If, after incorporating the
aforementioned dietary modifications, exercise routine and other
lifestyle changes, youíre triglyceride levels remain elevated, you
may wish to discuss medication with your doctor. Donít take this
step lightly, however. You need to give a determined effort to change
your habits over time. That is always the preferred option.
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 1960ís 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.
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
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.
derivatives should not be taken by those who have active liver
disease, peptic ulcers or arterial bleeding.