Drugs to lower blood cholesterol: a list of drugs in tablet form and which ones are better depending on the form of hypercholesterolemia

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.

For what indicators are tablets prescribed?

Drugs will be prescribed to patients if the expected benefit from their use significantly outweighs the harm. Lipid-lowering drugs are indicated for use in the following cases:

1. Cholesterol deposits on the walls of blood vessels when there is excess cholesterol in the blood.

   The blood cholesterol level is more than 8 mmol/l. Moreover, this figure should remain stable. A one-time jump in cholesterol will not be a reason to prescribe medications. They have side effects and are used only in extreme cases - to save the lives of patients.

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2. The patient has recently experienced a myocardial infarction or stroke. Then the pills will be prescribed even if there is a slight increase in cholesterol in the blood. There is a high risk of developing complications for a weakened heart and brain.
3. There is a period of rehabilitation after vascular surgery: bypass surgery, angioplasty. The drugs are prescribed for prevention.
4. Atherosclerosis was diagnosed.
5. Increased c-reactive protein in the blood.

A doctor may prescribe medications for people with mildly elevated cholesterol, if calcium levels in the blood are also elevated, or if calcification of blood vessels is diagnosed.

In this case, any plaque is instantly saturated with calcium and quickly increases in size. Atherosclerosis develops rapidly; emergency measures are needed to stop the growth of cholesterol.

With minimal side effects

The main goal of synthesizing new drugs is to reduce the number of side effects while maintaining the high effectiveness of the drug. Therefore, new generation cholesterol pills - inhibitors of cholesterol absorption in the intestines (Ezetrol) - are considered the safest lipid-lowering drugs. This is not to say that these medications do not have side effects - they do exist, and their list is quite large. But according to the instructions for use, these undesirable manifestations are observed in the categories “infrequently” and “rarely,” which speaks in favor of safety.

Despite the minimum side effects, before using all drugs, consultation with a specialist is necessary. A modern view of high cholesterol.

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.

Which ones are better to drink?

What to choose from the list of such controversial medications, which ones are better to drink?
Statins and fibrates are scary because of their effects on the liver and skeletal muscles; the newest drugs are too expensive. Doctors still recommend starting with careful and controlled use of statins, and if they turn out to be effective and well tolerated, you can complete the full course of treatment. If statins or fibrates are not suitable, there are other tablets from the group of cholesterol absorption inhibitors or combination drugs based on them.
Sometimes you can hear that the bioactive supplement (dietary supplement) Energy can be used as cholesterol pills. But according to the instructions for use, products with the trade name Energy are vitamin-mineral complexes intended for people deficient in certain microelements and vitamins. The annotation does not say that Energy is an anti-cholesterol pill. The drug is not a medicine at all, nor even a metabolic stimulant, so it is not advisable to give it the role of a lipid-lowering agent.

Patients probably confuse Energy with a combined lipid-lowering drug produced in Italy or Singapore by Imeji based on simvastatin and ezetimibe (a statin and a cholesterol absorption inhibitor). This is a really good medicine for hypercholesterolemia.

It is necessary to say something about Alisat pills (or simply “Garlic”), which many consider cholesterol pills. This dietary supplement is intended to replenish the body's deficiency of allicin, an organic substance with antifungal and bactericidal properties.

If you really want to be treated not with cholesterol pills, but with dietary supplements, you can pay attention to Aterolex capsules, which help improve lipid metabolism, after coordinating their use with your doctor.

Fibrates as an addition or replacement to statins

These drugs are less effective compared to stanines. Prescribed for mild to moderate atherosclerosis or in combination with statins, as they enhance their effect. According to their chemical structure, they are derivatives of fibric acid. The drugs within the group differ in the structure of the molecules of the active substance, but the effect is absolutely identical.

Operating principle and effectiveness

Fibrates are activators of lipoprotein lipase. This is a substance that breaks down “bad” cholesterol in the blood (free and as part of cholesterol plaques). As a result, the level of “good” cholesterol increases, and the fat balance is normalized.

Medicines generally affect metabolism, normalizing not only lipid but also carbohydrate balance. It also affects blood cholesterol levels.

These drugs were noted to be well tolerated. The side effects stated in the instructions occur only in 10% of cases.

The best fibrate drugs and their cost

1. "Fenofibrate". A complex action drug, the most effective of fibrates. In parallel with the lipid-lowering agent, it functions as an antioxidant, anti-inflammatory and tonic. Available in 200 mg capsules. The price of one package is 1000 rubles. The medicine is prescribed for a long course, the capsule is taken once a day between meals.

2. "Bezafibrate." The substance affects not only the level of cholesterol in the blood, but also the level of glucose. Effectively reduces both indicators. The medicine is indicated for people with a combination of atherosclerosis and diabetes. Available in 200 mg tablets, it is recommended to take 1 tablet 2-3 times a day after meals. The price in pharmacies is about 800 rubles.

List of names of the best drugs

When a person is trying to find a list of the names of very good drugs, he should go not to the pharmacy, but to the clinic and first make sure that he really needs cholesterol pills.

If there are any obstacles (contraindications) to the use of cholesterol pills, lipid-lowering therapy may result in complications that are difficult to treat. This should not be forgotten.

The best medications are usually those developed taking into account all the shortcomings of previous drugs that have appeared in clinical practice. We are talking about the latest medications of the so-called latest generations, they are among statins, and in the group of fibrates, and other drugs. Of course, the price of these drugs is much higher than the cost of “ordinary” cholesterol pills. We present a list of the best (expensive) lipid-lowering drugs in the table.

Bile acid sequestrants

Sequestrants are not independent drugs. They are always prescribed in combination with other medications for high cholesterol. If the indicator increases slightly, the doctor may prescribe them as the main treatment, but this is rare. If the health condition is satisfactory, the doctor tries to make do with increased physical activity and diet, so as not to overload the body with medications.

Mechanism of action

Bile acids are the main constituent of bile. They are formed from metabolic products of cholesterol and fats. Sequestrants bind these acids and are actively removed from the body. The liver has to synthesize them constantly and in large quantities to make up for the body's deficiencies.

Synthesis is accompanied by active consumption of cholesterol, and the LDL (low-density lipoprotein) fraction. This is the “bad” cholesterol that is part of cholesterol plaques. The drugs gradually reduce the concentration of LDL in the blood and normalize lipid balance.

The main advantage of these drugs is their local effect; they are not absorbed into the systemic circulation and act only in the intestines. Systematic administration of bile acid sequestrants is an effective and reliable prevention of complications on the cardiovascular system: heart attack, stroke, angina.

The local action of sequestrants almost completely eliminates the development of side effects. Occasionally, dyspeptic disorders may occur: flatulence, diarrhea or constipation, lack of appetite.

List of the best drugs

1. "Cholestyramine." The medicine enters the small intestine and forms complexes with bile acids, and also prevents the absorption of cholesterol and food into the bloodstream. The dual mechanism of action makes this drug highly effective. The price of the drug is about 1800 rubles. Available in the form of 4 grams of powder and tablets. The medicine is taken once a day before meals.

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2. "Colestipol". This medication acts in the intestinal lumen. Mainly prevents the absorption of cholesterol from food, according to medical practice, it is less effective compared to Cholestyramine. Release form: powder and tablets. The price of the drug is from 500 rubles. The drug is taken 5 grams per day once.

3. "Kolesevelam." A medicine of a new generation of bile acid sequestrants, more effective compared to other drugs in this group. The only remedy for high cholesterol approved for use by pregnant women. The price of tablets in Russian pharmacies is from 400 rubles. Apply similarly - 1 time per day.

How to lower cholesterol without drugs?

Given the risks and financial costs of treatment, many patients seek a non-drug alternative to lipid-lowering therapy.
And such methods really exist, although they require special diligence, discipline and patience, since these methods will not give quick results. We are talking about eliminating such provoking factors for lipid metabolism disorders as physical inactivity, bad habits and unhealthy diet. The complex of non-medicinal measures should also include the organization of a daily routine with proper rest and minimization of stress.

Diet

By clearing your diet of harmful foods, you can relieve your digestive system of the need to absorb excess fats and saccharides, which will have a positive effect on your lipid profile. And to stabilize blood cholesterol levels, it is necessary to follow a special lipid-lowering diet that helps normalize metabolism.

Why men have high cholesterol levels – read here, and you will find dietary recommendations in this article. Meal plan for women.

