesterol medicines

With dozens of medicinal options to lower high cholesterol levels, the task to choose a medication in every particular case can be quite challenging. Of course, one of the first questions, arising while evaluating the options, is “How effective is a particular medicine?”

The table below gives the comparison of different medications effectiveness rates. Since treating cholesterol is not only about lowering bad cholesterol, the table also contains data, demonstrating pills’ effectiveness in increasing good cholesterol and lowering triglycerides.

Efficacy rates of the most common cholesterol-lowering medications

 
Treatment option
Efficacy Rates (%)
Lowering LDL (“bad”) cholesterol
Increasing HDL (“good”) cholesterol
Lowering triglycerides
Single-drug therapy
 
 
 

Crestor (rosuvastatin)

45 % - 63 %
3 % - 14 %
10 % - 35 %

Lescol (fluvastatin)

22 % - 35 %
3 % - 7 %
12 % - 19 %

Lipitor (atorvastatin)

39 % - 60 %
5 % - 9 %
19 % -37 %

Niaspan (niacin)

3 % - 17 %
10 % - 26 %
5 % - 35 %

Zocor (simvastatin)

26 %- 47 %
8 % – 16 %
12 % - 33 %

Tricor (fenofibrate)

20.6 %
11.0 %
28.9 %

Welchol (colesevelam)

15 % – 18 %
3 %
9 % - 10 %

Zetia (ezetimibe)

18 %
1 %
8 %
Combined therapy
 
 
 
Advicor

(niacin + lovastatin)

47 % for women
34 % for men
33% for women
24 % for men
48% for women
35 % for men
Caduet

(amlodipine + atorvastatin calcium)

33.4 % - 49.1 %
n/a
n/a

Niaspan + lovastatin

30 % – 42 %
20 % - 30 %
32 % - 44 %

Welchol + atorvastatin

48 %
11 %
1%

Welchol + simvastatin

42 %
10 %
12 %

Welchol + lovastatin

34 %
4 %
1 %

Zetia + atorvastatin

56 %
7 %
33 %

Zetia + lovastatin

40 %
9 %
25 %

Zetia + simvastatin

51 %
9 %
29 %

Zetia + fenofibrate

20 %
19 %
44 %
 

Note: Some table entries contain efficacy ranges, since the efficacy of a particular medication may very depending on the dosage and duration of treatment.

Safety is definitely not the last aspect to consider, since anti-cholesterol medications are usually prescribed for long periods of time and one should be ready for the long-termed influence of the treatment on the organism. The good news is that practically all medications, used to treat high cholesterol levels, are generally well-tolerated and only about 2 % of patients experience side effects. The table below gives the summary of adverse reactions, associated with a particular medication, as well as it explains the mode of action of different options to treat cholesterol.

Mode of action and safety profile of the medications, commonly prescribed for lowering cholesterol levels.

 
Medication
Type of medication
Mode of action
Side effects
Statin

Statin medications reduce the production of cholesterol by the body itself. They block the effect of enzyme HMG-CoA reductase, thus leading to the reduction of cholesterol production in liver.

Headache, myalgia, abdominal pain, asthenia, nausea

Lescol

Myalgia, arthritis, sinusitis, bronchitis, dyspepsia, diarrhea, abdominal pain, nausea, flatulence, insomnia, headache

Infection, headache, flu syndrome, abdominal pain, back pain, constipation, diarrhea, dyspepsia, flatulence, sinusitis, rash, myalgia

Constipation, diarrhea, upset stomach, gas, heartburn, stomach pain, anorexia,

loss of appetite, nausea, inflammation of the pancreas, hepatitis, muscle cramps, joint pain; dizziness, headache, insomnia, tingling, rash, itching, blurred vision

Niaspan

Niacin or nicotinic acid

Niacin reduces very low-density lipoprotein, which is converted into low-density lipoprotein and as a result reduces this LDL (‘bad’) cholesterol level in the blood.

Headache, abdominal pain, diarrhea, dyspepsia, nausea, vomiting, rhinitis, pruritus, rash

Fibrate

TriCor works mostly for lowering high triglycerides levels. It blocks VLDL particles and significantly reduces their amount in blood. As the result, triglycerides cannot circulate in the blood stream and are eliminated from the body.

Abdominal or back pain, headache, asthenia, flu syndrome, diarrhea, nausea, constipation, respiratory disorder

Welchol

Bile acid resin

Welchol lowers blood cholesterol by absorbing bile acid in the bowel. The body uses bile for production cholesterol, and when there is not enough bile, the body starts to use more cholesterol from blood to produce as much bile as it is necessary for normal fat digestion. This results in lowering cholesterol amount in the bloodstream.

Infection, headache, pain, flu syndrome, flatulence, nausea, diarrhea, sinusitis, rhinitis

New class medication

Zetia works in the human digestive tract by blocking cholesterol absorption from foods we consume.

Fatigue, abdominal pain, diarrhea, sinusitis, back pain, coughing

 
Nick


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