Dyslipidemia: Abnormal Lipid Levels

What is Dyslipidemia?

Dyslipidemia is a medical condition that’s characterized by excessively high or low cholesterol or lipid (fatty acids) levels in your blood. Lipoproteins carry cholesterol since cholesterol cannot be dissolved in your blood.

The 3 major types of lipoproteins include the following:

Low-density lipoprotein (LDL)

• LDL, otherwise referred to as the “bad cholesterol,” causes the buildup of plaque formation in your blood vessels.
• A heart attack could result from too much plaque in your heart's arteries.

High-density lipoprotein (HDL)

• HDL is otherwise referred to as the “good cholesterol” due to its ability to remove LDL from your blood.

Triglycerides (TG)

• TG is produced from the calories you consume, but you don’t immediately burn off.
• TG is also stored in your fat cells and is released as energy when required.
• High levels of TG in your blood may lead to pancreatitis (inflamed pancreas).

High levels of LDL and/or TG, or low levels of HDL, may increase your risk of developing atherosclerosis (a medical condition involving the formation of fats or cholesterol in your artery walls) diseases, such as peripheral artery disease (PAD).

What are the signs and symptoms of dyslipidemia?

• Dizziness
• Nausea
• Swelling in your ankles and/or feet
• Difficulty breathing
• Increased heart rate
• Chest pain and/or tightness
• Fatigue
• Heartburn

What are the different classifications of dyslipidemia?

Dyslipidemia, or abnormally high or low levels of lipids, can occur when you have high levels of LDL and TG and/or low levels of HDL in your blood.

This condition can be inherited and is classified as primary or familial. However, the majority of individuals who have dyslipidemia get it from a bad diet, an unhealthy lifestyle, drugs, or other factors.

Primary, also referred to as familial

Genetic abnormalities known as familial hypercholesterolemias (FH) cause high cholesterol increases and an elevated risk of prematurely developing atherosclerotic cardiovascular disease (plaque buildup in the walls of your arteries).

Secondary, also referred to as acquired

Lifestyle choices, such as diet, and/or certain medical conditions that affect blood lipid levels over time may result in secondary dyslipidemia.

• Hypothyroidism
• Diabetes
• Obesity
• Cushing’s syndrome
• Excessive alcohol consumption
• Chronic kidney disease
• Inflammatory bowel disease (IBS)

When dyslipidemia is brought on by an individual’s diet and lifestyle, it can be treated with medicine, better-eating habits, and frequent exercise.

Which medications are used to treat dyslipidemia?

Statins (HMG-CoA reductase inhibitors)

Statins are a drug class of medications most frequently prescribed to treat dyslipidemia. This drug class lowers your LDL levels by preventing your liver from producing cholesterol.

• Atorvastatin (brand: Lipitor): 10–80 mg daily
• Rosuvastatin (Crestor): 5–40 mg daily
• Simvastatin (Zocor): 10–40 mg daily in the evening
• Fluvastatin (Lescol XL (extended-release)): 20–80 mg taken in the evening
• Pitavastatin (Livalo, Zypitamag): 1–4 mg daily
• Pravastatin (Pravachol): 10–80 mg daily

Compare the different statins.

Common side effects:

• Muscle pain and/or weakness
• Joint pain
• Diarrhea
• Cognitive impairment

If statins are unable to reduce LDL and TG levels, your healthcare provider may suggest other medications, such as:

Cholesterol absorption inhibitors

• Ezetimibe (Zetia): 10 mg daily

  This medication works by inhibiting the absorption of cholesterol in your small intestine.

Common side effects:

• Muscle pain
• Joint pain
• Diarrhea
• Urinary tract infections
• Cold symptoms, including stuffy nose, sneezing, and/or sore throat

Bile acid sequestrants/bile acid-binding resins

This drug class of medications is used to lower high levels of cholesterol in your blood, particularly LDL levels.

• Cholestyramine (Prevalite, Questran): 4 grams daily or twice a day
• Colesevelam (Welchol): 3.75 grams daily or in divided doses with a meal and liquid
  This medication can be considered an option for pregnant women.

Common side effects:

• Constipation
• Stomach pain
• Cramping
• Bloating
• Gas
• Nausea

Fibrates

This drug class of medications works by lowering TG and cholesterol levels. An increased risk of atherosclerosis (clogged arteries) is linked to high blood levels of certain kinds of fat.

Fenofibrate, Fenofibric acid (Antara, Tricor, Trillipix)

• Antara (micronized capsule): 30-90 mg daily
• Tricor: 48-145 mg daily
• Trillipix: 45-135 mg daily

Gemfibrozil (Lopid): 600 mg twice a day, taken 30 minutes before breakfast and dinner

Common side effects:

• Myopathy (muscle disease)
• Dyspepsia (indigestion)
• Runny nose and/or sneezing
• Stomach pain
• Urinary tract infection

Niacin

This drug class of medications is used to decrease LDL levels and increase HDL levels in your blood.

• Immediate-release niacin (Niacor): 250 mg with evening meal
• Extended-release niacin (Niaspan): 500 mg taken every night for approximately 4 weeks
• Sustained-release niacin (Slo-niacin): (Over-the-counter medication) 250–750 mg daily

Common side effects:

• Flushing, including redness, warmth, and/or a tingling sensation
• Itching
• Skin discoloration
• Nausea
• Vomiting
• Diarrhea
• Gout
• Headache
• Cough

Speak With Your Doctor

Dyslipidemia can be controlled with the use of statins or fibrates, a healthy lifestyle, and other factors. Speak with your doctor today about which treatment plan is best suited for you, and send your prescription to Marley Drug. Save up to 95% compared to your local pharmacy by using Marley Drug.