How Your Doctor Picks the Triglyceride Med for You

From the WebMD Archives

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:

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:

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:

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:

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.

Continued

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:

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:

What You Need From Follow-up Visits

After you get your prescription, you'll probably see your doctor every six weeks until your triglyceride levels drop. Use these check-ins to talk about any side effects you find bothersome.

Tell your doctor if you get pregnant, are considering pregnancy, or are breastfeeding. If you are, you may need to switch medicines or stop taking certain ones.

Based on how your levels are improving, your doctor may change the dose of your meds. If you're taking fibrates or niacin, your doctor may use these follow-up visits to take blood to check your liver and kidneys.

Once you reach your goal level, you'll see your doctor every 6 to 12 months. At these follow-up visits, they’ll take blood to make sure your triglycerides are still under control. Keep these appointments -- they’re a key part of lowering your risk of heart attack and stroke.

WebMD Feature Reviewed by Brunilda Nazario, MD on November 12, 2012

Sources

SOURCES:

Robert Bonow, MD, past president, American Heart Association; professor of Medicine, Northwestern University.

Michael Miller, MD, director, Center for Preventive Cardiology, University of Maryland Medical Center.

Jellinger, P. Endocrine Practice, March/April 2012.

American Heart Association: "Triglycerides: Frequently Asked Questions."

Tracy Stevens, MD, Saint Luke’s Mid America Heart Institute, Kansas City, Mo.

Mann, D. Cardiovascular Drugs and Therapy, August 2007.

Miller, M. Circulation, April 18, 2011.

AstraZeneca.

© 2012 WebMD, LLC. All rights reserved.

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