If, after incorporating the aforementioned dietary modifications, exercise routine and other lifestyle changes, you’re triglyceride levels remain elevated, you may wish to discuss medication with your doctor. Don’t take this step lightly, however. You need to give a determined effort to change your habits over time. That is always the preferred option.

If you do need more help than can be provided by a diet and lifestyle change, the most commonly prescribed group of drugs are HMG-CoA (3-hydroxy-3-methylglutaryl coenzyme A) reductase inhibitors, commonly known as Statins. The most common brand names of statins in the United States are Lescol, Lipitor, Mevacor, Pravachol, and Zocor. Statins are generally free of adverse effects. However, some people have reported skin rash, gastrointestinal upset, sleep disturbance and headaches. It is important to know that grapefruit juice should be off limits when taking statins. A chemical in grapefruit juice deactivates a liver enzyme that is important in breaking down statins; and this leads to excessively high levels of the drug in the bloodstream, causing statin toxicity symptoms such as extreme tiredness, muscle aches and possibly heart malfunctioning. You should also avoid alcohol when taking a statin drug.

Another group of triglyceride lowering drugs are known as Fibrates. Fibrates have been around since the early 1960’s and the most common ones used today are bezafibrate, gemfibrozil and fenofibrate. The most widely used brand name in the United States is Lopid (Gemfibrozil). The drug acts by several mechanisms, the principal effect being to reduce VLDL (very low density lipoproteins) in the blood. These structures are composed predominantly of triglycerides. There are a few side effects associated with fibrates, though these are considered minor and temporary. They include gastrointestinal discomfort, increased likelihood of developing cholesterol gallstones, nausea, headaches, skin rash, muscle aches and liver problems.

Diabetics with high triglyceride levels are likely to be treated with fibrates. It is possible for a person to be treated with statins and fibrates at the same time. This, of course, increases the likelihood of adverse side effects.

A third group of triglyceride reducing drugs are known as nicotinic acid derivatives. They are derived from nicotinic acid, commonly called niacin (vitamin B3) and work in the liver to lower levels of both cholesterol and triglycerides. Some commonly used brand names are Niacor, Niaspan, Nicolar, Nicotinex Elixir, Slo-Niacin. Since Niacin is also a vitamin some of these medications are available without a prescription. Although effective in bringing down triglyceride levels, nicotinic acid derivatives do exhibit a major side effect ; a flushing sensation, which typically occurs on the face, neck, chest, and back, and is characterized by redness, tingling, or itching. In most cases, flushing lasts for one hour, approximately two to four hours after taking the dose. To minimize flushing, you should avoid alcohol, hot drinks, and spicy foods. Other side effects include edema, asthenia, chills , atrial fibrillation and other cardiac arrhythmias, tachycardia, palpitations, orthostasis, syncope ,hypotension ,toxic amblyopia, cystoid macular edema , activation of peptic ulcers and peptic ulceration , jaundice , gout , myalgia , dizziness, insomnia , hyper-pigmentation, acanthosis nigricans, maculopapular rash, urticara, dry skin , sweating and migraine.

Nicotinic acid derivatives should not be taken by those who have active liver disease, peptic ulcers or arterial bleeding.