If your doctor has decided that you need to take medicine to reduce high cholesterol, it’s because you’re at high risk for heart disease or stroke. Usually the treatment combines diet and medicine.

Most heart disease and many strokes are caused by a buildup of fat, cholesterol and other substances called plaque in the inner walls of your arteries. The arteries can become clogged and narrow, and blood flow is reduced. If a blood clot forms and blocks blood flow to your heart, it causes a heart attack. If a blood clot blocks an artery leading to or in the brain, a stroke results.

By following your doctor’s advice, you can help prevent these diseases.

What should I know about the medicine?

Your doctor will decide which medicine is best for you. Often you’ll be asked to take more than one. Always follow your doctor’s orders carefully, and let the doctor know if you have any side effects. Never stop taking your medicine on your own!

Bile acid binders (resins) help rid the body of cholesterol. Some names are cholestyramine, cholestipol and colesevelam.

  • These often come in a powder that you mix with water or juice. They are not absorbed from the gastrointestinal tract where they bind cholesterol.
  • Side effects may include constipation, bloating, nausea and gas. To reduce these effects, eat more fiber and drink more fluids.

Nicotinic acid or niacin is a B vitamin. Take this only if your doctor has prescribed it.

  • It can lower total cholesterol, LDL “bad” cholesterol and triglyceride (blood fat) levels. It can also raise HDL “good” cholesterol levels.
  • It may cause flushing and itching. It could also upset your stomach and cause other side effects your doctor can describe.

HMG-CoA reductase inhibitors (statins) stimulate the body to process and remove cholesterol. Their major effect is to lower LDL cholesterol. Some names are lovastatin, pravastatin simvastatin, fluvastatin and atorvastatin.

  • Possible side effects include constipation, stomach pain or cramps and gas.
  • A few patients experience muscle pain, weakness or brown urine.

Fibric acids are especially good for lowering triglyceride (blood fat) levels and, to a lesser extent, raising HDL cholesterol levels. Some names are gemfibrozil, clofibrate and fenofibrate.

  • A few patients have stomach problems when they take this.
  • Fibric acids can increase the effect of medications that thin the blood. This should be monitored closely.

How do I remember to take my medicine?

Sometimes it’s hard to keep track of your medicines. To be safe, you must take it properly.

  • Take your medicine at the same time each day along with meals or other daily events, like brushing your teeth.
  • Use a weekly pill box with separate compartments for each day or time of day.
  • Ask family and friends to help remind you.
  • Use a pill calendar or drug reminder chart.
  • Wear a wristwatch with an alarm.

How do I know if it’s working?

Your doctor will test your blood cholesterol level when needed. Together with your doctor, set a goal and ask how long it may take to reach that goal.

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