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    Types of cholesterol  
    Cholesterol and heart disease  
    Reducing cholesterol level  
    Treatment for high
    cholesterol
 
    Statins  
    Other drugs
         Other drugs

Other cholesterol-lowering drugs
There are other types of drugs which can be used to lower blood cholesterol levels. These are:
fibrates
drugs which bind bile acids
nicotinic acid drugs, and
ezetimibe.
These drugs all act by preventing the intestine from absorbing cholesterol.

Fibrates
Examples of fibrates include bezafibrate, ciprofibrate, fenofibrate and gemfibrozil. Fibrates are useful for people who have a high level of both blood cholesterol and triglycerides. You will not usually be given fibrates if you are also taking statins, except under strict medical supervision. You should not use fibrates during pregnancy, or if you have liver or kidney disease.

Drugs which bind bile acids
These drugs (which are also called ‘bile acid binding drugs’) include cholestyramine and colestipol. They work by binding bile acids which the liver makes from the cholesterol in the blood, and preventing the bile acids from getting reabsorbed into the bloodstream.

They come in powder form, in sachets. You have to soak some types in fruit juice before you take them. Others are already mixed with fruit flavouring and you just need to add water. You should take these drugs immediately before or during a meal. They may make you feel fuller than usual at first, but most people gradually get used to this.

These drugs are not absorbed into the body, so they can also be used safely by children and pregnant women.
Possible side effects
Some people who take these drugs may get heartburn or constipation, but this is more likely with larger doses.

 Nicotinic acid drugs
Nicotinic acid and acipimox are drugs that help to lower LDL levels and increase the level of ‘good’ HDL cholesterol.

Ezetimibe
Ezetimibe is another type of cholesterol-lowering drug. It can be used along with a statin, or people who cannot take statins can take ezetimibe on its own. Ezetimibe helps to lower blood cholesterol levels by preventing the small intestine from absorbing cholesterol.

Ezetimibe can help reduce LDL cholesterol by about 18%, and if it is combined with low-dose statins it can be even more effective. 
Possible side effects
Unwanted effects of ezetimibe include headaches, pain in the abdomen and diarrhoea.

Drugs which reduce triglyeride levels (fish oils)
If you regularly eat oily fish, control your weight, and limit how much alcohol you have and yet you still have a high triglyceride level, your doctor may prescribe fish oils for you.

If you are taking fish oils which you have bought over the counter, tell your doctor about them so that he or she can make sure that they don’t interfere with any other drugs you are taking such as warfarin.

 
      Doctor Tips
Angina is an uncomfortable feeling or pain in the chest.
   
It usually feels like a heaviness or tightness.
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