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How Your Doctor Picks the Triglyceride Med for You

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WebMD Feature

Sometimes diet and exercise alone can’t protect you from the risks of high triglycerides. To lower them, your body needs an extra nudge in the form of medicine.

Your doctor will likely prescribe meds if you have: 

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  • Very high triglycerides -- over 500 mg/dL
  • Both high triglycerides and high "bad" LDL cholesterol levels 

Your doctor will consider many factors when choosing the right medicine for you. For instance, are you taking other meds? What is your overall health?  

Your doctor will consider these main types of triglycerides meds:

  • Fibrates
  • Niaspan
  • Prescription-strength omega-3 fatty acids

Fibrates

In addition to lowering triglycerides, most fibrates also lower cholesterol as well as ApoB, a protein found in LDL "bad" cholesterol.

Medicine names:

  • Atromid-S (clofibrate)
  • Lipofen and Tricor (fenofibrate)
  • Fibricor and Trilipix (fenofibric acid)
  • Gemcor and Lopid (gemfibrozil)

You should not take fibrates if you have liver, kidney, or gallbladder disease.

Medicines that can interact: Before taking fibrates, be sure to tell your doctor about other supplements and meds you take, especially:

  • Blood thinners (anticoagulants) such as Coumadin (warfarin)
  • Oral diabetes medicines
  • Cholesterol-lowering meds including Lipitor (atorvastatin), Prandin (repaglinide), or Zocor (simvastatin)
  • Insulin

 

Niacin

This class of medicine reduces triglycerides and also improves cholesterol levels. Niacin lowers the amount of LDL cholesterol as well as ApoB. Plus, it increases the amount of HDL "good" cholesterol.

Medicine name: Niaspan (niacin)

You should not take niacin if you have:

  • An allergy to aspirin, niacin, or tartrazine (a yellow dye in some medicines and processed foods)
  • Any bleeding problems
  • Diabetes
  • Gallbladder disease
  • Heart disease
  • Liver problems or jaundice
  • A stomach ulcer
  • Plan to have any type of surgery, including dental procedures

Medicines that can interact: Before you take niacin, be sure to tell your doctor if you:

  • Take supplements or meds such as blood thinners (anticoagulants), which includes Coumadin (warfarin).
  • Take insulin or oral diabetes meds (Niacin can increase blood sugar levels, so your doctor may need to change your dose.)
  • Drink large amounts of alcohol

Prescription-Strength Omega-3 Fatty Acids

This class of medicines lower levels of triglycerides and may increase HDL "good" cholesterol.

Medicine names:

  • Epanova (omega-3-carboxylic acids)
  • Lovaza (omega-3-acid ethyl esters)
  • Vascepa (icosapent ethyl)

You should not take prescription omega-3s if you:

  • Are allergic to fish or shellfish
  • Drink more than two glasses of alcohol each day
  • Have diabetes, liver, pancreatic, or thyroid disease

Medicines that could interact: Tell your doctor if you take meds such as:

  • Aspirin or aspirin-containing medicines
  • Blood thinners (anticoagulants) such as Coumadin (warfarin) or Plavix (clopidogrel)
  • Birth control that contains estrogen
  • Estrogen replacement therapy
  • Certain high blood pressure or heart medicines, such as beta-blockers or diuretics

When You Also Have High Cholesterol

High triglycerides and high cholesterol often go hand in hand. If you have both conditions, your doctor might also want you to take a cholesterol-lowering medicine. These meds can slightly lower triglycerides, too. There are three main groups:

  • Cholesterol absorption inhibitors: Zetia (ezetimibe)
  • Statins: Such as Crestor (rosuvastatin), Lipitor (atorvastatin), and Zocor (simvastatin)
  • Statin combination drugs: Such as Advicor (niacin extended-release and lovastatin) and Simcor (niacin extended-release and simvastatin)

Is This Normal? Get the Facts Fast!

Is Your Cholesterol Level Heart Healthy?
What is your LDL (low-density lipoprotein) level?

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or
Answer:
Desirable
0-199
Borderline
200-239
High
240+

Your level is currently

Congratulations! Your total cholesterol level is in the Desirable range, and your level of "bad" LDL cholesterol is optimal.

Congratulations! Your total cholesterol level is in the Desirable range, and your level of "bad" LDL cholesterol is near optimal.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is borderline high. If your LDL goes higher, your total cholesterol level could become Borderline High. Consider reducing the amount of foods you eat with saturated fats and increasing physical activity. If you get more exercise, your level of "good" HDL cholesterol may increase, which could also help to keep your levels of LDL and total cholesterol in check.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL. The HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is Very High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL because the HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is Borderline High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. But your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol is High, but your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol is High, but your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is Borderline High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe medication, such as statins. Following medication, dietary, and exercise instructions should result in improvements.

Your total cholesterol level is High, and your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe statins or other cholesterol-lowering medications.

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