Review of drugs that lower blood cholesterol: not just statins

When choosing cholesterol pills, the most important thing is to get an adequate result from the treatment.
Elevated levels of lipids in the blood are dangerous to health because they cause serious complications: stroke, heart attack, heart failure. Atherosclerosis must be treated.

In this article you will find a description of the most effective drugs for high cholesterol in tablet form and recommendations for their use.

History of development

Medicine has been looking for cholesterol-lowering drugs for quite a long time (since 1962). Even then it was known that it was he who was the culprit not only of atherosclerosis, but also of ischemic heart disease and heart attack. A large number of laboratory studies, many years of work, huge sums of money - for decades all this did not bring any results. There were two problems. Firstly, they were afraid that such drugs would have a lot of side effects, since lipoproteins are building materials for cell membranes and active participants in the production of bile acids and steroid hormones. If you suppress their synthesis, all these processes will be disrupted. Secondly, experiments on rats did not produce any results, no matter what developments were tested on them.

Despite these difficulties, Japanese scientist Endo Akira continued to search for a cure that would save humanity from cholesterol plaques, atherosclerosis and other cardiovascular diseases. His research lasted from 1971 to 1976. 6,000 studies and 5 years - that’s how long it took his team to invent the first statin.

The talented doctor quickly dealt with the second stumbling block: it turned out that cholesterol is common and harmful. The drugs suppressed the synthesis of the second, but the animal’s body compensated for its lack by increasing the first, and it was this that was monitored during laboratory work. When this was clarified, it turned out that the drug actually works and is quite effective.

The first statin drug was Compactin, which had to withstand a lot of attacks. Despite its effectiveness, it was recognized as carcinogenic and production was closed. However, the era of statins had already been opened, and humanity could not refuse them. Since the 80s of the 20th century, they have brought good income to pharmaceutical companies.

However, the very first problem that arose at the beginning of the development of drugs for cholesterol remains relevant to this day. Statins do indeed have a lot of side effects. Therefore, in the last decade, active development of other lipid-lowering drugs has been underway.

Using statins to lower cholesterol

Before considering each cholesterol medicine, we suggest considering the pharmacological group of statins.

The instructions for drugs in this group indicate the following pharmacodynamic properties:

• Reducing cholesterol in the blood plasma due to inhibition of reductase and suppression of cholesterol synthesis in the liver.
• Over the course of treatment, the drugs lower fatty acid levels in people with homozygous hypercholesterolemia (an inherited disorder), a condition that is not treatable with other categories of lipid-lowering drugs.
• During use, the level of total cholesterol decreases by 25-45%, harmful - up to 60%.
• The concentration of alipoprotein A increases due to the synthesis of beneficial fatty acids.
• There is no carcinogenic or mutagenic effect.

Despite a number of positive effects, statins have many side effects, the most common of which are headache, digestive disorders, myalgia, possible allergic reactions, dizziness, hypoesthesia, neuropathy and other disorders in the nervous system.

Criticism of the use of statins

Given the relatively high cost of treatment and the long course, there has been repeated criticism of statins as cholesterol medications.

general information

If during examinations and blood tests an elevated cholesterol level is detected, the doctor prescribes cholesterol-lowering drugs. And most often these are statins. Other lipid-lowering drugs that have slightly different pharmacological effects, developed in recent years, have fewer side effects. But their performance does not stand up to criticism. After a course of treatment, only a slight improvement in the condition of patients is observed. Therefore, doctors who want to see dynamics and progress remain faithful to tri-hydroxy-tri-methylglutaryl-CoA reductase inhibitors (the scientific name of statins).

When prescribing cholesterol-lowering drugs to their patients, doctors are required to warn them in advance about the following points:

• in order to reduce bad cholesterol, you sometimes have to take statins on an ongoing basis, that is, throughout your life;
• no deviations are allowed in terms of instructions for their use;
• There are not just a lot of side effects - among them there are those that significantly affect well-being and reduce the quality of life.

Therefore, despite the doctor’s prescription, after reading the list of side effects, only the patient decides whether to take statins. A few years ago there was no choice, since they were the only drugs with a lipid-lowering effect. But the modern level of medicine offers alternatives: fibrates, combined lipid modifiers, sequestrants, lipid metabolism correctors, etc. All of these are drugs that lower cholesterol and cleanse blood vessels of atherosclerotic plaques and harmful lipids. However, in terms of their effectiveness, they are significantly inferior to statins, which to this day, despite numerous criticisms, remain leaders in the fight against low-density lipoproteins (LDL).

Medicines to lower blood cholesterol

Drugs to lower blood cholesterol are prescribed by a doctor and taken under the supervision of tests; Ezetrol and bile acid sequestrants are less dangerous, but they are not completely free of side effects. To normalize metabolism and get rid of elevated levels, you need diet, physical activity, and giving up bad habits.

Women are not prescribed statins for “bad” cholesterol, but for older people they are the mainstay of therapy. New generation tablets, atorvastatin and nicotinic acid from a domestic manufacturer can be bought for 300 rubles, 100 hryvnia per month. To remove cholesterol, herbal preparations and dietary supplements, including Energy, are used.

Watch the video about ways to lower cholesterol:

How to lower blood cholesterol with medications

To reduce blood cholesterol with medications, you should consider the following treatment rules:

• drugs are prescribed only by a doctor after a blood test for the lipid spectrum, since they have different effects on the fat ratio;
• before starting treatment, it is important to examine the condition of the liver, kidneys, carbohydrate metabolism, blood clotting, and then monitor them at least once every 3 months;
• if the cost of the chosen product is high, then the question of replacement is decided by the doctor, since there are differences in the final effectiveness of the original and analogues (generics);
• the criterion for the success of therapy is considered to be a target cholesterol level of up to 5 mmol/l, and low-density lipoproteins should not be higher than 3 mmol/l;
• Dietary supplements and dietary supplements cannot be compared in effectiveness with drugs;
• It is not recommended to independently change the dose or discontinue use;
• If side effects occur, it is necessary to contact your doctor for examination and correction of therapy.

It is important to eliminate the reasons why cholesterol increases and blood circulation worsens:

• stop smoking;
• control blood pressure;
• reduce consumption of animal fats;
• increase physical activity - walking and gymnastics should be part of the daily routine, their minimum duration is 30 minutes.

You won't be able to quickly reduce cholesterol with medications. For sustainable results, medications are taken for at least 3 years. During the first year of use, the risk of acute circulatory disorders decreases by only 11%, and by the end of 3-5 years it reaches a maximum of 35%.

Drugs for high cholesterol in women

The main groups of drugs for high cholesterol in women and men are similar, but an important feature is that not all tablets can be used during childbearing years. Medicines from the statin group have an adverse effect on the course of pregnancy and fetal development. Therefore, they are not prescribed to patients who do not use reliable methods of contraception. When conception occurs, taking statins is strictly contraindicated.

Nicotinic acid and bile acid sequestrants are used with caution and only under medical supervision. The drug Ezetrol has been shown to be safe in animal studies, but no such studies have been conducted in pregnant women. Therefore, its use is not recommended. The same applies to products with omega-3 fatty acids.

The most appropriate and safe way to reduce cholesterol during pregnancy is to exclude fatty meat and dairy products from the diet. It is important to eat fresh and steamed vegetables as much as possible. If there is a lack of dietary fiber, bran is added to the menu. Their use should be combined with a drinking regime (at least 1.5 liters of water), as they can increase constipation due to water deficiency.

Which cholesterol medications are less harmful?

Less harmful drugs for cholesterol are those that act only in the intestinal lumen and do not penetrate into the bloodstream - bile acid sequestrants and Ezetrol. There are no drugs without side effects among the medications taken for atherosclerosis.

The choice of the right drug should be made only after an examination, since the risk of complications and the presence of concomitant diseases should be taken into account. Only proper nutrition is absolutely harmless, physical activity in accordance with individual training, smoking cessation, control of blood pressure and blood sugar are useful.

Herbal preparations to lower blood cholesterol

The most effective herbal preparations for lowering blood cholesterol (dietary supplements) are listed in the table.

Dietary supplements, that is, dietary supplements, have a supporting role in normalizing fat metabolism. Use is recommended for the prevention of atherosclerosis. This means that if you have angina pectoris, cerebrovascular accidents or in the lower extremities, they will no longer help.

They are rarely prescribed in addition to cholesterol-lowering medications. This is due to the fact that most dietary supplements have an unexplored mechanism of interaction with drugs and increase the risk of adverse reactions.

Medicine for high cholesterol for the elderly

For elderly patients, the optimal group of drugs for cholesterol are statins; fourth-generation drugs based on rosuvastatin (for example, Roxer), pitavastatin (Livazo) are recommended, and atorvastatin (Atoris) is also widely used.

Only if intolerance or other contraindications to use are detected, the doctor can recommend medications from other groups. But they are inferior in efficiency. When, despite proper nutrition and taking statins at the maximum dose, the desired effect is not achieved, these medications are combined with nicotinic acid or fibrates (Lipantil, Traykor).

Expert opinion

Alena Ariko

Expert in Cardiology

It is very important for elderly patients not to interrupt the prescribed course of therapy, take blood tests every 2-3 months for liver function, sugar and cholesterol, coagulation, and keep blood pressure under control.

Anti-cholesterol drugs, the cheapest in the pharmacy

The cheapest anti-cholesterol drugs are:

• A nicotinic acid,
• Atorvastatin,
• Rosuvastatin.

