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Other cholesterol-lowering medications


What are these medications?

The most commonly prescribed cholesterol lowering medications are statins.

Sometimes, other medications are used to lower your cholesterol. These may include:

Cholesterol absorption inhibitors

  • Ezetimibe (Ezetrol®)

Fibrates

  • Bezafibrate (Bezalip®)
  • Fenofibrate (Lipidil®)
  • Gemfibrozil (Lopid®)

Niacin

Resins (bile acid sequestrates)

  • Cholestyramine (Questran®)
  • Colestipol (Colestid®)

Be aware:

  • Generic names are listed first.
  • Canadian brand names are in brackets.
  • This list doesn’t include every brand name.
  • If your prescription isn’t listed, your pharmacist is the best source for more information.
Cholesterol absorption inhibitors

Ezetimibe (Ezetrol®)

  • Helps lower the overall cholesterol in your blood.
  • Only prescribed when your cholesterol can’t be controlled with diet and physical activity.

What does it do?

  • Helps prevent your body from absorbing and storing cholesterol in your liver.
  • Improves the way cholesterol is cleared from your blood.

How do I take it?

Take your medication exactly as prescribed.

  • May be prescribed with a statin, the generic name for cholesterol-lowering drugs.

Be Aware: If you miss a dose of this medicine, take it as soon as you remember. Do not take more than one dose per day.

Are there any interactions?

Cholesterol absorption inhibitors are less effective in people who are overweight.

Your healthcare provider may suggest you:

  • Maintain a healthy weight.
  • Follow a lower-fat, low-cholesterol diet.
  • Get regular physical activity.

Talk to your healthcare provider before beginning any weight-loss plan.

Always tell your doctor or pharmacist about any other medications you are taking. These include:

  • Prescriptions
  • Non-prescription drugs
  • Inhalers
  • Creams or ointments
  • Over-the-counter or natural health products
  • Alternative therapies
  • Vitamins, minerals or supplements
  • Herbal remedies
  • Homeopathic medicines
  • Traditional remedies, such as Chinese medicines
  • Probiotics
  • Amino acids or essential fatty acids

Are there any side effects?

You may experience some side effects including:

  • Headache
  • Diarrhea
  • Dizziness
  • Sore throat
  • Runny nose
  • Sneezing
  • Joint or muscle pain

If you have side effects, talk to your pharmacist or healthcare provider.

Fibrates (Fibric Acid Derivatives)

Bezafibrate (Bezalip®)
Fenofibrate (Lipidil®)
Gemfibrozil (Lopid®)

What does it do?

  • Lowers your triglycerides (a type of fat found in the blood).
  • Reduces your “bad” cholesterol.
  • Increases your “good” cholesterol.

How do I take it?

Take your Fibrates exactly as prescribed.

  • Some Fibrates need to be taken with meals, usually your main meal. Your pharmacist can tell you how best to take your medication.

Are there any interactions?

Tell your healthcare provider if you:

  • Have kidney, liver or gallbladder problems.
  • Are taking blood thinners (warfarin).
  • Experience unexplained muscle pain, tenderness or weakness.

Always tell your doctor or pharmacist about any other medications you are taking. These include:

  • Prescriptions
  • Non-prescription drugs
  • Inhalers
  • Creams or ointments
  • Over-the-counter or natural health products
  • Alternative therapies
  • Vitamins, minerals or supplements
  • Herbal remedies
  • Homeopathic medicines
  • Traditional remedies, such as Chinese medicines
  • Probiotics
  • Amino acids or essential fatty acids

Are there any side effects?

Some common side effects include:

  • Skin rashes
  • Upset stomach or stomach pain
  • Vomiting
  • Gas
  • Headache or dizziness
  • Muscle pain

If you have side effects, talk to your pharmacist or healthcare provider.

Niacin

Nicotinic acid
Niacin is one of the B vitamins. It is also known as nicotinic acid.

What does it do?

  • Slows the liver’s production of bad cholesterol.
  • Raises the good cholesterol.

