Cholesterol pills review

Review of the best according to the editorial board. On the selection criteria. This material is subjective and does not constitute advertising and does not serve as a purchase guide. Before buying, you need to consult with a specialist.

Many people believe that lowering cholesterol with pills, diet, or recommendations for adhering to a healthy lifestyle is an independent goal: cholesterol should be within specified, normal limits. Cholesterol is really 'good' and 'bad', and 'bad' cholesterol is gradually deposited in the lumen of blood vessels, forming plaques, which cause an increased risk of developing vascular catastrophes – heart attack and stroke.

But taking drugs that lower cholesterol, or lipid-lowering drugs, is primarily indicated not only for maintaining normal cholesterol, but for the so-called secondary prevention in patients with myocardial infarction. First of all, these medicines are needed in order to prevent a second heart attack. There are many reliable clinical studies in which it was revealed on hundreds of thousands of volunteers that long-term use of drugs from the statin group reduces the risk of overall mortality after a previous heart attack by at least 30%. Here we are talking really about long-term use, for 3 or 5 years.

Of course, elevated blood cholesterol, or hypercholesterolemia, is not only a risk factor for heart attack or coronary heart disease. It promotes obesity, high blood pressure, increases the risk of diabetes and pancreatitis.

It is important that only a doctor should prescribe drugs to reduce cholesterol, and standard tactics should be followed. Initially, a patient with an increased risk of heart attack and stroke should follow dietary recommendations, change their lifestyle, give up bad habits, and only if all these measures are ineffective, drug therapy is prescribed.

Achieving your total cholesterol targets is very important. As an example, a healthy person should have a total cholesterol value lower than 6.2 mmol / L. In patients with coronary heart disease, the target level, that is, the concentration of cholesterol in the blood plasma, which must be achieved by prescribing a drug, should be below 5 mmol / L.

It has been reliably proven that long-term use of statins according to indications and the achievement of target values ​​for total cholesterol and its fractions can reduce the risk of heart attacks, strokes, and sudden cardiac death. This rating includes the most modern and effective cholesterol pills. These are lipid-lowering drugs from the group of statins, fibrates and bile acid sequestrants.

Cholesterol pills review

Nomination	a place	Name of product	price
Modern statins to lower cholesterol	1	Rosuvastatin – Crestor (Rosucard, Rosulip, Tevastor)	583 r
	2	Atorvastatin – Liprimar (Tulip, Torvakard, Atoris)	226 r
	3	Fluvastatin – Lescol Forte	RUB 1,750
drugs of other groups to reduce cholesterol	1	Ezetrol (ezetemib)	RUB 1,695
	2	Omakor	RUB 1,546
	3	Lipantil (fenofibrate)	906 r

Modern statins to lower cholesterol

Several generations of statins are now known. And while several classes of drugs lower cholesterol, statins are the leading prescription drug worldwide. They all work in about the same way, they inhibit a special enzyme called 'HMG-CoA reductase'. It works in the liver and is involved in the synthesis of cholesterol. Let's consider first the most modern cholesterol remedy – the last, fourth generation statin.

Rosuvastatin – Crestor (Rosucard, Rosulip, Tevastor)

Popularity rating: 4.9

The drug Crestor is indicated for all patients to achieve target cholesterol values ​​who have a high risk of developing vascular accidents. Such patients include persons with arterial hypertension, diabetes mellitus, ischemic heart disease. There are certain conditions: before taking the drug, the patient must prove that he can modify his diet and follow a diet aimed at lowering cholesterol. It makes no sense to take medications if the patient is not on a diet and consumes a lot of sources of cholesterol from the diet. Therefore, all cholesterol-lowering drugs require diet.

The standard dosage of Crestor is 5 to 10 mg per day, with the initial dose depending on the initial concentration of cholesterol. You can increase the dose only after a month. The maximum daily dose is 40 mg per day. The tablet should not be chewed and can be taken at any time of the day without regard to food intake.

Crestor is produced by the English company Astra Zeneca, and a package with a minimum dosage (5 mg tablet) will cost 1,835 rubles for 28 tablets. This is the minimum cost of a monthly course of the original drug. Given that quite often a gradual increase in dose is required, other figures can be cited as an example. The same package of four times higher dosage, 0.02 g will cost 3925 rubles, it is also designed for one month of admission. There are also cheaper options. So, the packaging of the drug Rosart (Actavis) costs 535 rubles, the same 28 tablets of 5 mg each.

Advantages and disadvantages

The advantage of the drug is its high activity and proven effectiveness. In the elderly, no dose adjustment is required, and usually this fact must be taken into account when prescribing many drugs to the elderly. Also, you can not change the dosage for mild manifestations of renal failure.