When choosing tablets from a domestic manufacturer at a pharmacy, a month of treatment with these medications will cost no more than 300 rubles, 100 hryvnia.

Energy cholesterol tablets

Energy capsules contain vitamins (E, group B, nicotinic acid), chromium, guarana, caffeine, ginseng, green tea. Their effect is enhanced by extracts of licorice, eleutherococcus, rhodiola, gotu kola and mate tea, and lipoic acid.

This complex has a normalizing effect on the metabolism of fats and carbohydrates and has a pronounced tonic effect. The reduction in cholesterol will be quite insignificant. Used to improve performance and general strengthening of the body. Not recommended if you have arterial hypertension, insomnia, or nervous agitation.

Due to the content of nicotinic acid, when taken, redness of the skin and ringing in the ears often occur. If the patient is taking medications to treat the heart or blood vessels, then before starting to use the capsules, it is important to consult a doctor, as there may be dangerous interactions.

Pharmacists in pharmacies often encounter erroneous questions from patients. The drug that actually lowers cholesterol is called Ineji. It is a combination of simvastatin and ezetimibe, that is, a statin and a substance that interferes with the absorption of fats from the intestines.

The situation is similar with novostatin. It is confused with the drug Novostat, which contains atorvastatin. To avoid mistakes, you should always come to the pharmacy with written doctor's orders.

Classification

To choose an alternative to statins and evaluate the effectiveness of other drugs in reducing cholesterol to normal, you need to have an understanding of them. They are classified on different grounds.

Classification according to ATS

• Statins;
• fibrates;
• sequestrants;
• products based on niacin acid;
• other lipid-lowering drugs;
• combined lipid modifiers.

Compound

As for the classification regarding the composition of drugs that can lower cholesterol, almost all of them are synthetic. Herbal remedies include Lovastatin (oyster mushrooms), Policonazole (sugar cane alcohols), Guarem (hyacinth beans) and dietary supplements, sometimes prescribed for the resorption of atherosclerotic plaques, but they do not belong to the full-fledged lipid-lowering drugs recorded in the ATC.

Release form

In terms of release form, most drugs are produced as tablets or capsules. Some are like water-soluble powder. Nicotinic acid and innovative American drugs Repatha and Praluent, which have yet to conquer the pharmaceutical market, are prescribed as injections.

Benefits and Side Effects

Side effects that usually accompany taking medications for high cholesterol are:

• dysfunctions of the digestive system: nausea, vomiting, diarrhea;
• disruption of the functioning of liver cells;
• pain and swelling of the muscles.

As for the benefits of these medications, they are:

• improve blood composition;
• dilate the walls of blood vessels;
• prevent the increase of atherosclerotic plaques.

Also, cholesterol pills are an excellent prevention of heart attack or stroke. In addition, they are prescribed during the rehabilitation period after a stroke.

Statins

Official name: tri-hydroxy-tri-methylglutaryl-CoA reductase inhibitors.

PBX code: C10AA.

List

The table provides a list of the main active ingredients of statins and drugs developed on their basis, indicating their effectiveness (by what percentage they can reduce cholesterol levels in the blood):

Generations of statins:

• I: Lovastatin, Simvastatin, Pravastatin;
• II: Fluvastatin;
• III: Atorvastatin, Cerivastatin;
• IV: Pitavastatin, Rosuvastatin.

The goal of each subsequent generation of drugs is to increase their effectiveness and reduce the risk of side effects and contraindications. As it turned out in clinical trials, this did not work for statins. Development companies have not achieved any of these goals. And even the fourth and latest generation products are still dangerous in terms of health consequences.

Action

Pharmachologic effect:

• quickly and effectively reduce blood cholesterol levels by 60%, as they block the activity of enzymes (HMG-CoA reductase), which contribute to the production of harmful lipoproteins;
• increase the concentration of healthy cholesterol;
• improve the structure of the heart muscle, preventing its weakness;
• allow it to function more fully;
• relieve stress;
• reduce the risk of ischemia by 15%, angina pectoris and heart attack - by 25%;
• increase life expectancy.

Indications:

• arterial hypertension;
• atherosclerosis;
• hypercholesterolemia;
• myocardial infarction;
• IHD;
• OKS;
• prevention of stroke, heart attack;
• surgical operations on blood vessels and the heart.

However, as practice shows, it is advisable to prescribe statins against atherosclerosis and other CVDs only to middle-aged people. For older people (after 60-70 years) they are useless and will do more harm than help.

Side effects

The instructions for all statins state that they do not have mutagenic or carcinogenic properties. However, they can cause multiple side effects:

• anorexia, obesity;
• hepatitis, renal failure, pancreatitis;
• headaches, dizziness, partial short-term memory loss;
• impotence;
• cataract;
• itching, urticaria, anaphylactic shock, toxic epidermal necrolysis;
• myopathy (rhabdomyolysis - an extreme degree of the disease), myalgia, myositis, paresthesia, lower back pain, arthritis;
• disruption of amino acid formation in the body;
• diabetes;
• chronic fatigue syndrome, sleep disturbances, hyperesthesia, general malaise, weakness, depression;
• nausea, vomiting, abdominal pain, flatulence, constipation, diarrhea;
• thrombocytopenia.

Medicines that are contraindicated for use simultaneously with statins (combining them provokes the development of hepatotoxicity, myositis and rhabdomyolysis):

• azoles-antimycotics (Oxiconazole, Sulconazole, Ketoconazole);
• Amiodarone;
• Verapamil;
• HIV protease inhibitors (Saquinavir, Ritonavir, Indinavir, Nelfinavir, Amprenavir);
• macrolides (Azitral, Erythromycin, Rovamycin, Clarithromycin, Ecomed);
• nicotine;
• fibrates;
• Cyclosporine.

Typically, statins are prescribed in combination with other drugs for the prevention and treatment of CVD: Diroton, Concor, Propanorm.

Cautious use of statins under constant medical supervision is required in the following cases:

• alcoholism;
• age after 60 years;
• menopause;
• belonging to the Mongoloids;
• liver failure;
• poor nutrition, poor and unbalanced diet;
• polypharmacy;
• drinking grapefruit juice;
• surgical intervention.

In these cases, the doctor must constantly monitor the condition of the patient taking drugs of this group. You need to start with minimal dosages. If your health worsens or there is no effectiveness (lowering cholesterol is not diagnosed), it is recommended to try prescribing non-statins.

If statins are prescribed to diabetics, they should increase the dosage of insulin or glucose-lowering drugs, as these drugs increase blood glucose concentrations.

Controversy

Scientists around the world are calling on the medical community to abandon statins as cholesterol-lowering drugs once and for all.

At the moment, many studies have been carried out, during which it was revealed that, while helping to cope with CVD diseases, these drugs cause irreparable damage to other organs and systems. Arguments against their active use:

• there is information (not yet confirmed by WHO or other official organizations) that they lead to the development of cancer and suicide;
• in fact, heart attacks and strokes are not a consequence of high cholesterol, but of magnesium deficiency, which means that statins are useless for their prevention;
• men taking drugs of this group will never be able to boast of muscle relief, since for its formation a sufficient level of cholesterol is simply necessary;
• they provoke the development of diabetes, which, in turn, leads to an increase in harmful lipoproteins - a vicious circle is obtained;
• side effects do not manifest themselves immediately, which does not allow one to clearly see the whole picture of the pharmacological action of statins;
• liver cells slowly die;
• intellectual abilities deteriorate;
• amnesia can be quite deep and long-lasting.

Despite all these warnings, statin drugs still remain the mainstay of the therapeutic course for atherosclerosis and other CVDs.

List of drugs

Medicines are divided by type. Depending on the generation.

First generation

It is highly effective when used. These are classic remedies that historically appeared earlier than others.

Despite the “shock” action, it is not selective. Therefore, the tolerability of such drugs is usually insufficient. The likelihood of side effects is high. The use of medications is indicated only in complex clinical cases.

In total, three subgroups of drugs can be named:

• Pravastatin. The main trade name is Lipostat.
• Simvastatin. Simgal, Simlo and others.
• Lovastatin and medications based on it.

All three types have approximately the same pharmacological effect and are used as complete analogues. If one is intolerant, another is prescribed.

Second generation

Intermediate. Presented with a small amount of medications. The development took into account the lack of portability of previous generation products.

With approximately identical effectiveness to the previously mentioned medications, these have slightly fewer side effects and also do not have many contraindications.

List of statins: Fluvastatin, Leskol. They are prescribed relatively rarely.

Third generation

Despite its high effectiveness, there are still many reasons for refusing to use it, as well as side effects when taken systematically.

Modern statins are still not suitable for long-term use, and even if they are prescribed as such, constant monitoring of well-being is required.

It is the third generation drugs that are most often used as they are well studied, effective and inexpensive. Among the common names are products based on Atorvastatin.

In medical practice, Atoris, Liprimar, Torvacard are most often prescribed.

These medications have a good combination of safety and beneficial effects. But they are still inferior to later analogues in the group.

Fourth generation

The latest generation of statins are the safest and most effective compared to previous ones, but in some cases the intensity of action is not enough.

Medicines are produced based on two active ingredients:

The first is pitavastatin, which appeared in Russia in 2019 and is sold under the single trade name Livazo, costing from 600 rubles.

The second is rosuvastatin. The list of names of drugs based on it is presented in the table.

The cost of medicines from the list is higher than that of the items of the previous generation.

This is due to greater effectiveness (for example, rosuvastatin is 1.5-2 times better at reducing the level of low and very low density lipoproteins than atorvastatin), fewer side effects and generally more complex production technology.

