Popular cholesterol-lowering drugs

People suffering from elevated cholesterol levels in the blood know that this pathological condition leads to atherosclerosis. And this disease, in turn, leads to the development of heart attacks, strokes and massive damage to the vascular network throughout the body.

That is why the question of which tablets are very good and inexpensive are used to lower cholesterol levels is very relevant. Only a specialist can prescribe medications that prevent the formation of atherosclerotic deposits in capillaries and arteries.

A preliminary examination is carried out to assess the state of health, blood vessels, internal organs and systems. And only then, based on the data received, the doctor selects the appropriate medications. This article is for informational purposes only, since choosing anti-cholesterol drugs on your own can lead to a number of complications.

General information

Cholesterol is a fatty alcohol, an organic compound found in the cell membranes of living organisms.
Two concepts are often used - cholesterol and cholesterol . What is the difference between them? In fact, this is the name of the same substance, only in the medical literature the term “cholesterol” is used, since the ending “-ol” indicates its relationship to alcohols. This substance is responsible for giving strength to cell membranes .

Sources of cholesterol

But if the level of cholesterol in the body is elevated, cholesterol plaques form in the walls of blood vessels, which, when cracked, create a favorable environment for the formation of blood clots . Plaques narrow the lumen of the vessel.

Therefore, after a cholesterol test, the doctor, if necessary, decides what to do if you have high cholesterol. If the interpretation of the cholesterol test indicates high levels, the specialist often prescribes expensive medications - statins , which are designed to prevent diseases of the cardiovascular system. It is important that the doctor explains that after prescription, the patient needs to take such tablets constantly, as the instructions for use suggest.

But anti-cholesterol drugs have certain side effects, which doctors should warn patients about, explaining how to take the pills correctly.

Therefore, every person who has elevated cholesterol levels must decide whether to take such medications.

There are two main groups of cholesterol medications currently offered: statins and fibrates . In addition, experts recommend that patients consume Lipoic acid and Omega 3 . The drugs used to lower cholesterol are described below. However, their use is advisable only after examination and prescription by a doctor.

Summarizing

The choice of appropriate drugs for high cholesterol is the prerogative of the attending physician. Only a specialist is able to assess the patient’s health and select pills for him depending on the indications and taking into account existing contraindications. When choosing medications, you cannot focus only on cost.

Cheap products may not always be of high quality, although a high price does not guarantee a quick and long-lasting effect. It is better to stick to the golden mean, follow the doctor's instructions and take the pills strictly according to the plan. Then the prescribed drug will be beneficial and will not have side effects on the body.

Statins to lower cholesterol

Before taking such drugs, you need to know what statins are - what they are, the benefits and harms of such drugs, etc. Statins are chemicals that in the body reduce the production of enzymes necessary for the process of cholesterol synthesis.

In the instructions for such drugs you can read the following:

• They reduce the concentration of cholesterol in plasma due to inhibition of HMG-CoA reductase , as well as a decrease in cholesterol synthesis in the liver.
• Reduce cholesterol concentrations in people suffering from homozygous familial hypercholesterolemia , which is not amenable to treatment with lipid-lowering drugs.
• Their mechanism of action makes it possible to reduce total cholesterol levels by 30-45%, and “harmful” cholesterol levels by 40-60%.
• When taking statins, HDL cholesterol and apolipoprotein A increase.
• The drugs reduce the likelihood of ischemic complications by 15%, in particular, according to cardiologists, the risk of angina pectoris and myocardial infarction is reduced by 25%.
• No mutagenic or carcinogenic effects are observed.

What are statins

The class of statins are pills that are most often prescribed by doctors to patients with high levels of cholesterol in the blood plasma. Therefore, it is believed that statins are the best means for normalizing cholesterol levels, preventing heart attack, ischemia and cerebral hemorrhage.

But to understand the mechanism of action of this group of medications, you should know how lipophilic alcohol is formed, what its purpose and role in the body are. Cholesterol is 85% produced in the body on its own, and only the remaining 15% comes from food.

An organic compound is involved in many processes:

• biosynthesis of hormones, including sex hormones;
• protection of red blood cells from toxic damage by hemolytic poisons;
• regulation of vascular permeability and cell membranes;
• production of bile and vitamin D;
• maintaining the strength of cells throughout the body.

