Cholesterol is a form of lipid found in many oily foods. In addition it is synthesized by the human body. An increased level of cholesterol, especially LDL cholesterol in the blood is one of the main risk factor for ischemic heart diseases. So doctors prescribe wide variety of drugs to reduce blood cholesterol levels. Some inhibit cholesterol synthesis and others inhibit cholesterol absorption from the gut. However many drugs have side effects.
What are the main classes of drugs?
Statins, Fibrates, bile acid sequestrants, cholesterol absorption inhibitors and Nicotinic acid reduce blood cholesterol levels.
What are the side effects of statins (Lipitor®, Alticor®, Lescol®)?
Statins are the most popular class of high cholesterol drugs. They inhibit cholesterol synthesis. Main side effects associated with statins are liver cell destruction and muscle break down. Liver cell destruction can cause loss of appetite, nausea, vomiting, malaise and yellowish discoloration of the body.
In addition statins can cause muscle destruction. It is manifested as muscle pain and muscle weakness. In addition, some patients can get abdominal bloating and constipation with this drug.
What are the side effects of fibrates (Trico®, Lopid ®)?
Fibrates reduce cholesterol and triglycerides in the blood. Similar to statins fibrates can cause liver damage. So symptoms of liver disease such as loss of appetite, fatigue, nausea, vomiting and loss of appetite can occur with fibrates.
In addition fibrates can increase the incidence of gall stones. So if you get any dull, long lasting abdominal pain that is associated with food intake then you should seek medical help. This medication can also cause muscle break down (symptoms are similar to statins). Additionally fibrates can cause pancreatitis. This can cause severe abdominal pain.
Fibrates must not be used in pregnancy. Fetal malformations and fetal deaths have been clearly demonstrated with this product. This medication can also cause serious problems in nursing infants as well. So this should not be used in lactation and pregnancy.
What are the side effects of bile acid sequestrants (Questran®, Cholestagel®, Colestid®)?
Significant side effects of these drugs are gastrointestinal disturbances (nausea, vomiting, loss of appetite and abdominal bloating) and rarely muscle toxicity characterized by muscle pains.
What are side effects of Ezetimibe (Ezetrol®)?
This is a cholesterol absorption inhibitor. Main side effects are gastrointestinal disturbance and fatigue.
What are the side effects of nicotinic acids?
Nicotinic acid derivatives are useful only when the statins have failed. They have some troublesome side effects due to dilation of the blood vessels such as flushing, increased heart rate and headache.
High cholesterol drugs are essential medications that can prolong life. But they have some side effects. Most drugs can cause liver damage and muscle damage. In addition most drugs are not recommended during pregnancy.
Learn more about this author, Dr. Manura Nanayakkara.