Active lifestyle

Insufficient physical activity leads to blood stagnation and deposition of unspent energy reserves in the form of excess fat in the body. They are deposited in almost all vital organs, interfering with their normal functioning and disrupting natural fat metabolism. Changing your lifestyle towards increasing physical activity helps improve blood circulation and normalize all processes, including fat metabolism. This is why it is so important to exercise regularly - daily morning exercises, running, walking, swimming several times a week, regular warm-ups during work (especially if it is sedentary).

Nicotinic acid in tablet form is a good and cheap remedy for cholesterol

Nicotinic acid is taken in tablet form as a cholesterol medicine. This is an inexpensive and effective method. Its lipid-lowering effect was discovered relatively recently; it manifests itself only when taking the drug in a large dose, many times higher than the daily requirement for the vitamin.

Tablets are available in dosages of 50 and 100 mg of the active substance, and in order for a pronounced therapeutic effect to appear, up to 5 g of nicotinic acid must be taken per day.

The human body cannot immediately accept such a large dosage, all the side effects will appear, a severe form of allergy may develop, so the patient gets used to it gradually - from small doses.

The dosage is increased over one to two months until the patient fully adapts. Next, the therapeutic effect of nicotinic acid begins to increase; it manifests itself gradually, since it reduces cholesterol in the blood indirectly.

The main effect of the medicine is to dilate blood vessels. It lowers blood pressure and improves blood circulation, which slows down significantly with atherosclerosis. To a mild extent, the drug also affects “bad” cholesterol, reduces its level, and promotes accelerated elimination from the body.

Nicotinic acid is suitable for people whose cholesterol levels are not critically elevated. Then it makes sense to start using nicotinic acid regularly, gradually increase the dose and wait for the effect of taking the pills.

Review Reviews

It is interesting to hear reviews from patients about the different active ingredients of lipid-lowering drugs, allowing us to understand which of them are better tolerated and which are more effective.

As patient assessments show, most of them are treated with statins prescribed to them in the clinic. Of this group of drugs, cholesterol tablets based on atorvastatin and rosuvastatin received positive reviews. By the way, rosuvastatin is called the best, since most patients did not experience any adverse reactions while taking it.

Among fibrates, Traykor received positive reviews.

Ezetrol is called the best cholesterol pill, but both doctors and patients o.

Inhibitors of cholesterol absorption in the intestine

The action of these drugs is also associated with the circulation of bile acids in the body, but they act somewhat differently than sequestrants. These substances prevent the reuptake of bile by the liver, which creates a deficiency of bile acids in the body. Then a similar effect develops - a large amount of cholesterol is spent on the synthesis of new portions.

The secondary mechanism is an obstacle to the absorption of cholesterol and food along with excess bile. The dual action makes these medications highly effective and safe, since they do not enter the systemic bloodstream.

Among the cholesterol absorption inhibitors are the drugs Ezetimibe, Lipobon and Ezetrol. These are the same active ingredient, but different manufacturing companies. Medicines reduce the absorption of lipids with bile and are used as part of complex therapy for atherosclerosis (together with statins).

Functions of cholesterol in the blood and in the body

Obviously, cholesterol, like any useful substance in our blood, must be contained in a certain amount, called the norm. A significant excess of cholesterol levels in the blood is called hyperlipidemia, and drugs that lower cholesterol are, accordingly, hypolipidemic.

Hypocholesterol drugs (to lower cholesterol) are relevant in the case of a fat metabolism disorder, in which cholesterol, due to its high content in the blood, is more intensively infiltrated into the vascular wall. This creates the preconditions for complications in the form of severe vascular and cardiac pathologies.

Despite the fact that these atherosclerosis, hypertension, coronary artery disease and strokes can develop even with normal cholesterol levels, it has been proven that its increase, which persists for a long time, increases the risk of vascular accidents.

The main functions of cholesterol:

1. It acts as the main building material of cell membranes (shells), ensuring their strength and elasticity.
2. On its basis, the body produces vitamins of group D, and the liver synthesizes bile acids necessary for the digestive process.
3. It is the first link in the chain of biosynthesis of steroids and sex hormones.
4. With its participation, cell permeability is regulated, allowing it to protect erythrocytes (red blood cells) from hemolytic toxins.

In addition, cholesterol performs a transport function, moving fats to peripheral tissues as part of fat-protein compounds - low and very low density lipoproteins (LDL and VLDL). The opposite group - high-density lipoproteins - transports cholesterol from the periphery to the liver, from where it is evacuated from the body with bile.

Structure of lipoproids

Dietary supplements and vitamin complexes

Among dietary supplements, herbal preparations like “Atheroclephyte” are especially popular. The product contains a large number of medicinal herbs (extracts) that improve metabolism, the functioning of the gastrointestinal tract and liver. The active functioning of digestive processes in the body normalizes metabolism and stabilizes lipid balance.

Another group of popular dietary supplements are products containing omega-3 fatty acids. These substances dissolve cholesterol plaques and normalize hormonal balance naturally.

These dietary supplements include the following:

• flaxseed oil in capsules and liquid form;
• omega-3 in its pure form;
• fish oil (liquid and capsules);
• "CardioActive Omega-3" or "CardioActive Q10".

The required dosage of omega-3 per day to exhibit a therapeutic effect is 2000 mg. Fish oil and flaxseed oil require the use of large volumes, so it is easier and more convenient to purchase omega-3 concentrate in its pure form.

Vitamin complexes are necessary for patients with atherosclerosis to maintain the elasticity of blood vessels (vitamins C and PP), the rheological properties of blood (C and group B), and the health of the heart muscle (microelements potassium and magnesium). The doctor may prescribe these substances separately, or perhaps as part of a complex multivitamin in tablet form.

Fibrates

Another thing worth mentioning is cholesterol-lowering drugs – fibrates. They can significantly increase the level of high-density lipoprotein and lower cholesterol that is harmful to humans. Among fibrates, the following drugs have good reviews from doctors and patients:

1. Lopid. The drug is produced in the form of tablets and capsules. The dose of the active substance in tablets is twice as much as in capsules. The mechanism of action of Lopid is based on the conversion of triglycerides and low-density lipoprotein into high-density lipoproteins.

   Also, under the influence of Lopid, the evacuation of cholesterol from the liver is accelerated and its excretion by bile is activated. The drug is quite fast-acting - it reaches its highest concentration in the gastrointestinal tract within one to two hours after ingestion. It is recommended to take the drug half an hour before meals. More than half is excreted by the kidneys, and a small part is excreted in feces.

2. Tricor. A number of medical companies present it under the name Traikor. This drug is available in tablet form of 145 mg - the optimal therapeutic dose of the active substance. You need to take one tablet per day. Studies have found that in forty percent of cases the drug leads to a persistent slowdown in the progression of atherosclerosis, and also significantly solves this problem in people with type 2 diabetes. At the same time, studies note the positive effect of Trikor on those fractions of lipoproteins that are not affected by statins.
3. Atromid. A remedy for high cholesterol, which significantly lowers triglyceride levels and also enhances fibrinolytic blood parameters. Atromid reduces the tendency of blood to form blood clots and enhances the effect of anticoagulants. The drug is especially indicated for those patients who suffer from vascular pathologies, cerebrovascular accidents, and a tendency to form blood clots. It is necessary to take Atromid strictly according to the doctor’s indications, since the dose is calculated individually depending on the patient’s body weight.

Unfortunately, fibrates may not be suitable for all patients due to their side effects. In particular, among the negative effects of fibrates, one can note problems with the liver, weakened potency, arrhythmia, nausea and abdominal pain. It is noted that Atromid is a drug that increases appetite, so it is not recommended for people with excess body weight.

Where to buy lipid-lowering drugs?

To buy medicines without leaving home, we recommend that you familiarize yourself with the largest trusted online pharmacies:

1. https://apteka.ru - approximate prices for medications: “Atorvastatin” - from 300 rubles, “Fenofibrate” - from 459 rubles, “Rosuvastatin” - from 468 rubles.
2. https://wer.ru – prices: “Atorvastatin” - from 141 rubles, “Fenofibrate” - from 464 rubles, “Rosuvastatin” - from 321 rubles.

In Moscow

Lipid-lowering drugs can also be purchased at regular pharmacies. In the networks presented below, tablets are always in stock.

1. "Rigla", metro Paveletskaya, emb. Derbenevskaya, building 22. Phone: 8-800-777-03-03.
2. "EAPteka", metro Avtozavodskaya, st. Masterkova, 3. Phone: 8-800-775-03-33.

In St. Petersburg

1. "Rigla", metro station Kupchino, st. Balkanskaya, 17. Phone: 8-800-777-03-03.
2. "Ozerki", metro station Begovaya, st. Turistskaya, 10. Phone: 8-812-603-00-00.