For the full supply of cholesterol to all tissues and internal organs, special proteins are produced - lipoproteins. If the level of lipophilic alcohol in the body is elevated, measures must be taken to reduce it.

In the initial stages of atherosclerotic changes, these include diet, exercise, giving up addictions, proper rest and frequent exposure to fresh air. If the above measures have no effect, doctors prescribe statin drugs. They inhibit the production of enzymes involved in the production of lipoproteins.

As a result, the volume of cholesterol penetrating deep into tissues decreases, and the volume of reverse transport increases. In connection with taking drugs from the statin group, the amount of lipophilic alcohol in the body decreases, and at the same time the fat and plaques already accumulated in the capillaries are broken down.

The benefits and harms of drugs

Statins are not a group of drugs that you can prescribe yourself, since they have a lot of side effects if used incorrectly. With a slight increase in cholesterol levels, you can cope with it at home with the help of diet and physical therapy. But if there are serious indications, doctors in most cases recommend taking statins.

If non-drug treatment is ineffective, this group of drugs can not only reduce total cholesterol levels, but also prevent dangerous diseases of the cardiovascular system. Benefits of statins:

What medications are statins?

• reducing the risk of having a heart attack;
• prevention of cerebral hemorrhage;
• relieving signs of vascular atherosclerosis and preventing complications of the disease in the future;
• stabilization of cardiac activity during angina and ischemia;
• relief of diabetes mellitus;
• weight loss in obese patients;
• relieving inflammation of capillary walls;
• blood thinning and thrombosis prevention;
• increase in the diameter of the lumen of capillaries;
• establishing exchange processes.

Statins are prescribed to speed up recovery after a heart attack, cerebral hemorrhage, pulmonary embolism, as well as after surgery (stenting, coronary bypass surgery, angioplasty). Statins, designed to lower blood cholesterol, also have disadvantages, the main one being the development of side effects.

With a decrease in the amount of lipoproteins produced by the body, the production of coenzyme Q10 also decreases. This substance is designed to provide muscles and brain tissue with energy reserves, and if there is a lack of coenzyme, a person begins to suffer from muscle pain, weakness, surges in blood pressure, apathy and fatigue.

With continued use of statins, muscle tissue destruction may begin, scientifically called rhabdomyolysis. Side effects can occur if the pills are used incorrectly by any of the body systems.

Side effects

Numerous negative effects may occur after administration:

• Frequent side effects: asthenia , insomnia , headache , constipation , nausea , abdominal pain, diarrhea , myalgia , flatulence .
• Digestive system: diarrhea, vomiting, hepatitis, pancreatitis , cholestatic jaundice, anorexia .
• Nervous system: dizziness , amnesia, hypoesthesia, malaise, paresthesia, peripheral neuropathy.
• Allergic manifestations: rash and itching of the skin , urticaria , anaphylaxis , exudative erythema, Lyell's syndrome.
• Musculoskeletal system: back pain, myositis , cramps , arthritis , myopathy .
• Hematopoiesis: thrombocytopenia .
• Metabolic processes: hypoglycemia , diabetes mellitus , weight gain, obesity , impotence , peripheral edema.
• The most severe complication of statin treatment is rhabdomyolysis , but this occurs in rare cases.

Who needs to take statins?

Informing what statins are, advertising stories and instructions for the drugs indicate that statins are effective drugs for lowering cholesterol, which significantly improve the overall quality of life, and also reduce the likelihood of developing strokes and myocardial infarction . Accordingly, taking these pills every day is a safe method to lower your cholesterol levels.

But in fact, until today there is no accurate information about whether treating patients with such medications is really so safe and effective. After all, some researchers claim that the potential harm and side effects outweigh the benefits of statins as a prophylactic drug used to prevent cardiovascular diseases. Experts are still arguing whether it is worth taking statins, weighing the pros and cons. Doctors' forums almost always contain debates on the topic “Statins - pros and cons.”

But, nevertheless, there are certain groups of patients for whom statins are required.

The latest generation statins must be used:

• for the purpose of secondary prevention after a stroke or heart attack ;
• for reconstructive surgical interventions on large vessels and the heart;
• in case of myocardial infarction or acute coronary syndrome ;
• with ischemic disease with an increased likelihood of stroke or heart attack.