Fibrates

Code in the telephone exchange: C10AB.

List

List of the main active ingredients of fibrates and drugs developed on their basis:

• Bezafibratum;
• Gemfibrozil: Lopid, Gevilon;
• Clofibrate: Aluminum Clofibrate, Atromidine, Lipomide, Miscleron, Clofibride;
• Ronifibrate;
• Simfibrate;
• Fenofibrate: Lipantil, Traykor, Exlip 200, Trilipix;
• Ciprofibrate: Ciprofibrate Lipanor;
• Etofibrate.

They are derivatives of fibric acid.

Fibrate-based drugs

Action

Pharmachologic effect:

• form inextricable chemical compounds with bile acid, which leads to a decrease in the production of cholesterol by the liver.
• they reduce the level of predominantly triglycerides (increase the destructive effect of cholesterol), in this regard they are more effective than statins;
• reduce the concentration of uric acid;
• eliminate extravascular deposits;
• choleretic;
• weaken postprandial hyperlipidemia, which most often affects diabetics (type II disease);
• reduce the concentration of bad cholesterol by 25%, triglycerides by 50%, increase the amount of healthy lipoproteins by 30%.

Despite the widespread use of fibrates in the treatment of CVD, their effectiveness in influencing cholesterol is significantly inferior to statins.

Side effects

Fibrates have milder and less dangerous side effects than statin drugs. However, you don’t need to think that they don’t exist at all. Most often noted:

• vomiting, increased gas formation, gastric and intestinal dyspepsia, diarrhea, abdominal pain, nausea;
• pancreatitis, hepatitis, cholelithiasis;
• myopathy (up to the development of rhabdomyolysis), myalgia, myositis, paresthesia, lower back pain, arthritis;
• migraine;
• impotence, frigidity, infertility;
• thromboembolism of the pulmonary artery and veins;
• dermatological problems.

To lower blood cholesterol levels, combinations of statins and fibrates are possible. At the same time, the dosage of both is reduced, as is the risk of side effects.

Contraindications include pathologies of the liver, gall bladder, and impaired hematopoiesis.

Drugs of the statin group

Having considered the general information, we suggest that you familiarize yourself with specific drugs from the statin group, each of which can be used as a medicine for high cholesterol:

• Simvastatin - also known under the commercial names Ovenkor, Simvakol, Simvor, Vazilip, Kholvasim, etc.;
• Pravastatin;
• Lovastatin - also known as choletar or cardiostatin;
• Fluvastatin (Leskol);
• Atorvastatin (Lipoford, Ator, Atokor, Liptonorm, etc.);
• Rosuvastatin (Rozulip, Rozart, Akorta, Tevastor).

It is not recommended to take statins if there is only high cholesterol, but no atherosclerosis, and also if the level of C-reactive protein in the blood is less than 1 mg/dl.

Note that this category includes the best cholesterol pills. Other drugs also have a positive effect, but along with them there is an increased likelihood of adverse reactions.

As an example, let's look at other drugs that can be used in practice as cholesterol-lowering drugs.

Bile acid sequestrants

PBX code: C10AC.

List of medications:

• Kolextran (Questran);
• Colesevelam;
• Cholestipol, Colestipol (Colestipol);
• Cholestyramine, Colestyramine.

They have a powerful pharmacological effect. They form strong chemical bonds with bile acids and remove them. The body is experiencing an acute shortage of substances so useful for its vital functions. A corresponding signal is sent to the liver, which begins their active synthesis. To do this, it requires large reserves of cholesterol, which it uses up. This reduces its concentration in the blood.

Bile acid sequestrants

Most often they come in the form of powders, soluble in water or juice.

They are not absorbed into the blood, therefore they are relatively safe for health. However, a number of doctors also oppose them due to the fact that they reduce the concentration of bile acids, which are vital for the functioning of most organs and systems. The liver does not always have time to synthesize the required amount. It also reduces the absorption of folic acid in the intestines.

It must be kept in mind that triglyceride levels do not decrease when consuming bile acid sequestrants. Especially for this, you have to take some other drugs at the same time.

Bile acid sequestrants to lower cholesterol

Bile sequestrants are medicinal drugs that are used to reduce the index of low molecular weight lipoproteins in the blood. Drugs are prescribed as an additional medication that enhances the therapeutic effect of statins and fibrate tablets.

Sequestrants are divided into three groups of drugs:

• Colesteramine tablets. Accelerates the process of elimination of cholesterol molecules through the intestines;
• The drug Colestipol. Reduces the absorption of cholesterol into the bloodstream, thereby reducing its concentration in the bloodstream. Effectively used to treat the pathology of hypercholesterolemia;
• Colesevelam is a medicine that inhibits the synthesis of cholesterol molecules by liver cells. Can be taken as a treatment for high cholesterol during pregnancy.

Photo gallery: Bile acid sequestrants.

Colestipol

Colesteramine Colesevelam

Bile sequestrants prevent the occurrence of such pathologies in the body:

• Ischemia of the cardiac organ;
• Acute coronary insufficiency;
• Atherosclerosis of the main arteries;
• Ischemia of brain cells;
• Thrombosis.

The drugs have a minimum of side effects, which most often occur from the wrong dosage.

Preparations based on niacin

PBX code: C10AD.

List of funds:

• Acipimox;
• Aluminum nicotinate;
• Niacin (Acidum nicotinicum);
• Nicotinyl alcohol, Pyridylcarbinol;
• Nicofuranoza;
• Niceritrol;
• Enduracin (Endur-acin).

Niacin
Pharmacological action:

• reduce bad cholesterol and increase good cholesterol;
• activate fibrinolysis;
• reduce thrombosis.

Treatment is long-term, with gradually increasing dosage. Statins and fibrates are contraindicated for use simultaneously with nicotine-based drugs (combining them provokes the development of side effects).

Contraindications:

• diabetes;
• gout;
• gastritis;
• stomach ulcer.

One hour before and an hour after taking niacin acid preparations, you should not drink hot drinks. Side effects include discomfort in the stomach, but most often this occurs in the presence of gastritis or ulcers. Immediately after consumption, severe facial flushing may begin. To eliminate this consequence, take aspirin half an hour before the appointment. Some note dermatological troubles: skin itching, the appearance of ulcers and erythermas.

Cascade plasmafiltration

Patients who are not helped by diets, and drugs for high cholesterol do not produce any results, are prescribed cascade plasma filtration. This is a special blood purification technique that has been used in Western countries for more than 30 years.

Today, similar treatment methods are used in domestic countries, but only after treatment with cholesterol-lowering drugs did not produce any results.

The procedure lasts for two hours and proceeds as follows: the patient’s blood passes through a special separator, which divides it into plasma and cellular fractions; the latter enter back into the human body, and the plasma is purified using special devices.

This technique allows you to get rid of cholesterol even before the formation of cholesterol plaques - this allows you to cleanse both the blood and tissues.

Other lipid-lowering drugs

PBX code: C10AX.

Ezetimibe (Ezetimibum)

Trade names: Ezetrol, Ezetimibe, Lipobon, Otrio. New generation drug. Its pharmacological action differs from the principle of operation of other lipid-lowering drugs. It concentrates in the small intestine and interferes with the absorption of cholesterol. This leads to a decrease in its entry into the liver. So the reserves of lipoproteins are reduced, and their removal from the blood increases.

Contraindications: hypersensitivity, severe liver diseases, lactation, pregnancy.

Side effects: diarrhea, fatigue, flu, sinusitis, upper respiratory tract infection, arthralgia, muscle pain. It is not recommended to combine with cyclosporine and other lipid-lowering drugs.

Policosanol

A cholesterol-lowering drug of the latest generation. After clinical trials, it showed high effectiveness even compared to statins. At the same time, side effects are observed much less frequently, and they are not so dangerous to health. At the same time, it reduces the concentration of alanine aminotransferase and gamma-glutamyl transpeptidase. Produced on the basis of aliphatic alcohols from sugar cane.

Contraindications: age under 18, pregnancy, hypersensitivity, lactation.

Side effects: nausea, diarrhea.

Probucol

Trade names: Bifenabid, Fenbutol, Lesterol, Lipomal, Superlipid. It has a double effect: it reduces the synthesis of cholesterol in the liver and its absorption into the blood from the intestines. Does not affect triglyceride concentrations in any way. Prescribed for hypercholesterolemia, damage to the coronary vessels. Contraindications: ventricular arrhythmias, pregnancy, lactation. The most common side effect is dyspepsia. The downside of Probucol is that it reduces both bad and good cholesterol. Many also do not like the length of treatment required. The first effect is noticeable only 2 months after the start of its use. It must be borne in mind that this remedy may distort the results of the electrocardiogram.

Omega-3 polyunsaturated fatty acids

Dietary supplements with Omega-3 polyunsaturated fatty acids

Trade names of dietary supplements: Doppelgerz Omega, Omacor, Oceanol. Most often they contain fish oil. It reduces the risk of developing CVD, lowers cholesterol, saves from depression, and eliminates arthritis. If used incorrectly or for too long, it can cause the development of pancreatitis.

Dextrothyroxine

It has good absorption in the intestine. It is prescribed when it is necessary to reduce the prohibitive concentration of cholesterol. At the same time, it helps to normalize the functioning of the thyroid gland. Enhances its lipid-lowering properties in combination with nicotine and clofibrate. Treatment is prescribed with minimal dosages and their subsequent increase. Side effects: tolerance to carbohydrates decreases, bilirubin increases, leukopenia is diagnosed.

