Statins (HMG-CoA Reductase Inhibitors)
Statins are the first choice of medicine for people with heart disease. This is because most statins (lovastatin, pravastatin, simvastatin & atorvastatin) have been shown to reduce the possibility of heart attack or death in these high risk people.

Statins reduce LDL (bad lipid) 20-60% - depending on medicine and dose.
Statins will have a mild to moderate benefit on HDL (good lipid) and Triglycerides.
All statins lower C-Reactive Protein (C-RP).

Advicor® (extended-release nacin & lovastatin)
Altocor® (extended-release lovastatin)
Crestor® (rosuvastatin) 
Lescol® (fluvastatin)
Lipitor® (atorvastatin calcium)
Caduet® (amlodipine besylate & atorvastatin calcium [Norvasc® & Lipitor®])
Mevacor® (lovastatin)
Lovastatin is available as a generic
Pravachol® (pravastatin)
Pravigard® (pravastatin & buffered aspirin)
Zocor® (simvastatin)
Vytorin® (ezetimibe & simvastatin [Zetia® & Zocor®]) 

Livalo® (pitavastatin) - not available in the U.S.

Click here for Clinical Trials of Statin Medicines
Click here for updated information on the safety of statins - Aug. 2002

Lovastatin, Pravastatin and Simvastatin are naturally derived HMG-CoA reductase inhibitors.
Atorvastatin, Fluvastatin, Pitavastatin and Rosuvastatin are synthetic HMG-CoA reductase inhibitors.


Bile Acid Sequestrants
Bile Acid Sequestrants lower LDL (bad lipid) up to 20% - at maximum doses.
Bile Acid Sequestrant can increase Tryglycerides.
Recommended for children and adolescents.
Can be combined with statins, in adults, for better results.

Colestid® (colestipol)
Colestipol is available as a generic
Prevalite® (cholestyramine)
Questran® (cholestyramine)
Cholestyramine is available as a generic
WelChol® (colesevelam HCl)


Fibric Acid Derivatives
Fibric Acid Derivatives lower Triglycerides 30-60% and increase HDL (good lipid) 15-25%.
In people with moderatly high Triglycerides (200-400), Fibric Acid Derivatives can lower LDL (bad lipid) 15-25%.
In patients with higher Triglycerides (above 400), Fibric Acid Derivatives can increase LDL.
Can be combined with statins for better results.

Lopid® (gemfibrozil)
Gemfibrozil is available as a generic
Tricor® (fenofibrate)
Lofibra® (fenofibrate)


Niacin (Nicotinic Acid)
Niacin increased HDL (good lipid) 30-35%, lowers Triglycerides 25-40% and lowers LDL (bad lipid) 15-25%.
Niacin also lowers Lp(a).
Can be combined with statins for better results.

Niacor® (niacin)
Niaspan® (extended-release nacin)
Slo-Niacin® (controlled-release niacin) sold over the-counter
Endur-acin® (SR Niacin) (controlled-release niacin) sold over-the-counter

These brands of niacin have been clinically tested to be safe and effective.


Intestinal Absorption Inhibitors
Studies have shown LDL reductions of 15-25%.Can be combined with statins for better results.

Zetia® (ezetimibe) - in the U.S.
Ezetrol® (ezetimibe) - in Europe, Middle East & Africa


Plant Sterol Esters (dietary supplement)
The proven ability of plant sterol and stanol esters to lower cholesterol is supported by more than 20 scientific studies, both in the United States and in Europe. Plant sterol and stanol esters work by blocking the absorption of cholesterol from the diet.

Plant sterols have been shown to reduce cholesterol levels twice as much when used as part of a low saturated-fat diet. Plant sterols also increase the cholesterol lowering effects of statin medicines.

Plant sterols can be found in the margarine Benecol which contains no saturated fats or trans-fatty acids (found in hydrogenated oils).

Plant sterols are now showing up in diet supplement pills. The safety and effectiveness of most have not been established or tested. Look for independent research, don't just take their word. Buyer beware!


Fish Oil (EPA & DHA) (dietary supplement)
Fish oil supplements (EPA & DHA) can significantly lower triglyceride levels. I suggest a well-known and trusted brand and one that says "MAX EPA".

There are a few issues that should be checked by your doctor before you start such supplements. Fish oil supplements can cause bleeding complications so your doctor should evaluate any possible bleeding disorders. Fish oil supplements can also cause stomach upset and even a fishy smell of your body.

The typical dose is 2-6g 2-3 times a day, starting at a lower dose and increasing the dose as tolerated over a few weeks time. It is best to take with or just after food.

Fish oil supplements should be viewed as a drug therapy. I suggest you talk with your doctor before starting fish oil supplements.

Omacor® is a prescription medication that consists of a high concentration of highly purified omega-3 fatty acid ethyl esters.  Each 1 gram Omacor capsule contains 90 %omega-3-acid ethyl esters. These are predominantly ethyl esters of eicosapentaenoic acid (EPA) 460 mg and docosahexaenoic acid (DHA) 380 mg.  Omacor reduces triglycerides by up to 45%.