That is, anticholesterol drugs are indicated for coronary patients in order to increase their life expectancy. In this case, to reduce side effects, the doctor must select the appropriate medicine and monitor biochemical parameters. If there is a 3-fold increase in transaminases, statins are discontinued.

The advisability of prescribing medications from this group for such patients is questionable:

• at low risks;
• for diabetes mellitus ;
• in women before menopause.

If statins are prescribed to people with diabetes, they may need additional tablets to lower their blood , since statins raise their blood sugar in such patients. Medicines to lower blood sugar should only be prescribed and their dosage adjusted by a doctor.

Currently in Russia, the treatment standards for most cardiac pathologies include the use of statins. But although medical prescription reduces mortality, this is not a prerequisite for prescribing drugs to all people with coronary artery disease or hypertension. They should not be used by anyone over 45 years of age or by anyone with high cholesterol levels.

It is important to consider the compatibility of these drugs with other drugs.

If necessary, together with anticholesterol drugs, the doctor prescribes other drugs for the treatment of cardiovascular diseases: Diroton , Concor , Propanorm , etc.

Diroton (active ingredient - lisinopril ) is used to treat arterial hypertension.

Concor (active component - bisoprolol hemifumarate ) is used for the treatment of arterial hypertension , heart failure, angina pectoris .

The best pills to lower blood cholesterol.

May 13, 2021
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• Atoris
• Livazo
• Ezetrol
• Roxera
• Ineji

If you have had a blood test that shows that your cholesterol levels are elevated, be sure to consult your doctor. He will give recommendations on nutrition and lifestyle adjustments. If necessary, he will prescribe the most effective cholesterol pills that will reduce the risk of developing dangerous diseases.

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is a blood test for cholesterol, and if it shows a high level of only “bad” or total cholesterol, you should take this seriously and do everything to reduce these levels.

For some people, to reduce cholesterol, it is enough to change their lifestyle (diet and more physical activity), but for others whose levels are too high, they need to add drug treatment. If your doctor has prescribed you medications to lower cholesterol levels, take them according to a clearly indicated schedule and do not skip them, because your health depends on it.

There are different groups of drugs to normalize cholesterol .

Statins.

They are suitable for most patients, and they are the only drugs that directly reduce the risk of heart attack or stroke. If statins do not help you or there are unwanted side effects, your doctor will help you choose cholesterol pills from a different group.

PCSK9 inhibitors.

Drugs in this group for lowering “bad” cholesterol deactivate the protein in the liver. PCSK9 inhibitors are often prescribed in parallel with statins.

Selective cholesterol absorption inhibitors.

This is a relatively new group of drugs that interfere with the absorption of cholesterol in the intestines. SIACs are most effective in reducing the level of “bad” cholesterol, and can also increase “good” cholesterol. Such medications are prescribed for high cholesterol levels, as well as for some hereditary problems with lipid metabolism.

Resins.

This group of cholesterol-lowering drugs is also called bile acid sequestrants or bile acid binders. Resins act in the intestines, helping to remove cholesterol. Our body uses cholesterol to produce bile. If the level of bile in the gastrointestinal tract is insufficient, the liver will stimulate its production, and the more bile produced, the more cholesterol the liver needs. As a result, less of it will circulate in the blood.

Fibrates.

These drugs are very good at lowering triglyceride levels and often normalize the “good” level. At the same time, fibrates have virtually no effect on “bad” cholesterol.

Niacin (nicotinic acid, vitamin PP or B3).

This substance affects the production of fats by working in the liver. When taking drugs from this group, it is necessary to monitor liver function, since niacin is toxic. Side effects include: upset stomach, redness, itching. Patients with diabetes should take the drug with caution, as it may increase blood sugar levels.

Omega-3 ethyl esters.

Cholesterol drugs in this group are made from fish oil (modified and purified). Prescribed against the background of a special diet to reduce cholesterol levels. Serious side effects may occur in patients with allergies to fish or shellfish.

Fish oil with omega-3 polyunsaturated fatty acids (PUFAs).

These supplements are also called omega-3 acids and are prescribed to lower triglyceride levels.

All of the above drugs should be prescribed exclusively by a doctor, because there are contraindications and side effects with large doses of such drugs. Dangerous side effects include hemorrhagic stroke and sugar spikes in diabetics.

In Russia, doctors usually prescribe statins to lower cholesterol levels, so let’s talk about drugs from this group.