Contraindications: heart failure, severe angina, diabetes mellitus.

American injectable drugs Repatha (Repatha) and Praluent (Praulent)

Lipid-lowering drugs designated under the ATC code C10AX also include:

• Benfluorex - banned in a number of countries due to high toxicity;
• Magnesium pyridoxal, coenzyme B6 (Magnesium pyridoxal 5-phosphate glutamate);
• Meglutol;
• Tiadenol.

American injectable drugs Repatha and Praluent promise to normalize cholesterol levels in just 2 injections a week. However, the medical community is in no hurry to recommend them to its patients, since there are still a lot of clinical trials ahead to confirm their effectiveness.

Statins are the most common cholesterol pills

Statins are modern and very effective pills for lowering blood cholesterol. They combine high efficiency, ease of use and good tolerability. There are several generations of these drugs, each of which has its own characteristics. The doctor individually selects the most suitable remedy for the patient.

Action and efficiency

About 70-80% of cholesterol is produced by the liver and only about 25% comes from food.

Any active ingredient in statin drugs is an inhibitor of HMG-CoA reductase. This is a liver enzyme involved in the formation of cholesterol. About 80% of cholesterol is produced inside the body by liver cells. Statins block the enzyme that serves this process and inhibit cholesterol synthesis in general, which means they lower its concentration in the bloodstream.

The mechanism of action is proven and effective. The drugs quickly lower cholesterol. Within 1-2 months, its blood level drops significantly. At the same time, “good” cholesterol increases.

You need to be careful about the dosage of cholesterol-lowering medications so as not to cause fat deficiency in the body. This primarily concerns statins.

Names of the best drugs and their costs

Let's look at the best drugs from the group of statins with different active ingredients.

1. Atorvastatin (Atoris, Torvacard). This is the most popular drug among statins. It is well tolerated and highly effective. The following dose options are available: 5, 10, 20, 40 mg. The tablets are produced in a film shell. It is needed so that the substance is released in the small intestine and quickly absorbed into the blood. Gastric juice can destroy the active substance. You need to take the medicine every day in the evening, an hour after meals. Drink with a small amount of water. The approximate cost of tablets in Russian pharmacies is from 300 to 1000 rubles (depending on the manufacturer and dosage). Domestic analogues are cheaper.

2. "Rosuvastatin" ("Rozart", "Roxera"). The drug is the fourth (last) generation of statins. It differs from Atorvastatin in its high safety profile without reducing its effectiveness. Available in similar dosages. It is also taken in the evening after meals every day. The course of the medication is long - from several years to lifelong prescription. The price in pharmacies ranges from 300 rubles to 5000. It is determined by the dosage, the degree of purification of the active substance and the country of origin of the tablets.

3. "Pitavastatin" ("Livazo"). Another substance from the latest generation of statins. Has increased efficiency. The medicine should be taken with extreme caution, since if the dose does not match, there is a high risk of developing hypolipidemia (a pathological decrease in cholesterol in the blood). Dose options: 5, 10, 20, 40 mg. Taking the drug is similar to statins of other groups and is also prescribed for life. As cholesterol levels decrease, the dose may be reduced, but the medication will not be discontinued. Price starts from 500 rubles, depends on the dosage and manufacturer.

Reviews

Irina, 59 years old, Moscow: “My high cholesterol was caused by diabetes. The doctor looked at the tests and prescribed statins. I picked up one of the last ones - Rosuvastatin. He said drink it and don’t worry, it has fewer side effects than similar drugs. Indeed, the medicine is very good cholesterol has decreased significantly. True, I had a course of treatment for almost 2 months.”

Olga, 48 years old, Moscow: “I take cholesterol pills. It turns out that it's too high for me. We settled on the drug Atorvastatin. It is not expensive, but effective. I’m worried that I’ll have to drink them for a very long time, but my health needs to improve.”

Sergey, 60 years old, Rostov-on-Don: “After another medical examination and a blood test, we discovered an increase in cholesterol. Moreover, the figure was almost 8, and this is a lot. The doctor talked about the existing risks (stroke, heart attack) and prescribed Atoris. After two weeks of taking it, he ordered me to take a blood test again to monitor the indicator. As a result, cholesterol dropped by 0.5 and became 7.5. I continue to take this medicine, there is a downward trend.”

Statins – what are they?

These drugs rank first in the number of patients who take them. The mechanism of action of lipid-lowering medications is based on the inhibition of enzymes with the complex name “HMG-CoA reductase,” which provoke the production of new cholesterol in the liver.

Statins restore damaged blood vessels when atherosclerosis has not yet been identified, but “bad” cholesterol is already accumulating in the walls. They improve medications and the rheological capabilities of blood: they reduce viscosity and prevent the appearance of blood clots.

In terms of effectiveness, the leading drugs for high cholesterol are the new generation, based on atorvastatin, cerivastatin, rosuvastatin and pitavastatin.

Statins not only reduce the concentration of bad cholesterol, but also increase the content of good cholesterol. The results from the use of drugs in this group can be seen within a month after regular use. Statins are prescribed once a day, at night; a combination of cardiological drugs in one tablet is allowed.

Self-medication with statins is unacceptable, since the doctor’s recommendations are based on the results of biochemical blood tests, in particular, LDL readings. When this parameter does not exceed 6.5 mmol/l, it is reduced by adjusting diet and lifestyle. If these measures are not enough, after six months the doctor prescribes statins.

It is not easy for the uninitiated consumer to understand: rosuvastatin and atorvastatin - what is the difference between these and other similar drugs that inhibit the enzyme that synthesizes cholesterol? Rosuvastatin is a new generation drug that compares favorably with its predecessors.

At doses equivalent to atorvastatin, it has a more pronounced effect. An important argument will be its lower toxicity.

You can learn more about how to take statins correctly from the video

Types of medicines

Today there are many drugs that are used for high cholesterol. They are available in the form of tablets and capsules. The doctor, taking into account the patient’s condition, selects the most effective means with the fewest side effects.

Medicines used for high blood cholesterol are divided into several types.

These include:

1. Statins.
2. Fibrates.
3. Medicines that interfere with the absorption of low-density lipoproteins.
4. A nicotinic acid.

There are no best cholesterol pills; each type of medication has many advantages and disadvantages.

The most common are beds; they quickly reduce cholesterol. They do not harm the liver, and even have a beneficial effect on it. However, if a person has severe liver disease, these drugs should not be used, as a serious complication (liver failure) may occur.

List of popular statins:

1. Simvastatin – Zocor, Vasilip.
2. Atorvastatin – Liprimar, Atoris.
3. Rosuvastatin – Crestor, Akorta.

Atorvastatin and Rosuvastatin are considered the strongest; they are recommended to be taken once at night. They have virtually no side effects, so they can be prescribed even to children.

Treatment with fibrates is considered less effective. They affect lipid metabolism, in particular high-density lipoproteins. These drugs are prescribed in courses. Fibrates should not be mixed with statins. They, like all medicines, have side effects, so when prescribing them, the individual characteristics of a person are taken into account.

Cholesterol absorption inhibitors (CAIs) are less popular; you can buy one type of drug at the pharmacy (Ezetrol). Cholesterol is reduced by stopping the absorption of lipids from the intestines. The medicine has no strong side effects and can be combined with statins.

Nicotinic acid or niacin gives good results. It interferes with the production of lipids. However, nicotinic acid affects only fatty acids, so after completing the course, blood microcirculation is noted. As a rule, with regular use of these drugs, a lowering effect occurs.

Also, to regulate digestion, you should take bile acid sequestrants. Cholestyramine and Colestipol are considered the most effective. They seem to bind bile acids and transport them to the right channels. With a lack of them in the body, cholesterol increases. However, they are prescribed less frequently because they have many side effects.

Polyunsaturated fatty acids increase oxidation in the blood, thereby reducing lipid levels. They do not have side effects, but their effect does not occur immediately, but after a long time.

Dietary supplements reduce triglycerides in the liver and lower LDL. The treatment results last longer, so they are prescribed in addition to the main drugs. For example, if a person’s diet contains little plant food, then taking dietary supplements based on fiber will make up for this deficiency.

The most effective for reducing blood cholesterol are:

1. Omega forte.
2. Tykveol.
3. Lipoic acid.
4. Linseed oil.

Sometimes certain drugs, such as statins or fibrates, are contraindicated for patients; in this case, the doctor prescribes them on a herbal basis.

When prescribing cholesterol pills, first of all take into account:

• gender and age;
• the presence of chronic and cardiovascular diseases;
• bad habits and lifestyle.

Thus, there is an extensive list of cholesterol pills

Here it is important to choose the right remedy, taking into account all the individual characteristics of the patient, only in this case the reduction will be beneficial

Only a doctor can prescribe appropriate medications and other recommendations that must be followed.

For prevention purposes, doctors advise after 20 years of age (twice a decade) to do a cholesterol test to determine the amount of cholesterol. Since with age, in people leading an unhealthy lifestyle, it can increase. If the patient is at risk, then the indicator should be monitored regularly, at least 1-2 times a year.

Lowering blood cholesterol with drugs that have a choleretic effect has an additional, positive effect on normalizing the level of triglycerides and low-density lipoproteins. The principle of action of choleretic drugs is simple: they bind excess cholesterol and gradually remove it from the body.

There are special drugs that significantly reduce the absorption of cholesterol directly in the gastrointestinal tract. These include: Xenical, Orlistat, Ezetrol. Such drugs will become indispensable helpers if excess cholesterol enters the body through food.

