Blood Cholesterol: How Much Reduction is Beneficial? Conventional normal value may be too high for Indian cases because various studies have shown that we are genetically more prone to heart disease (and are likely to have more complications at young age!) and tolerate cholesterol levels poorly. Hence, lower values are recommended. Obviously aggressive reduction of blood cholesterol reduces chances of atherosclerosis.
Ezetimide (Ezetip, Lipezet 10 mg tab)
This drug prevents absorption of cholesterol from small bowel. It reduces LDL-cholesterol levels and further reduces LDL-C by 25% and triglycerides by 14%. It is well tolerated but occasional abdominal pain, diarrhoea, joint pains, headache, dizziness may be there. Its usual dose is 10 mg once a day regardless of meals. It can be combined with statins.
Nicotinic acid (Nialip 500 mg tab)
It is Vitamin B3 (Niacin or nicotinamide) derivative and reduces tryglycerides and VLDL-C (2050%) rapidly and followed by LDL-C (15-25%) subsequently. It is the most effective drug to raise good cholesterol (HDL-C) by 15-30%. It acts on liver and prevents formation of triglycerides. Starting dose is 100 mg thrice a day with meals and gradually increased to 2 g to 6 g per day.
Adverse Effects: It is a poorly tolerated drug. It causes dyspepsia, flushing, itching and sensation of heat (skin blood vessels widen). It also causes diarrhoea, darkening of skin, worsening of diabetes, joint pains in gout and irregular heart beats. It is never given in pregnancy. 'It increases fall in BP due to drugs used for the treatment of high blood pressure.
Other Drugs
Guggulipid (GUGLIP 25 mg tab) is a plant derivative (gum guggul) which lowers lipids modestly. It may cause loose motions.
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