List of statin drugs

Which drugs are statins, and what their cholesterol-lowering activity is, can be found in the table below.

Classification of statins

In medicine, certain parameters are taken into account for classification.

Origin:

• Synthetic: Cerivastatin , pitavastatin , Rosuvastatin , Fluvastatin , Atorvastatin ).
• Semi-synthetic: Simvastatin , Pravastatin .
• Natural: Lovastatin .

By generation:

• First generation: lovastatin ( Choletar , Cardiostatin );
• Second generation: simvastatin ( Vasilip , Simvacard , Simvastatin , Simvor , Simvastol , Simgal , Zocor , Owencor , Sincard , etc.), pravastatin ;
• Third generation: atorvastatin ( Atomax , Tulip , Liprimar , Atoris , Torvacard , Liptonorm , Lipitor ), cerivastatin , fluvastatin .
• Fourth generation: pitavastatin , rosuvastatin ( Crestor , Akorta , Mertenil , Roxera , Rosuvastatin , Rozulip , Rosucard , Rozart , Tevastor ).

Livazo

These fourth generation high cholesterol pills are available by prescription. The active substance of Livazo is pitavastatin. This cholesterol medicine is best suited for people with diabetes: it does not increase blood sugar levels or affect glucose metabolism. It is very important to choose the right dose of the drug to prevent unwanted serious reduction in cholesterol.

Livazo

Pierre Fabre, Switzerland

- primary hypercholesterolemia, including heterozygous familial hypercholesterolemia (hyperlipidemia type IIa according to Fredrickson classification) or mixed hypercholesterolemia (hyperlipidemia type IIb according to Fredrickson classification), hypertriglyceridemia (hyperlipidemia type IV according to Fredrickson classification) as an addition to diet, when diet and other non-drug treatments (eg exercise, weight loss) are insufficient.
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How to choose statins?

Despite all the reviews about statins for lowering cholesterol, the patient must decide whether to take such medications, but this should be done only on the basis of the recommendation of a specialist. What is important, first of all, is not the reviews, but the doctor’s prescription.

If a person nevertheless decides to take statins, then the choice factor should not be the price of the drug, but, first of all, the presence of chronic diseases.

Self-treatment if cholesterol is elevated cannot be carried out with any medications. Treatment for high cholesterol and lipid metabolism disorders is prescribed by a cardiologist or therapist. In this case, the specialist must assess the following risks:

• age;
• floor;
• weight;
• presence of bad habits;
• diseases of the cardiovascular system, other diseases (diabetes, etc.).

It is important to take statins in the dose prescribed by your doctor, and it is important to take a biochemical blood test as often as prescribed by a specialist.

If too expensive pills were prescribed, you can ask the doctor to replace them with drugs that are cheaper. However, it is recommended to use original drugs, since domestically produced generics are of lower quality than the original drug and generics offered by imported manufacturers.

Those who, before taking them, are interested in what the real benefits and harms of statins against cholesterol are, need to consider several important factors in order to minimize the harm of these drugs.

If the medicine is prescribed to elderly patients, it must be taken into account that the risk of myopathy doubles if taken together with medications for hypertension , gout , diabetes .

For chronic liver diseases, it is advisable to take Rosuvastatin in low doses; Pravastatin ( Pravaxol ) can also be used. These drugs provide liver protection, but when using them, you should absolutely not drink alcohol or practice antibiotic .

If there is constant muscle pain or there is a risk of muscle damage, it is also advisable to use Pravastatin, since it is not so toxic to the muscles.

People with chronic kidney disease should not take Fluvastin Lescol , nor should they take Atorvastatin calcium ( Lipitor ), as these medications are toxic to the kidneys.

If a patient seeks to lower low-density cholesterol, it is recommended to use different types of statins.

Currently, there is no clear evidence that it is advisable to take a combination of statins plus nicotinic acid. When taking nicotinic acid, people with diabetes may have a decrease in blood sugar, attacks of gout, bleeding from the gastrointestinal tract are also possible, and the likelihood of rhabdomyolysis and myopathies .

Atoris

This cholesterol-lowering drug comes in tablet form and is available by prescription. The active substance is atorvastatin. "Atoris" is a third-generation cholesterol-lowering medicine and, when taken in a course, helps to cope with the problem. Typically, this drug is prescribed for severe forms of hypercholesterolemia, hereditary high cholesterol, etc. Atoris is indicated for diseases of the cardiovascular system, high risks of coronary artery disease and heart attack.