Side effects when using these drugs are quite unpleasant: frequent urge to defecate, which is accompanied by the release of excess fat, pain in the abdomen, allergic reactions. While taking drugs of this group, a strict diet is required with the complete exclusion of fatty foods.

Statins are a group of drugs designed to reduce cholesterol levels in the blood. Used for the treatment and prevention of atherosclerosis.

Nowadays, there are several statins of different generations. Statins are the most popular pills of all groups of drugs for lowering cholesterol levels. Their action is based on the production of a special enzyme, HMG-CoA reductase. The enzyme is involved in the synthesis of cholesterol in the liver.

Latest, fourth generation statin.

Rosuvastatin – Crestor (Rosucard, Rozulip, Tevastor) Popularity rating*: 4.9

Intended for people at high risk of stroke and heart attack. People suffering from diabetes, coronary heart disease, and arterial hypertension.

To reduce cholesterol, the patient must follow a diet, review his diet, and only then start taking the drug.

Taking Rosuvastatin depends on the level of lipids in the blood and is in a standard dosage of 5 to 10 mg per day.

Atorvastatin – Liprimar (Tulip, Torvacard, Atoris) Popularity rating*: 4.8

Atorvastatin belongs to the third previous generation of statins, the main substance is atorvastatin.

The difference between fourth and third generation drugs is that in addition to reducing the level of bad LDL cholesterol, they increase the concentration of good HDL cholesterol. However, Atorvastatin is a very effective drug and has an original formula.

Fluvastatin – Leskol Forte Popularity rating*: 4.8

Fluvastatin Leskol Forte is also a very popular drug for lowering cholesterol levels. It is prescribed for high cholesterol with hereditary hypercholesterolemia, prevention of myocardial infarction, and coronary heart disease. It can be prescribed as monotherapy when other drugs are no longer needed.

Nicotinic acid (niacin) is found in the food we eat and belongs to the B vitamins. If low-density lipoprotein levels are elevated, the doctor may prescribe taking Niacin in high doses.

Nicotinic acid reduces the flow of fats from subcutaneous tissue into the blood, thereby reducing LDL levels and increasing HDL levels.

It is also prescribed for atherosclerosis, it has a pronounced vasodilating effect and blocks cholesterol synthesis in the liver, reduces blood glucose levels, which is effective for diabetics, and “resolves” cholesterol plaques.

The medicine acts in the intestines, binding bile acids and removing them from the body. Bile acids are involved in the metabolism of cholesterol and fats and thus reduce lipid levels.

They have the disadvantage that bile acid sequestrants cause disorders in the patient's gastrointestinal tract and can cause constipation.

Fibrates

These are derivatives of fibric acid, a group of drugs that lower triglycerides (lipids) in the blood and increase the level of high-density lipoproteins.

This is another group of drugs that lowers the level of triglycerides in the blood and also increases the level of high-density lipoprotein HDL.

Side effects include nausea, abdominal pain, arrhythmias, liver dysfunction, and decreased libido.

Review of the most effective and safe statins

There are four main groups of drugs for lowering cholesterol, among which the latest generation of statins, which have hydrophobic (water-soluble) properties, unlike earlier drugs, have proven their effectiveness and safety.

Crestor

Crestor is a fourth-generation synthetic statin based on rosuvatsatin, which quickly reduces bad cholesterol and increases “good” cholesterol. Crestor is available in the form of tablets in dosages of 5, 10, 20 and 40 mg of rosuvastatin. The medicine contains lactose, calcium phosphate, magnesium stearate.

The therapeutic effect of statins is achieved 3-4 weeks after regular medication use, and the risk of myocardial infarction and stroke is reduced by 47-54%.

Crestor tablets are not used in case of individual intolerance to rosuvastatin, under the age of 18 years, during pregnancy and breastfeeding, with severe pathologies of the kidneys and liver.

Livazo

Livazo belongs to the latest generation of anticholesterol drugs. The active ingredient Livazo (pitavastatin) is characterized by high bioavailability and long-lasting action and is prescribed in a small dosage (from 1 to 4 mg per day).

When using Livazo, you must adhere to a low-fat diet, and it is recommended to take the tablets regularly at the same time, preferably in the evening, taking into account the characteristics of lipid metabolism in the body.

About 4% of people using the statin Livazo experience severe muscle pain accompanied by weakness and swelling, and less than 3% experience insomnia and headache.

In some cases (if you have a drug allergy to other types of medications, with diseases of the excretory system, as well as with regular consumption of alcoholic beverages), after short-term use of Livazo it is necessary to undergo an examination to identify possible negative effects on the organs of the excretory system.

In cases where Livazo is used for the prevention of cardiovascular diseases in diabetes, blood glucose levels should be monitored, since in some cases there may be an increase in sugar to high levels requiring drug treatment.

Rosuvastatin-SZ

Rosuvastatin-SZ is used for primary and familial hypercholesterolemia, hypertriglyceridemia, as well as for the prevention of complications in cardiovascular diseases.

Rosuvastatin-SZ is produced in the form of tablets of 5, 10, 20 and 40 milligrams. Regular use of a statin can reduce cholesterol by 40-50% within 6-8 weeks of treatment. You can use the product regardless of the time of day or meal. The maximum level of rosuvastatin in the blood is observed 5 hours after administration, gradually decreasing over 19 hours.

In combination with treatment, it is recommended to use a diet low in animal and vegetable fats, and eliminate alcohol consumption and smoking.

Contraindications to the use of Rosuvastatin-SZ are myopathy, renal and liver failure, lactose intolerance, pregnancy and lactation, use of cyclosporine and HIV protease inhibitors. High-dose statins (40 mg) are not prescribed for hypothyroidism, as well as with the simultaneous use of fibrates.

Liprimar

Liprimar is an effective drug based on atorvastatin and is used for disorders of fat metabolism, angina pectoris and a high risk of heart attack, for the prevention of recurrent stroke, as well as for type 2 diabetes mellitus to reduce the risk of developing cardiovascular diseases. Liprimar, if necessary, can be prescribed to children over 9 years of age.

In cases where statins are used simultaneously with the use of nicotinic acid, cephalosporins, fibrates, some antibiotics (erythromycin, clarithromycin) and antimycotics, then there is a high risk of developing one of the side effects of the drug - weakness of certain muscle groups (muscular dystrophy).

Atoris

Atoris, which contains atorvastatin, is prescribed for atherosclerosis, diabetes mellitus, high blood pressure, angina pectoris and to reduce risk if there is a family history of disorders of the cardiovascular system.

Atoris quickly reduces the level of “bad” cholesterol (14-18 days after the start of therapy) and has an anti-sclerotic effect, as it promotes vasodilation, affecting the growth factors of the internal endothelium, thins and normalizes blood clotting.

For low blood pressure, alcohol abuse, electrolyte imbalance and after surgery, the drug is prescribed after additional tests. Atoris is not recommended for use during pregnancy, lactation and under the age of 16 years.

Caduet

Caduet is an effective drug with a combined composition that not only reduces cholesterol in the body due to the content of atorvastatin, but also normalizes blood pressure with the help of amplodipine, a calcium channel blocker (normalizes calcium levels in cells and helps reduce systolic and diastolic pressure).

The drug is available in tablet form and may contain active substances in different proportions. The statin dosage is prescribed individually after studying the lipid profile in a biochemical blood test, the condition of the heart, kidneys and liver.

Caduet is used for all types of hypertension in combination with angina, dyslipidemia or atherosclerosis. During statin treatment, it is necessary to monitor the condition of the liver (test for “liver” transaminases) and teeth (to prevent hyperplasia and gum pain) every 4-6 months.

Abrupt discontinuation of therapy with the statin Caduet is prohibited, as this may lead to the development of angina, especially in older people.

Simwahexal

Simvahexal belongs to the first generation of statins, but despite this, it is an inexpensive and effective drug, and is used for chronic ischemia, hypercholesterolemia and hyperlipidemia, for the prevention of coronary atherosclerosis and heart attack.

Since the formation of lipoproteins in the body occurs at night, statins are taken once a day in the evening, given that the maximum concentration of the drug is reached after 1.5-2 hours and decreases after 12 hours.

Therapy with this type of statin should not be combined with the use of cytostatics, antimycotics (ketoconazole), immunosuppressants, anticoagulants (the drug enhances the therapeutic effect of anticoagulants and increases the risk of bleeding).

A nicotinic acid

Nicotinic acid is a water-soluble vitamin necessary for the normal functioning of the body. Therapeutic effect: reduction of cholesterol and lipid fractions, vasodilation.

Prevents the development of cardiovascular diseases, has a detoxifying and calming effect.

When it enters the body, nicotinic acid is converted into the active substance nicotinamide. It is involved in the metabolic processes of vitamins, synthetic processes, and tissue respiration.

The substance improves microcirculation, normalizes lipoprotein levels, reduces LDL and triglycerides, and increases HDL. Metabolized in the liver, excreted by the kidneys. The peak concentration of the substance is reached after 45 minutes.

List of medications: Enduracin, Niceritrol, Acipimox. Preparations based on nicotinic acid are cheap and accessible to many.

Indications for use:

• initial stage of hyperlipidemia;
• cerebrovascular accidents;
• vitamin PP deficiency;
• prolonged stress;
• atherosclerosis;
• during rehabilitation after heart attacks and strokes;
• microagniopathy;
• atherosclerotic cardiosclerosis;
• ulcers on mucous membranes and skin;
• angina pectoris;
• neuritis of the facial nerve;
• spasms of blood vessels in the extremities;
• diabetic polyneuropathy;
• enterocolitis, colitis, gastritis.

