Lipid Lowering Drugs

Lipid lowering drugs are a group of drugs that are used to treat, or provide protection against, hyperlipidaemia (abnormally high levels of the fatty substances cholesterol and triglycerides in the blood). These drugs help to prevent, or slow the progression of, severe atherosclerosis (narrowing of the arteries due to deposits of fatty material) and coronary artery disease.

How they work

Most groups of lipid-lowering drugs act on the liver to inhibit the processes by which fatty acids are converted into lipids. Statins cause the liver to produce less cholesterol, while fibrates and nicotinic acid reduce the formation of both cholesterol and triglycerides. Omega-3 marine triglycerides reduce the levels of triglycerides. Drugs that bind to bile salts reduce the absorption of these salts (which contain high levels of cholesterol) from the small intestine into the bloodstream. The lowered blood levels of bile salts stimulate the liver into converting more cholesterol into bile salts.

Possible adverse effects 

Drugs that bind to bile salts may cause constipation, and sometimes nausea and diarrhoea, as a result of the increased amount of bile in the digestive tract. They may also reduce the absorption of fat-soluble vitamins. Fibrates may cause an increased susceptibility to gallstones, while statins need to be used with care in people who have a history of liver disease. Rarely, combinations of drugs that act on the liver may cause a painful muscle condition called rhabdomyolysis.

Common drugs

Fibrates

  • Bezafibrate
  • Ciprofibrate
  • Fenofibrate
  • Gemfibrozil

Statins

  • Atorvastatin
  • Fluvastatin
  • Pravastatin
  • Simvastatin

Nicotinic acid and derivatives

  • Acipimox
  • Nicotinic acid

Drugs that bind to bile salts

  • Colestipol
  • Colestyramine

Other drugs acting on the liver

  • Omega-3 marine triglycerides

Other drugs

  • Ispaghula

tags: