How safe is your cholesterol-lowering drugs?

The 21st century is the age of fast foods and unhealthy dietary habits. The nutrition and the nourishment that people get nowadays due to their poor eating habits is far less than the recommended levels or what people used to get earlier before the introduction of these fast foods into the markets. Binge-eating and fast food addictions have given rise to a host of serious health disorders like obesity, diabetes, cardiovascular problems etc. One of the main culprits behind the fatal ailments caused as a result of unhealthy diets are abnormally high cholesterol levels. Cholesterol is a compound which is found naturally in our body tissues and if they are present in excessive amounts in our blood, then they can lead to various ailments of our arteries. Because of the serious health issues caused by high levels of blood cholesterol, patients are taking recourse to certain cholesterol lowering drugs. What we are going to discuss in this article is whether these drugs are safe enough to be recommended for regular use. In order to do that, first let us know more about the different types of these drugs.

What are these cholesterol-lowering drugs?

The major causes of high cholesterol are diets containing high amounts of fats, obesity, lack of physical activities or exercise, smoking and alcohol addiction, certain hereditary or genetic factors and specific medications and ailments. The major risks of high cholesterol levels are diseases like atherosclerosis caused due to hardened arteries as a result of the accumulation of excess cholesterol in them and this leads to health problems like high blood pressure levels , fatal strokes or heart attacks, blood clots etc. Some of the drugs which are usually prescribed for the treatment of high cholesterol levels are:

1.statins,
2.PCSK9 inhibitors
3.bile acid sequestrants,
4.cholesterol absorption inhibitors,
5.nicotinic acid agents and
6.fibrates etc.

 Taking cholesterol-lowering drugs? Here's what you must be aware of:

Generally for patients suffering from high cholesterol levels, the main advice of medical experts is to make certain changes in their lifestyles to alleviate the problem such as following a regular and healthy diet and exercise routine, totally avoiding tobacco and alcohol consumption and maintaining a healthy waistline. But even if these lifestyle modifications are not entirely successful in lowering their cholesterol levels, then certain cholesterol-lowering drugs are usually administered to the patients after a period of roughly three months and for patients suffering from or prone to heart problems, these drugs are prescribed in addition to the lifestyle changes right away without even waiting for three months for the lifestyle improvements to work. But even if one of these drugs are prescribed, the patients must adhere to all the lifestyle changes and especially take care to avoid foods containing high amounts of cholesterol in order to mitigate their risks of developing high cholesterol levels and consequently heart disorders, diabetes and other serious medical conditions. If all the measures are followed properly, then the quantity of drugs needed might be reduced and the medicines will also work better, thus lessening the patient's risk of developing these health problems. But these drugs have certain unwanted side effects which everyone must be aware of before thinking of using them. So, the nature of each of these drugs and their respective side effects are discussed below which will help us in making the correct decisions with respect to the treatment of high cholesterol levels:

