What are lipid-altering medications?

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Lipid altering medications are used in lowering blood levels of undesirable lipids such as LDL cholesterol and triglycerides and increasing blood levels of desirable lipids such as HDL cholesterol. Several classes of medications are available in the United States, including HMG CoA reductase inhibitors (statins), Nicotinic Acid, fibric acid derivatives, and medications that decrease intestinal cholesterol absorption (bile acid sequestrants and cholesterol absorption inhibitors). Some of these medications are primarily useful in lowering LDL cholesterol, others in lowering triglycerides, and some in elevating HDL cholesterol. Medications also can be combined to more aggressively lower LDL, as well as in lowering LDL and increasing HDL at the same time.

Medication class	Medication examples	Effects on blood lipids
statins	Pravachol, Mevacor, Lipitor, Lescol, Crestor, Zocor	Most effective in lowering LDL, mildly effective in increasing HDL, mildly effective in lowering triglycerides
Nicotinic Acid (Niacin)	Niacin, Niaspan, Slo-Niacin	Most effective in increasing HDL, effective in lowering triglycerides, mildly to modestly effective in lowering LDL
Fibric acid	Lopid, Tricor	Most effective in lowering triglycerides, effective in increasing HDL, minimally effective in lowering LDL
Bile acid sequestrants	Questran, Welchol, Colestid	Mildly to modestly effective in lowering LDL, no effect on HDL and triglycerides
Cholesterol absorption inhibitors	Zetia	Mildly to modestly effective in lowering LDL, no effect on HDL and triglycerides
Combining Nicotinic Acid with statin	Advicor (lovastatin+niaspan)	Effective in lowering LDL and triglycerides and increasing HDL
Combining a statin with an absorption inhibitor	Vytorin (Zocor + Zetia)	Synergistic in lowering LDL and effective in lowering LDL with low doses of each ingredient

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