How do I take it?

Take your medication exactly as prescribed.

  • Niacin should be taken with food.

ONLY take Niacin to lower your cholesterol as prescribed by your healthcare provider.

Are there any interactions?

Tell your healthcare provider if you have:

  • Gout, liver or gallbladder problems
  • Diabetes.
    • Niacin can affect your blood sugar. It may need to be monitored.

Always tell your doctor or pharmacist about any other medications you are taking. These include:

  • Prescriptions
  • Non-prescription drugs
  • Inhalers
  • Creams or ointments
  • Over-the-counter or natural health products
  • Alternative therapies
  • Vitamins, minerals or supplements
  • Herbal remedies
  • Homeopathic medicines
  • Traditional remedies, such as Chinese medicines
  • Probiotics
  • Amino acids or essential fatty acids

Are there any side effects?

Some common side effects include:

  • Flushing (redness, burning or itching sensation)
  • Dry skin or rash
  • Upset stomach
  • Diarrhea
  • Headaches

Be Aware: Most of these side effects last two to six weeks.

  • You will probably start with a low dose and gradually increase it.
  • If you stop taking niacin, then go back, start over at the low dose.
  • Some people take a regular-strength ASPIRIN® (ASA, 325 mg) 30 to 60 minutes before the niacin to reduce flushing. This is not suitable for everyone. Talk with your healthcare provider first.

If you have side effects, talk to your pharmacist or healthcare provider.

Resins (Bile acid sequestrants)
  • Cholestyramine (Questran®)
  • Colestipol (Colestid®)

What does it do?

Resins lower your cholesterol. Here’s how:

  • Your body needs cholesterol to make bile.
  • Resins help you “trick” your body into using its cholesterol to produce more bile.
  • Resins bind to bile so your body can’t absorb it. Instead, it passes in your stool (poop).
  • This forces your body to make more bile. And to use more cholesterol.
  • The result is less bad cholesterol circulating in your blood.

How do I take it?

Usually taken once or twice a day with meals.

  • Cholestyramine: a coarse powder.
  • Colestipol: powder or tablet.

Never take the powder dry. Either:

  • Mix with water, milk, a flavoured drink, juice, soda.
  • Or, with cereal, thin soups, yogurt, pudding, cottage cheese or fruit cocktail.

Are there any interactions?

Resins can bind to other medications. This can make the other drugs less effective.

  • Take your other medications either one hour before, or four hours after your resin.

Always tell your doctor or pharmacist about any other medications you are taking. These include:

  • Prescriptions
  • Non-prescription drugs
  • Inhalers
  • Creams or ointments
  • Over-the-counter or natural health products
  • Alternative therapies
  • Vitamins, minerals or supplements
  • Herbal remedies
  • Homeopathic medicines
  • Traditional remedies, such as Chinese medicines
  • Probiotics
  • Amino acids or essential fatty acids

Are there any side effects?

Some common side effects include:

  • Constipation
  • Diarrhea
  • Abdominal pain or cramping
  • Bloating
  • Gas
  • Heartburn
  • Nausea or vomiting

If you have side effects, talk to your pharmacist or healthcare provider.

Lifestyle changes that can also help

There are two ways to control and manage your heart health: medication and lifestyle.

Medication can help you control heart disease and high blood pressure, but it cannot cure it.

A healthy lifestyle can help you keep medication to a minimum.

Visit heartandstroke.ca/get-healthy. Learn how to keep your heart healthy with current information and advice from Heart and Stroke Foundation experts.

Talk to your healthcare provider about the most beneficial lifestyle goals for you.

Related information

Your healthcare provider or pharmacist are your best sources of information. You can also learn more about medications at any of these trusted sites.

Health Canada - Drugs and Health Products
Provides health and medical information for Canadians to maintain and improve their health.

Learn more about:

Your ministry of health also offers health resources in your province or territory. For example, Ontario’s MedsCheck program provides free pharmacist consultations. And British Columbia’s Senior Healthcare web page provides information about important health programs.

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