Contraindications for use:

• hypersensitivity to the substance;
• gastric ulcer (exacerbation);
• age less than 2 years.

The medicine should be taken with caution by persons with liver failure, glaucoma, or gout.

Side effects during administration:

• fatty infiltration of the liver is observed when taking the drug in high doses;
• hypotension;
• allergic skin manifestations;
• increased secretion of gastric juice;
• decreased glucose tolerance;
• irritation of the gastric mucosa;
• liver dysfunction;
• skin hyperemia;
• risk of developing myopathy when combined with statins.

Note! Nicotinic acid has hyperglycemic potential. People with diabetes should constantly monitor their sugar levels. NC reduces the effect of some hypoglycemic drugs.

Estimated cost of cheap drugs

If you do not take into account nicotinic acid and lipoic acid, then cheap cholesterol pills start at 160 rubles.

Dietary supplements will approximately cost in the range of 150-600 rubles per package. However, you need to know that dietary supplements do not treat or affect high cholesterol levels, but are preventive measures.

The most popular drugs of the old generation are statins:

• Lovastatin (Choletar, Cardiostatin);
• Simvastatin (Vasilip, Simgal);
• Pravastatin (Lipostat).

The drugs containing the active substance are indicated in brackets.

Simvastatin has proven itself best:

• It reduces blood pressure perfectly;
• Reduces vascular spasm;
• Excellent effect on cholesterol levels.

Of the second generation of drugs, Fluvostatin (Leskol Forte) can be noted. However, many side effects prevented this medicine from gaining widespread popularity among patients.

• Atorvastatin (Atoris, Tulip, Liprinorm) is still used. Atorvastatin is safe and very popular among doctors and patients.
• Ceristatin was discontinued due to patient deaths. This is why debate often arises about the harms and benefits of taking statins, since many medications have a lot of side effects.

The latest fourth generation is represented by: Rosuvastatin (Roxera, Cristor, Rosucard) and Pitastatin (Livazo). They are characterized by excellent tolerability and can be taken for a long time.

What properties do statins have?

• Prevents blood clots from forming;
• Do not allow plaques to grow and clog the lumen;
• Relieves inflammation of the vascular walls.

Statins should not be taken:

• For pathologies of the liver and kidneys,
• For diseases of the musculoskeletal system.

Problems with the thyroid gland and disturbances in the levels of the hormones TSH, T3 and T4 can lead to serious consequences such as hypothyroid coma or thyrotoxic crisis, which are often fatal. Normalizes sugar production and returns to normal life. Read more "

Latest generations of statins

If you choose very good cholesterol pills, it is worth buying 3-4 generation medications. The third is represented by drugs with atorvastatin:

1. Atoris (from 370 rubles);
2. Torvacard (from 266 rubles);
3. Novostat (from 560 rubles), or Novostatin;
4. Tulip (from 660 rubles).

Atorvastatin

lowers the level of low-density fats in the blood. It inhibits an enzyme that is involved in the early stages of cholesterol synthesis. Next, the activity of receptors is activated, increasing the rate of binding of fats and their removal from the plasma. The substance also prevents the destruction of the inner lining of blood vessels and promotes the growth of “good” cholesterol.

The effect of all medications is achieved within 2 weeks from the start of administration.

The patient can also be prescribed Atomax, Anvistat, Lipitor - they have the same active ingredient.

4th generation drugs are very effective, but quite expensive. These are drugs with rosuvastatin, pitavastatin. The group includes Crestor, Akorta, Livazo, Mertenil, Rozart. The price for a month of admission varies from 1000 rubles. up to 3000 rub. Usually in the first month they take 5-10 mg, then the dose is increased to 40 mg.

Exercise against high cholesterol

If you do not change your usual lifestyle to a more active one, you will not be able to completely solve the problem of clogged blood vessels. Sports activities in one form or another must necessarily become one of the main components of comprehensive measures against increased concentrations of cholesterol in the blood. In addition, physical activity reduces the risk of developing diseases such as atherosclerosis.

Without sports, it is impossible to quickly and effectively cope with high cholesterol. Loads on muscle tissue cause blockages in blood vessels to begin to break down. In addition, physical activity helps lower bad cholesterol.

Another pleasant bonus is that thanks to sports you can keep yourself in excellent shape and have a toned figure, and promptly prevent the deposits of subcutaneous fat. According to many scientific studies, high cholesterol levels are much less common in track and field athletes than in those who do not play sports.

This does not mean that you need to become a professional athlete. It’s enough just to do gymnastics, swim or attend a sports section that you like.

Folk remedies for high cholesterol with garlic

A mix of honey, lemon and garlic helps with the task of cleansing blood vessels from excess cholesterol. What is the benefit of the components used for atherosclerosis?

• Garlic. Has antiviral and antimicrobial activity. In addition, the spicy vegetable copes well with cholesterol plaques, helping to break them down and cleanse the lumen of the vessel.
• Lemon. Citrus juice also causes the dissolution of fatty deposits on the walls of blood vessels. It also contains a large amount of vitamin C, which is a powerful natural antioxidant.
• Honey. The product contains a large number of biologically active substances.

By combining these components with each other, you can obtain unique medicinal products for cleansing blood vessels.

Infusion of garlic and lemon

You will need 4 heads of garlic, 4 ripe juicy lemons. Preparation:

How to drink flaxseed oil to lower cholesterol?

• Peel the garlic and separate into cloves. Clean. Wash the lemon and cut into slices.
• Grinds both components. You can use a blender.
• Transfer the mixture into a 3-liter jar and fill with cooled boiled water up to the neck.
• Place the container in a dark place for three days. Its contents must be mixed every day.
• Filter the infusion from the sediment. Pour into a bottle and store in the refrigerator.

For people who do not have problems with diseases of the digestive system, drink 100 ml three times a day 20 minutes before meals. Everyone else - 3 tbsp. l. before meals. It is impossible to treat atherosclerosis with garlic if you have arrhythmia/tachycardia or a tendency to these pathologies.

Honey syrup with lemon and garlic

To prepare the product you will need: lemon - 6 pieces, garlic (heads) - 4 pieces, liquid honey - 350 ml. Preparation:

• Chop the peeled garlic and lemon (unpeeled). Place the mixture in a jar, pour in honey and top up with cooled boiled water.
• Leave the composition for 10 days in a dark place. Then filter through several layers of gauze.
• Store the product in the refrigerator in an airtight bottle.

Important! The product “works” more gently, so it can be used even by people with stomach problems.

Dosage regimen: 1 tbsp. l. Stir the syrup into 200 ml of water and drink the saza after waking up in the morning on an empty stomach, the second time in the evening at night. During the day you need to drink clean water with lemon juice.

Garlic and horseradish mixture

To lower cholesterol, you can prepare the following composition. Grind 1 kg of garlic. Add horseradish (50 g), salt (80 g) and a small bunch of dill to it. Transfer the mixture into a jar. Fill it with cooled boiling water to the top and leave in a warm place for 7 days. Filter the product and take the liquid 1 tbsp. l. before meals.

The combination of honey, garlic and lemon is an effective anti-sclerotic remedy.

A mixture of honey, garlic and lemon (free proportions) has good cleansing properties. You need to chop the garlic, mix it with honey and add citrus juice. Morning and evening eat 1 tsp.

Destination Features

Statins are quite finicky drugs, so they cannot be used with a number of other drugs. That is why, before starting to take statins, doctors recommend that patients stop taking other medications for the treatment of various pathologies, so that there is no interference with taking statins later.

In practice, doctors take into account the following features of prescribing drugs:

• if statins are prescribed together with nicotinic acid, the risk of developing kidney problems, as well as rhabdomyolysis, increases;
• if statins are prescribed simultaneously with diuretics, the level of steroid hormones produced by the body will decrease;
• the prescription of several types of lipid-lowering drugs poses a risk of developing side effects from taking statins;
• if the patient is taking cardiac glycosides, that is, there is a risk of increasing digoxin concentrations;
• you should not prescribe statins together with immunosuppressants, since in this case renal failure is almost guaranteed and the risk of rhabdomyolysis is high;
• simultaneous use of anticoagulants with statins can cause bleeding;
• The combination of statins with antimycotic drugs is not recommended due to the development of problems with the kidneys and the musculoskeletal system;
• Lipid-lowering drugs should be used with caution in patients with an addiction to alcoholic beverages.

Names of pills that lower lipoprotein levels

Lipid metabolism disorders are expressed in an increase in the level of low-density lipoproteins: they infiltrate into the vascular wall and, together with some other blood components, lead to sclerotization of the arteries - the appearance of “cholesterol plaques”. For this feature, low molecular weight lipoproteins are called “bad cholesterol” and strive to eliminate its excess.

When other treatment methods do not produce results and the amount of “bad cholesterol” in the blood remains elevated, drugs are selected to lower it. There are many such drugs, so we will name the most commonly used:

• Atorvastatin, Lovastatin, Rosuvastatin and other drugs from the statin pharmaceutical group;
• Omacor, Euphytol based on omega-3 triglycerides;
• Slimia, Goldline based on sibutramine – a centrally acting appetite regulator;
• Lipantil, Traikor - with the active ingredient fenofibrate from the group of fibrates;
• Ezetrol is a drug for high cholesterol from the group of cholesterol absorption blockers based on ezetimibe.

Capsules with fish oil and garlic oil are used as additional lipid-lowering drugs.