Cholesterol pills are generally well tolerated, although they do have side effects: joint pain, digestive problems, constipation, muscle pain, liver problems and increased blood sugar.

Contraindications include pregnancy, breastfeeding, serious liver and kidney diseases. In parallel with taking Atoris, you should not drink grapefruit juice or eat the fruit itself.

Atoris

JSC "Biolek", Ukraine

hypercholesterolemia: - as an adjunct to diet to reduce elevated total cholesterol, LDL-C, apo-B and TG in plasma in adult patients, adolescents and children aged 10 years or older with primary hypercholesterolemia, including familial hypercholesterolemia (heterozygous) or combined (mixed) hyperlipidemia (type IIa and IIb, respectively, according to the Fredrickson classification), when the response to diet and other non-drug treatment methods is insufficient;
- to reduce elevated total cholesterol, plasma LDL cholesterol in adult patients with homozygous familial hypercholesterolemia as an adjunct to other lipid-lowering treatments (for example, LDL apheresis), or if such treatments are not available. prevention of cardiovascular diseases: - prevention of cardiovascular events in adult patients at high risk of developing primary cardiovascular events, as an addition to the correction of other risk factors; — secondary prevention of cardiovascular complications in patients from 161

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Research on the effects of statins on the body

Previously, cardiologists prescribed statins to people suffering from coronary artery disease , arterial hypertension , and those with low risks of cardiovascular pathologies.

Currently, the attitude towards this type of drugs among some specialists has changed. Although in Russia there have not yet been full-fledged independent studies of the effects of statins on the body.

Meanwhile, Canadian scientists claim that after using statins, the risk of cataracts in patients increased by 57%, and if the person had diabetes , by 82%. Such alarming data were confirmed by statistical analysis.

Experts analyzed the results of fourteen clinical studies that were conducted to study the effect of statins on the body. Their conclusion was that this type of medication reduces the likelihood of strokes and heart attacks, but given the serious side effects, they are not prescribed to people who have not previously suffered strokes or heart disease. According to researchers, people who regularly take such medications develop the following side effects:

• renal failure;
• cataract;
• liver dysfunction;
• depression , mood swings;
• myopathy;
• memory losses.

But in general, there are different points of view on whether these drugs are harmful or relatively safe.

• Scientists from Germany have proven that with low cholesterol levels, the likelihood of developing cancer , liver disease and a number of other serious ailments, as well as early mortality and suicide, increases, thereby confirming that low cholesterol levels are more dangerous than high ones.
• Researchers from the USA claim that heart attacks and strokes do not develop due to high cholesterol, but due to low levels of magnesium in the body.
• Statins can inhibit the important function of cholesterol in repairing disorders in body tissues. In order for the body to grow muscle mass, and for its normal functioning in general, low-density fat cells, that is, “bad” cholesterol, are needed. If its deficiency is noted, myalgia and muscular dystrophy .
• When taking such drugs, cholesterol production is suppressed, and accordingly, the production of mevalonate , which is not only a source of cholesterol, but also a number of other substances. They perform important functions in the body, so their deficiency can provoke the development of diseases.
• This group of medications increases the likelihood of developing diabetes mellitus , and this disease leads to increased cholesterol levels. Various sources claim that if you take statins for a long time, the risk of diabetes ranges from 10 to 70%. Under the influence of these drugs, the concentration of the GLUT4 protein in the cell, which is responsible for blood glucose levels, decreases. British researchers have proven that taking such medications increases the risk of diabetes in women by 70% after a menstrual break.
• Negative side effects develop slowly; accordingly, the patient may not immediately notice this, which is dangerous with prolonged use.
• When using statins, there is an effect on the liver. Those who are obese or lead a sedentary lifestyle note an improvement in their vascular condition for a period of time. But over time, complex processes in the body are disrupted, which can lead to a deterioration in mental processes, especially in older people.

When a person under 50 years of age has elevated cholesterol levels, this indicates that serious disorders are developing in the body that need to be treated. In some countries, programs are being implemented at the national level to promote lowering cholesterol levels by promoting an active lifestyle, changing dietary principles, quitting nicotine addiction, and using statins.

As a result, this method “worked” in many countries: mortality from cardiovascular diseases decreased significantly. However, there is an opinion that quitting smoking, physical activity and changing the menu are a better way to prolong life than using medications that have contraindications and side effects.

