LDL is commonly known as “bad” cholesterol. It aids
clogging of blood vessels and it contributes significantly to risk of having
coronary heart disease (CHD), such as heart attacks. High-density
lipoprotein (HDL) (“good” cholesterol) yields the opposite effect.
Triglyceride is an oily substance which also clogs blood vessel.
Allow your doctor to first assess whether you have any
risk for CHD, such as diabetes, smoking, and hypertension. Based on your
risk status, your doctor will advise you on your target LDL and may ask you
to have a 3 month trial of non-medicinal measures (i.e. healthy eating,
regular exercise and smoking cessation).
If you fail to reach the predetermined target, discuss
with your doctor on whether you should take cholesterol-lowering medication
while continue using non-medicinal measures.
Below are descriptions of cholesterol-lowering
medications, to facilitate discussion with your doctor.
Statins (examples include simvastatin, atorvastatin,
lovastatin and pravastatin)
Statins block the production of cholesterol and are
particularly effective in reducing LDL. Some side effects include
constipation, indigestion and flatulence. Liver
damage and muscle degeneration are rare.
Fibrates (examples include gemfibrozil and fenofibrate)
Fibrates are usually used if the need to lower
triglyceride and raise HDL is more pressing. A common side effect is
gastrointestinal discomfort. Abnormal liver function test result may occur
in some patients.
Cholesterol Absorption Inhibitor (Ezetimibe)
Ezetimibe helps in reducing LDL by preventing the
absorption of cholesterol and is commonly used together with statins to
enhance LDL lowering. A common side effect is headache
Cholesterol-binding resin (cholestyramine and
colestipol) and Nicotinic Acid
While infrequently used due to annoying side effects,
they may be warranted under special circumstances.
Source: Khoo Suat Kee, Pharmacist,
Pharmaceutical Society of Singapore
More information and advice can be
obtained from your pharmacist. Send your questions to sthealth@sph.com.sg.