The variety of anticholesterol drugs does not make it possible to provide a complete list of names of drugs for reducing low-density cholesterol in the blood.

Drugs that inhibit the absorption of cholesterol in the intestines

Medicines that suppress the absorption of cholesterol in the intestines reduce absorption to reduce its concentration in the blood.

The presented group of drugs includes Lipobon, Ezetrol, Tribusponin, Guarem. They are not absorbed into the blood, they combine well with other drugs, and, unlike FFAs, they do not increase the secretion of bile acids.

As a result, after 14 days of taking the drugs, cholesterol absorption is reduced by 50%. Simultaneous consumption of food does not affect the bioavailability of drugs in this group. During administration, cholesterol levels are reduced by up to 20%.

Note! The result is not always achieved with monotherapy. Often such drugs are combined with other lipid-lowering drugs.

Indications for use:

• homozygous familial hypercholesterolemia;
• primary hypercholesterolemia;
• ineffectiveness of statin monotherapy;
• homozygous sitosterolemia.

They are used in conjunction with diet therapy; if there is no effect, they are combined with statins. Lipid metabolism correctors Essentiale and Lipostabil are often used.

Among the contraindications for use:

• liver failure;
• lactose intolerance or deficiency;
• hypersensitivity reaction;
• age less than 18 years;
• simultaneous use with fibrates.

Among the side effects observed:

• bloating;
• flatulence;
• bowel disorders (constipation and diarrhea);
• liver dysfunction;
• fatigue;
• headache.

Effective recipes

Next, we consider means by which you can not only reduce high cholesterol levels, but also prevent the development of atherosclerosis.

Flax – oil and seeds

Flaxseed oil contains a large amount of Omega-3 polyunsaturated fatty acids. They help normalize cholesterol levels. To do this, it is enough to take 2 tbsp daily. l. product in the morning on an empty stomach. You can use flaxseed to lower cholesterol. It contains vitamins A, C, E, F, minerals, amino acids.

Rinse the product, dry it, grind it in a coffee grinder and add little by little to any dishes - salads, cereals, soups, mashed potatoes, etc. And you can also prepare a decoction. To do this, cook 1 tbsp in 200 ml of boiling water. l. flax seeds for 15 minutes at a low boil. Filter the resulting product and take 1 tbsp of liquid. l. before meals.

Dried linden blossom

Linden blossom is good for cleaning blood vessels from cholesterol. It needs to be ground with a coffee grinder to a powder state. Dosage regimen: 15 grams 20 minutes before meals three times a day, washed down with the required amount of clean water. Course duration is a calendar month. Then you need to take a 14-day break and repeat the treatment.

It is important to remember the following points:

• During the entire period of taking linden, you need to follow a diet. The menu should contain products high in ascorbic acid (dill), as well as pectin (apples). They help strengthen vascular walls. Restores impaired liver and gallbladder functions, which helps lower the level of “bad” cholesterol.
• 14 days before cleaning the vessels, it is necessary to start taking choleretic agents - decoctions (take 1 tablespoon of herbs for 200 ml of boiling water) from corn silk, immortelle, tansy, milk thistle. The scheme is as follows: take a decoction of one herb for two weeks, then take a week break, and again start taking a decoction of another herb for 2 weeks, etc. The duration of the course is 3 months.

To remove the manifestations of atherosclerosis, linden blossom should be brewed and drunk as tea. Prepare the drink “by eye”, focusing on your taste. You should drink it warm in the evenings. Course duration is a week.

Important! The decoction should not be used by people with low blood pressure. In addition, the drink has a pronounced diuretic effect.

Kvass from jaundice

Kvass made from jaundice grass will help get rid of large amounts of “bad” cholesterol. Place 50 g of dry product in a gauze bag and add boiled water (3 l.). Add granulated sugar (200 g) and low-fat sour cream (10 g) to the jar. Keep the container in a warm place for 14 days, stirring the drink daily. Dosage regimen: ½ glass 30 minutes before meals.

Course duration is a calendar month. Every day you need to add the same volume of boiled water to the jar as the kvass you drank. First you need to stir it in it for 1 hour. l. granulated sugar. During the entire period of taking kvass, you need to completely exclude all foods containing fats from the menu. The basis of the diet should be vegetables, fruits, water-based cereals, seeds and nuts.

Juice treatment

Taking fresh vegetable and fruit juices will help cleanse blood vessels of cholesterol and significantly reduce its level in the blood.

Natural juices help lower cholesterol levels

You need to drink juices according to the scheme below.

• First day – 30 ml of celery and 60 ml of carrots.
• Second day – 60 ml carrots, 45 ml beets and 45 ml cucumber. The beet juice must first sit for 120 minutes in the refrigerator.
• Third day - 60 ml of carrots, 45 ml of apple and 45 ml of celery.
• Fourth day – 60 ml carrots and 30 ml cabbage.
• Fifth day – 30 ml of orange.

Varieties of juices can be mixed with each other. But ideally, 20 minutes should pass between doses. An absolute contraindication is insulin-dependent diabetes mellitus. With the second type of disease, you need to exclude juices from sweet fruits.

A mixture of Sophora japonica and mistletoe

An effective folk remedy that can reduce blood cholesterol levels is a remedy based on the fruits of Sophora japonica and the herb white mistletoe. In order to normalize the lipid profile, you can prepare and use the following product. Pour equal volumes (50 g) of the components with vodka (1 l). Leave the composition in a dark place for 21 days. Filter.

Take alcohol tincture 1 tsp. half an hour before meals. The duration of treatment is until the composition runs out. Thanks to this recipe, the following tasks are solved: blood supply to the blood vessels of the brain improves, blood pressure levels normalize, blood vessels are cleaned, and blockage is prevented. Mistletoe helps remove heavy metal salts from the body.

Other means

Be careful when purchasing advertised nutritional supplements that promise relief in two weeks. Treatment is really best carried out in combination using the advice of nutritionists. So, apples, garlic, legumes, cauliflower have a cholesterol-lowering effect. Stop eating fatty meats and love fish.

Do not give up proven folk remedies. To reduce cholesterol levels, infusions and tinctures of elderberry, hawthorn, calamus roots, rose hips, cinquefoil, meadow clover, motherwort, and elecampane are recommended. You just need to take them constantly for years.

For people under forty years of age who do not have symptoms of damage to the heart and blood vessels, but have received a ready-made blood test with alarming cholesterol levels, doctors recommend physical exercise: morning jogging, walking, swimming in the pool two to three times a week, cycling can reduce the initial level, play the role of a useful medicine for cholesterol.

So, to choose the most optimal product for yourself, you need to carefully read the instructions. It is not recommended to take the drugs simultaneously with grapefruit juice, as it impairs their absorption in the intestines. The combined use of statins and anticoagulants (medicines to reduce blood clotting) requires caution; bleeding is possible.

If you find any unclear indications or terms in the instructions, you should consult a doctor, since treating cholesterol with medications is the job of an experienced therapist.

High cholesterol: what to drink from tablets

Medical practice uses special agents – statins – to normalize cholesterol metabolism. These drugs have some features of use, namely:

• They must be taken constantly;
• They have serious side effects.

The effect of statins is so strong that they should be used to lower cholesterol only as a last resort, when a person urgently needs help.

What do supporters and opponents say about statins?

Opponents of such vascular cleaning tablets say that a number of their contraindications and side effects are dangerous to health. Their independent use, that is, without a doctor’s prescription, is extremely life-threatening. Opponents also note the lack of effect in the elderly category of patients, as well as the extremely negative impact on the liver of such a negative phenomenon as the destruction of muscle tissue of the body. In addition, a small percentage of patients using medications develop type 2 diabetes.

Proponents of drugs for cleaning blood vessels from cholesterol say that reasonable prescription and proper combination with other drugs gives excellent results. The main thing is to follow all the rules of admission, regularly take blood tests and visit your doctor.

It is important to know that an individual medication regimen is developed for each patient to cleanse the blood of harmful substances. But even supporters of this medicine say that one should strive to maintain normal cholesterol levels without the use of medications

Contraindications

In a situation where a person has a confirmed diagnosis of hyperlipoproteinemia type 3 or 4, that is, with an increase in the concentration of certain substances in the blood, provoking serious pathologies of the heart and blood vessels, taking FFA is absolutely contraindicated. Ignoring such a warning can lead to an increase in the level of triglycerides (a type of fat).

It is prohibited to use FFA for diseases caused by pathologies of the biliary tract - complete biliary obstruction and biliary cirrhosis.

An obstacle to taking FFA is considered to be frequent constipation in the patient. In order to eliminate the possibility of ineffective therapy for this reason, you should undergo treatment in advance, adjust your stool, and only then resort to the help of FFA.

In addition, it is necessary to prescribe such drugs with special care for kidney diseases, cholelithiasis, hemorrhoids, problems with blood clotting, as well as for stomach or duodenal ulcers. No less caution is exercised when prescribing this group of medications for gastrointestinal disorders and malabsorption syndrome (failure in intestinal absorption, against the background of which vital nutrients are not absorbed).

If there is poor tolerability of drugs from the FFA group, then they are excluded from therapy and the indicators of blood tests, liver enzymes and muscle tissue are monitored for some time. However, even patients who have no problems accepting such medications should understand that the use of drugs does not relieve them of the responsibility to monitor their lifestyle, diet, and control their weight.