Statins for older patients

Among the arguments in favor of the fact that older people should take statins only after carefully weighing the harm and benefits, we can recall a study that involved more than 3 thousand people aged 60 years and older who took statin medications. Approximately 30% noted muscle pain, as well as decreased energy, high fatigue, and weakness.

Muscle pain is most severe in those who have just started taking such medications. As a result, this condition reduces the intensity of physical activity - it is difficult for people to exercise and walk, which ultimately leads to an increased risk of strokes and heart attacks. In addition, a person who moves little begins to gradually increase body weight, which is also a risk of cardiovascular disease.

Nicotinic acid derivatives

Niacin, or nicotinic acid for atherosclerosis, is one of the most “deserved” drugs that has been used to treat hyperlipidemia since 1955 [6]. It acts only after being converted into nicotinamide in the body and subsequent binding to the coenzymes codehydrase I and codehydrose II, which transfer hydrogen.

The distinctive effects of nicotinic acid compared to other lipid-lowering drugs are the ability to significantly increase HDL levels, as well as a vasodilating effect.

The lipid-lowering effect of niacin requires higher doses than necessary for the vitamin effect to occur. On average, the dose of nicotinic acid as a lipid-lowering agent is 100 times higher than as a vitamin [1].

The mechanism of action is based on inhibition of triglyceride lipolysis in adipose tissue. Niacin reduces the synthesis of VLDL, reduces the level of total cholesterol, LDL, triglycerides and increases the content of HDL by 15-30%. The drug also has antiatherogenic properties [5].

Along with the hypolipidemic effect, nicotinic acid dilates small vessels (including cerebral vessels), improves microcirculation, and has a weak anticoagulant effect.

Triglyceride levels begin to fall within 1–4 days after starting to take nicotinic acid, while cholesterol levels drop on days 5–7 of using the drug.

Side effects

Along with quite powerful lipid-lowering properties, niacin is poorly tolerated. Up to 40% of patients refuse to take it due to side effects [6]. One of the side effects associated with low compliance is a feeling of heat and flushing due to the release of prostaglandins. This effect can be reduced by gradually titrating the dose and administering acetylsalicylic acid at a dose of 250 mg half an hour before taking nicotinic acid.

With the use of high doses of nicotinic acid (usually 2–6 g per day), skin itching and dyspepsia—vomiting and diarrhea—may occur. There is a risk of peptic ulcers, liver dysfunction, and increased levels of glucose and uric acid in the blood. Due to the possible development of hyperuricemia, nicotinic acid is contraindicated in gout. It is also not recommended for use in diabetes mellitus and metabolic syndrome [1, 3].

Due to the poor tolerance of nicotinic acid, its derivatives were synthesized with a higher safety profile. Xanthinol nicotinate has become one of the most prescribed.

What should I warn the client about?

Niacin, due to its vasodilating effect, can potentiate the effect of antihypertensive drugs and lead to a sudden decrease in blood pressure, so it should be used cautiously during antihypertensive therapy, after consultation with a doctor [7].

Nicotinic acid is recommended to be taken with meals.

Fibrates: what is it?

Fibrates are also used to lower cholesterol. These drugs are fibric acid . They bind to bile acid, thereby reducing the active production of cholesterol by the liver.

Fenofibrates medicinally lower lipid , which in turn leads to lower cholesterol. According to clinical studies, the use of fenofibrates lowers cholesterol by 25%, triglycerides by 40-50%, and also increases the level of so-called “good” cholesterol by 10-30%.

Instructions for the use of fenofibrates and ciprofibrates indicate that with high cholesterol levels, these drugs reduce the amount of extravascular deposits, and also reduce cholesterol and triglyceride levels in patients with hypercholesterolemia .

List of fenofibrate drugs:

• Thaicolor;
• Lipantil;
• Exlip 200;
• Ciprofibrate Lipanor;
• Gemfibrozil.

But, before you buy and take such medications, you should keep in mind that taking them leads to certain side effects. As a rule, various digestive disorders most often occur: flatulence , dyspepsia , diarrhea , vomiting .

The following side effects have been reported after taking fenofibrates:

• Digestive system: pancreatitis , hepatitis, vomiting, abdominal pain, nausea, diarrhea, flatulence, the appearance of gallstones.
• Musculoskeletal system: muscle weakness, rhabdomyolysis, diffuse myalgia, myositis, spasms.
• Nervous system: headache, sexual dysfunction.
• Heart and blood vessels: pulmonary embolism, venous thromboembolism.
• Allergic manifestations: skin itching and rash, photosensitivity, urticaria .

Combining statins with fibrates is practiced to reduce the dosage and, accordingly, the negative effects of statins.

The beginning of the beginning: classification of lipid-lowering drugs

First of all, let’s remember what lipid-lowering drugs are currently available in pharmacies.

Table 1: Lipid-lowering drugs

Lipid-lowering drugs normalize the lipid profile through various mechanisms. Among them [1, 2]:

• the most common mechanism of action: activation of lipoprotein uptake due to stimulation of LDL receptors located in the liver;
• blocking the synthesis of lipids and lipoproteins in the liver;
• inhibition of the absorption of cholesterol and bile acids from the intestine;
• activation of cholesterol catabolism, including its conversion into bile acids;
• stimulation of the activity of the enzyme that breaks down lipids - lipoprotein lipase of the vascular endothelium;
• blocking the synthesis of fatty acids in the liver and their release from adipose tissue (inhibition of lipolysis);
• an increase in the level of antiatherogenic HDL in the blood.

Let's take a closer look at how representatives of various subgroups of lipid-lowering drugs work and what features they have.

All other medications

Your doctor may recommend taking dietary supplements (dietary supplements).

However, natural remedies such as Omega 3 , Tykveol , flaxseed oil , and lipoic acid lower cholesterol levels slightly.

It should be borne in mind that dietary supplements are not drugs, therefore such drugs are inferior to statin drugs in terms of preventing cardiovascular diseases.

List of dietary supplements that are used for this purpose and contain natural components:

• Omega Forte;
• Doppelhertz Omega;
• Tykveol;
• Lipoic acid;
• SitoPren.

Omega 3

Tablets containing fish oil ( Omega 3 , Oceanol , Omacor ) are recommended for people who want to lower cholesterol. Fish oil protects the body from the development of vascular and heart diseases, as well as from depression and arthritis. But you need to drink fish oil very carefully, since taking it increases the risk of chronic pancreatitis .

Tykveol

Pumpkin seed oil is indicated for use by those who suffer from cholecystitis , cerebral atherosclerosis hepatitis . The product provides choleretic, anti-inflammatory, antioxidant, hepatoprotective effects.

Lipoic acid

This remedy is an endogenous antioxidant , it is used for the prevention and treatment of coronary atherosclerosis. There is a positive effect of the drug on carbohydrate metabolism. When taken, the trophism of neurons improves, and glycogen levels in the liver increase.

Vitamins

Vitamins help normalize cholesterol levels, increase hemoglobin , etc. The body needs vitamin B12 and folic acid , nicotinic acid . At the same time, it is very important that these are natural vitamins, that is, it is important to eat those foods that contain these vitamins.

SitoPren

Dietary supplement – ​​fir foot extract, it contains beta-sitosterol, polyprenols. Should be taken for hypertension , atherosclerosis , high levels of triglycerides and cholesterol.

Policosanol

Dietary supplement – ​​plant wax extract. Helps reduce low-density cholesterol levels and helps prevent atherosclerosis.

Other means

Bile acid sequestrants ( Kolesevelam , etc.) are medications that are used in complex treatment as an auxiliary component for lowering cholesterol. They suppress its synthesis in plasma.

Ciprofibrate Lipanor - suppresses cholesterol synthesis in the liver, lowers its level in the blood, reducing the level of atherogenic lipoproteins.

Ineji

These high cholesterol pills are also available with a prescription only. Ineji belongs to a new group of drugs - statins with cholesterol absorption inhibitors. The active ingredients of Ineji are simvastatin and ezetimibe. The medicine does an excellent job of reducing “bad” cholesterol.

Ineji is prescribed for the prevention of cardiovascular diseases, for coronary heart disease, after a stroke or heart attack (to prevent recurrent ones), for severely elevated lipids and hereditary problems with cholesterol.

Contraindications: allergic reactions, liver diseases, pregnancy, breastfeeding, age under 18 years, lactase deficiency. Side effects: depression, dizziness, joint pain, nausea, memory problems.

Ineji