1. Statins: Like atorvastatin, fluvastatin, lovastatin, pravastatin, simvastatin, and rosuvastatin, inhibit the enzyme HMG-CoA reductase, regulating cholesterol levels. They efficiently reduce "bad" cholesterol by 20-60%, adding "good" cholesterol and lowering overall cholesterol and triglyceride levels. Effects are typically felt in 4-6 weeks. Statins, available as tablets or capsules, are recommended for children with conditions like familial hypercholesterolemia when accompanied by a balanced diet. Caution is advised for those allergic to statins, pregnant/breastfeeding, liver issues, alcoholics, myopathy history, or renal failure due to rhabdomyolysis. Grape juice reduces statin metabolism; drug interactions can lead to harmful reactions. Consult a physician before combining statins with supplements, immune boosters, or other medications. Uncommon side effects include muscle pain, fatigue, vomiting, stomach issues, and brown urine, requiring immediate discontinuation and consultation. Rhabdomyolysis, though rare, may occur with specific drug combinations, demanding urgent attention. Mild side effects like loose motions, constipation, and abdominal pain usually subside as the body adjusts. Regular liver checks are essential. Rare cases report numbness and tingling, indicative of neuropathy.
2. PCSK9 Inhibitors: Like alirocumab and evolocumab, are man-made drugs injected to lower blood cholesterol levels. Part of the proprotein convertase subtilisin kexin type 9 inhibitors category, they target PCSK9 protein found on liver cells. By deactivating PCSK9, these drugs enhance LDL receptors (LDLRs), promoting the elimination of LDL cholesterol, reducing overall levels. Generally used for adults with conditions like familial hypercholesterolemia and cardiovascular disease, they complement other cholesterol-lowering drugs. Allergic reactions warrant avoidance, but in most cases, they show minimal side effects. Rare instances of severe hypersensitivity reactions may require immediate hospitalization, prompting cessation of drug use. Other less common side effects include injection site reactions, common cold symptoms, stomach issues, muscle pain, spasms, urinary tract infections, and potential liver problems.
3. Bile Acid Sequestrants: Like cholestyramines, colestipols, and colesevelams, mix with bile acids in the intestines, removing them with stools and reducing LDL cholesterol levels by 10-20%. When combined with statins, they can lower LDL cholesterol by over 40%. However, they don't impact triglycerides. Avoid if allergic or have a history of bile obstruction. Not recommended for phenylketonuria patients using aspartame-containing variants. Take with water or fruit juices, 1-3 times daily with meals. Lack of fluids may lead to stomach issues. Side effects include limiting the absorption of medications like coumadins and vitamins A and E. Antacids may render them ineffective, so take at least two hours apart. Long-term use may require vitamin supplements. Consult a medical expert for proper usage guidance. While generally safe, they may cause constipation, bloating, nausea, and gas.
4. Cholesterol Absorption Inhibitors : Like ezetimibe, reduce LDL cholesterol levels by 18-20% by selectively limiting cholesterol absorption. It also mildly lowers triglycerides. Prescribed for those intolerant to statins or in combination with statins, it can triple the cholesterol-lowering effect. Discontinue if allergic reactions occur. Typically taken once daily with or without food, often alongside statins for enhanced efficacy. When taken with bile acid sequestrants, allow a minimum 2-hour gap. Interactions with tricors, lopids, and cyclosporines can increase ezetimibe levels. Side effects include diarrhea, stomach, back, and joint pain, sinusitis, rare hypersensitivity reactions, nausea, pancreatitis, myopathy, and hepatitis. Regular monitoring is essential.
5. Nicotinic Acid Agents: Like niacins, niacors, and slo-niacins, are water-soluble B vitamins that significantly raise lipoprotein levels when prescribed in excess of body requirements. Nicotinic acid reduces overall cholesterol, LDL cholesterol, and triglyceride levels while increasing HDL cholesterol. It lowers LDL by 10-20%, triglycerides by 20-50%, and increases HDL by 15-35%. Nicotinamide, a niacin by-product, doesn't reduce cholesterol and shouldn't substitute nicotinic acid. Avoid if allergic, with liver problems, active peptic ulcers, or arterial bleeding. Start with a slow niacin dosage increase to prevent side effects. Immediate-release niacin, available without prescription, may have dangerous side effects and should not be taken without consulting a doctor. Extended-release niacin is more tolerated but may pose a serious risk to the liver; dosage must not exceed 2 grams daily. Niacin can interact with blood pressure medications, requiring careful monitoring during adjustment. Hot flashes are a common side effect, manageable by taking niacin with meals or aspirin. Other side effects include nausea, diarrhea, gas, vomiting, and peptic ulcers. Potentially serious effects include liver diseases, gout, and elevated blood sugar, requiring caution and monitoring during dosage adjustments, particularly for diabetics.
6. Fibrates: Like lopids and tricors, primarily reduce triglyceride levels and play a minor role in increasing HDL cholesterol. Avoid if allergic, have liver issues, cirrhosis, or serious kidney disease. Best taken with breakfast or evening meal. Combined with statins, there's a higher risk of myopathy or rhabdomyolysis. Fibrates enhance warfarin and oral diabetic medications' effects, requiring frequent monitoring. Cyclosporine users may experience reduced levels, necessitating expert dosage adjustments. Common side effects include loose motions, abdominal pain, diarrhea, headaches, fatigue, nausea, and vomiting. Muscle pain is reported, with rare instances leading to significant muscle damage, particularly when combined with statins. Gallstone formations and gallbladder surgeries have also been linked to fibrate use. Regular monitoring and expert guidance are crucial.

Conclusion:

According to a survey, 27% of Indians have been found to be suffering from high cholesterol levels and 79-80% of them have skewed lipid levels and 72 % have low good cholesterol and high bad cholesterol levels. www.thehansindia.com/posts/index/Life...Indians...high-cholesterol-levels.../109999timesofindia.indiatimes.com › City . Due to this India has the dubious distinction of being the country with the maximum number of heart attacks in males aged over 35 years. indiatoday.intoday.in › Magazine › Special Report. Millions of Indians suffer from this problem but unfortunately awareness about even basic things like blood pressure levels is totally absent among a surprisingly large number of them. Yet another survey reveals that one in every three or 33 % of Indians aged above 30 years suffer from various lifestyle related diseases triggered by causes such as high levels of blood cholesterol.zeenews.india.com › Health Lack of balanced diets, sedentary and stressful lifestyles, sleep disorders etc aggravate these health problems. So, naturally the use of cholesterol-lowering drugs is greatly increasing in India without the proper knowledge and guidelines on how to effectively take them. This is a worrying trend as can be validated by the fact that 30 million Indians have heart attacks every year and the number is constantly rising.www.livemint.com › Leisure › Business of Life. Cardiovascular problems, high blood sugar levels, memory failures etc can occur if patients who cannot tolerate certain cholesterol lowering drugs like statins take them without the necessary guidance and knowledge. First of all before taking these drugs, education and awareness about them is required and necessary steps must be initiated in this direction. Furthermore, regular medical check-ups and consultation of expert medical professionals is indispensable for patients suffering from high cholesterol levels. Following a healthy lifestyle according to the doctor's advice, practicing exercises and yoga regularly to keep fit and relieve stress etc should be made the first priority before taking such drugs. If the health problems still persist, then all medications must be taken under the close monitoring of an expert doctor. Last, but not the least, patients must actively look for alternative methods of treatment such as consuming foods like garlic bulbs which have been known to lower blood cholesterol levels. Other healthy alternatives to these cholesterol-lowering drugs include vegetables like artichokes, flaxseeds, foods rich in omega-3's like salmons, probiotics, yeast extracts, psylliums etc. These natural methods of alternative treatments along with a healthy diet and an active lifestyle can definitely go a long way in lowering our cholesterol levels and saving us from the side effects and the medical expenses that come with the usage of these cholesterol-lowering drugs. Most importantly, never ever forget to take an expert doctor's advice before starting any such medication. So, for those of you who suffer from high cholesterol levels and want to lower it in the safest possible manner without causing any sort of damage to your health, always remember this saying " Half knowledge is dangerous." Caution, proper knowledge and awareness and most importantly timely action and right decision-making are the ways by which you can avoid all your health problems and lead a longer, happier and more prosperous life.