Varieties

Also read: Lowering cholesterol without drugs

Rosuvastatin is an active substance from the statin group, representing the fourth generation of the drug group. At its core, today rosuvastatin tablets are the most powerful and also have the least side effects. Drugs containing rosuvastatin have the following trade names:

• Rozulip;
• Tevastor;
• Rosecard;
• Crestor.

Cholesterol-lowering drugs are generally well tolerated. If immunity develops, it is to the additional components included in the drug. The tablets and capsules include titanium dioxide, purified water, iron oxide, crospovidone, magnesium stearate and calcium phosphate, among other drugs.

The drug with rosuvastatin is recommended for use in patients with already diagnosed high cholesterol levels, as well as in the presence of all the prerequisites for hypercholesterolemia and the risk of stroke or heart attack. In this case, the drug will have a vasoprotective effect, protecting the walls of blood vessels from lipid deposits.

Among statins, the active substance atorvastatin also stands out, on the basis of which a large number of trade names are produced. Atorvastatin is the predecessor of fourth-generation statins; it has a slightly different effect, but drugs based on atorvastatin are one of the cheapest drugs. If the patient initially asks the doctor to find cheap drugs, then doctors focus primarily on drugs containing atorvastatin.

Drugs containing atorvastatin are represented by the following brands:

• Liprimar;
• Tulip;
• Atoris;
• Atorvastatin;
• Torvacard.

The main difference between third-generation atorvastatin and fourth-generation rosuvastatin is that newer drugs can affect the level of good cholesterol and high-density lipoproteins. For example, rosuvastatin increases the concentration of good cholesterol in the blood, but atorvastatin is only able to correct the concentration of bad cholesterol.

Cholesterol-lowering statins are available in tablets or capsules in various dosages. Usually this is from 10 to 40 mg, but there are also preparations with 5 and 80 mg of the drug. High doses are rarely prescribed, since the drugs are highly effective, and with a dosage of 40 mg, most patients achieve the desired effect and lower cholesterol levels. Usually, after high doses there is a gradual reduction to 20 and 10 mg of the drug - this dosage is recommended for future use.

Among the variety of statins, there is always a suitable remedy.

It is enough to take medications once a day, since the effect of statins lasts a little more than 24 hours. The time of taking does not depend on food intake - you can take statins both before and after meals, but doctors recommend taking the drug in the late afternoon.

Another effective remedy is fluvastatin. This component is part of the drug Lescol. The medication is well-deservedly popular because it allows you to quickly and effectively reduce blood lipid levels. The drug is prescribed to patients with coronary artery disease, for the prevention of myocardial infarction, as well as to patients with severe, familial cases of high blood cholesterol.

Fluvastatin acts a little slower - the drug shows its positive effect after about a month of constant use of the drug. Before starting therapy, a course of diet is recommended, and it is recommended to follow it throughout the entire period of taking the statin.

Among statins, lovastatin, pravastatin, and simvastatin are also used. These active substances act identically to the already mentioned atorvastatin, rosuvastatin and fluvastatin. The principles of prescribing medications are the same, side effects and contraindications in these subgroups of drugs are also no different.

Cheap drugs

The cheapest drug can be called lipoic acid; it will cost from 30 to 40 rubles . Nicotinic acid is considered one of the cheapest drugs. The cost of a package of 50 tablets will cost 50 rubles.

The cost of statins is by no means small, so the average bill for a medicine starts from 160 rubles per package. It can reach 2.2 thousand rubles if the doctor prescribes Lescol Forte.

Do not think that analogues will be cheaper than original products. Such medications are prescribed for life, so it is better to look at the list of contraindications, and not at the price. If the drug is well absorbed and gives a minimum of side effects, then you can live with the price.

If you need cheap cholesterol pills, you can choose:

Other drugs to lower cholesterol:

• Nicotinic acid and dietary supplements to lower cholesterol levels . This also has its pros and cons, so in no case should you purchase products without consulting your doctor.
• Berries: raspberries, rose hips, hawthorn, viburnum and chokeberry. They are used both together and separately.
• Herbal decoctions: wheatgrass and dandelion roots, oats, motherwort, yarrow, immortelle and others. Taking herbal remedies should also be agreed with your doctor, especially if pills have already been prescribed.

Alternative pills

Alternative pills for lowering blood cholesterol are herbal formulations. Most of them are based on extracts of rose hips, pumpkin, bioflavonoids and antioxidants of plant origin. The question of how good these drugs are remains open. After all, not a single centralized randomized study has been conducted to confirm their effectiveness.

But since Internet users continue to actively search for information about such drugs, we decided to tell you about two of them, the most proven:

1. Chitosan. In terms of its composition, Chitosan is an amino sugar, which is synthesized on the basis of the biopolymer chitin. Thanks to its unique properties, Chitosan binds to blood fats (all fractions, including cholesterol) and promotes their further utilization. Thus, the drug literally removes excess lipids, solving the problem of high cholesterol.
2. Tykveol. Based on the name, it is not difficult to guess that the drug is synthesized based on pumpkin extract. Tykveol is relatively cheap (compared to traditional cholesterol-lowering drugs), but in many cases it is effective.

   The therapeutic effect of such tablets is provided by biologically active substances contained in pumpkin in significant quantities. The drug should be taken exclusively under the supervision of a specialist, in order to avoid the implementation of its undesirable properties.

Of course, garlic has many beneficial properties, including the ability to reduce blood cholesterol levels.

However, a product consumed fresh orally will definitely be many times more effective than the same composition in tablet form. Another noteworthy fact is that there is not a single reliable review on the Internet about the effectiveness of garlic tablets. Only advertising texts were found, most of which were written as if they were carbon copies.

In any case, even the best, proven medications should be taken exclusively as prescribed by a doctor. You also need to undergo treatment under the supervision of a specialist.

In conclusion

If you are worried about high cholesterol, the pill may solve your problem. Of course, you will have to make an effort, because to achieve the desired effect you will need to strictly adhere to all the doctor’s recommendations, but the result is definitely worth it.

Patients often ask which of the drugs offered to them are the most effective. It is impossible to answer this question unequivocally, because what is good for one patient may be contraindicated for another, etc.

We can highlight only those drugs that are currently the most popular and are most often prescribed by doctors.

1. Atorvastatin.
2. Rosuvastatin.
3. Fenofibrate.

In some cases, drugs are combined and prescribed in combination with vitamins, which may include nicotinic acid. Good results are guaranteed by the doctor’s control over the course of treatment

Why is this so important? Indeed, at a certain stage (and possibly immediately) unwanted side reactions may occur. It is important to identify them in a timely manner and make appropriate adjustments to the treatment plan.

What should the patient be wary of?

Among the alarming symptoms:

• any manifestations of allergies (rashes, redness, etc.);
• increased body temperature;
• nausea, vomiting;
• stool disorders;
• headache;
• dizziness, tinnitus.

All of the adverse reactions described above are general symptoms of illness that will indicate that the cholesterol-lowering drug is not suitable for you. However, in the vast majority of cases, patients tolerate treatment well and complete the course completely, without unexpected interruptions.

DO YOU STILL THINK THAT IT IS IMPOSSIBLE TO RECOVER COMPLETELY?

Flaws

If we talk about the disadvantages of statins, then first of all it is worth mentioning the possible negative effects that statins have on the body of a person taking the drugs. At the same time, the effect of the drug occurs on absolutely all systems and organs, so it is difficult to predict where exactly cholesterol-lowering drugs will show their negative effect.

Side effects of statins include:

• a negative effect on the musculoskeletal and muscular systems, which manifests itself in the form of arthralgia, muscle hypertonicity, pain in the back, joints, exacerbation of arthritis, myalgia. Rarely, drugs from the statin group can provoke myopathy and rhabdomyolysis, at the first sign of which the drug is immediately discontinued;
• influence on the digestive system, in which the organs of the gastrointestinal tract respond with constipation, dyspepsia, gastritis. Nausea occurs, sometimes accompanied by vomiting. And an increase in liver enzymes (transaminases) is also recorded, but this phenomenon is reversible and when the dosage is reduced, the functioning of the organ returns to normal;
• respiratory disorders, manifested in the form of pharyngitis, rhinitis, sinusitis or exacerbation of other chronic pathologies, and sometimes bronchial asthma, pneumonia, and dyspnea develop;
• the negative impact on the central nervous system is manifested in dizziness, insomnia, the development of depression, neuralgia, an increase in general anxiety due to which some people develop panic attacks;
• the cardiovascular system can also be affected by statins, since angina pectoris, hypertension, tachycardia, and vasodilation have been reported as side effects;
• reactions from the immune system are predominantly expressed in the form of angioedema, rash or itching on the skin, and urticaria.

To avoid side effects, it is important to take statins strictly in the prescribed dosage.

Extremely rare, but still recorded among the side effects were diabetes mellitus, anemia, periodontal abscess, rarely - jaundice and even hepatitis. The relative disadvantages of the drug are that it is not adapted for pregnant women and nursing mothers, and there is also a need for constant monitoring of elderly patients taking statins.

Speaking about the disadvantages of cholesterol-lowering pills, it is worth mentioning the cost of medications. Due to the fact that many patients have to take statins for the rest of their lives, patients rightly pay attention to the price of the drugs. After all, stability in taking a drug should not depend on the patient’s ability to purchase this or that drug.

Since most of the statins are foreign-made, the high cost of drugs can be attributed to the disadvantages of the drugs. Russian companies are mastering the production of statins, and certain drugs have been available on the pharmaceutical market for a long time, so it is expected that this issue will be resolved and prices for statins will be reduced to make them more accessible to the general population.