Although Crestor has proven to be highly effective in many studies, it has contraindications. This is the simultaneous treatment with cyclosporine, pregnancy and the period of breastfeeding, the presence of various myopathies, and alcohol consumption. Crestor can be used with caution in case of decreased thyroid function, as well as in other severe endocrine disorders and epilepsy. However, with all the shortcomings, Crestor is one of the most effective and modern drugs for reducing the risk of sudden death and vascular accidents.

Atorvastatin – Liprimar (Tulip, Torvakard, Atoris)

Popularity rating: 4.8

Liprimar is a highly effective cholesterol pill, but it belongs not to the fourth, but to the third, previous generation of statins. The active ingredient is atorvastatin. The main difference between the fourth and third generation of statins is that the third generation drugs simply work well and reduce the amount of 'bad' cholesterol, while the fourth generation drugs, such as the Crestor described above, still increase the concentration of 'good' cholesterol in the blood. cholesterol. But Liprimar is a high quality and original drug.

It comes in four dosages: 10, 20, 40 and 80 mg. It is indicated for use with an increased level of 'bad' cholesterol – with hypercholesterolemia of various origins, in the complex prevention of myocardial infarction and coronary heart disease in high-risk patients, with both primary and secondary prevention in mind.

Liprimar is used, like Crestor, once a day, at any time and regardless of meals. The dosage can vary significantly from 10 to 80 mg, with a maximum dosage of 80 mg per day. Most often, treatment begins with a minimum dose of 10 mg per day, the dose is increased gradually and only as directed by a doctor. Liprimar costs less than Crestor. A package of 30 tablets, with a minimum dosage of 10 mg, calculated for a monthly course, can be found in pharmacies from 350 rubles, and the average price is 717 rubles per package. Liprimar is produced by the well-known pharmaceutical company Pfizer.

There are many analogues of Liprimar that are much more affordable at the price, including the domestic atorvastatin. So, exactly the same packaging, only produced by the Irbit Chemical Pharmaceutical Plant, will cost an average of 135 rubles. per package, but if desired, it can be found in pharmacies and at a price even cheaper than 60 rubles.

Advantages and disadvantages

The big plus of Liprimar is its good knowledge and international experience, high efficiency, convenient use once a day, and the ability to flexibly approach dosage changes. However, there are a large number of contraindications, side effects and special conditions, which include numerous interactions of atorvastatin with other drugs. So, Liprimar should not be prescribed with a high level of hepatic enzymes, pregnant and lactating women, persons under 18 years of age, as well as patients with severe renal dysfunction, reduced thyroid function and various muscle diseases.

Side effects such as headache and sore throat, constipation and bloating, various pains in muscles and joints, increased liver enzymes, allergies and even increased blood sugar are quite common. Liprimar interacts with a large number of different drugs, so a doctor must prescribe it, as well as monitor treatment. But this drug, being prescribed according to the indications by a specialist, taking into account all contraindications, does its job well and reduces the risk of cardiac accidents.

Fluvastatin – Lescol Forte

Popularity rating: 4.8

Lescol forte is a highly effective drug for lowering cholesterol levels. It is indicated for patients with coronary heart disease, for the purpose of primary and secondary prevention of myocardial infarction, with high levels of bad cholesterol, including those associated with familial cases of hypercholesterolemia. Lescol can be used as monotherapy, that is, apart from it, no additional drugs are required.

One tablet contains 80 mg of fluvastatin, and from this tablet the drug is released slowly, which allows you to create a uniform concentration in the blood plasma without fluctuations during the night, which explains its high cost. The maximum effect from its appointment develops in a month, at the same time it is possible to revise the prescribed dosage and change it upwards. Before starting treatment, the patient must be on a cholesterol-lowering diet, and this diet must be followed throughout the course of treatment. This drug is produced by the pharmaceutical company Novartis, and the cost of one package of 28 tablets, calculated for one month, averages 2800 rubles.

Advantages and disadvantages

The advantage of Lescol is its high quality, proven efficacy, sustained release, which does not allow fluctuations in concentration, as well as a long-term effect after drug withdrawal. But Lescol is contraindicated in pregnant and lactating women, in the presence of active pathological processes in the liver, which are accompanied by an increase in the activity of liver enzymes. There are also some side effects. Symptoms such as headache, abdominal discomfort, and nausea are common. Despite the high efficiency, it is necessary during the course of treatment every three months to assess the state of the liver enzymes using a biochemical blood test. This is done in order to control the liver against the background of the prescribed drug.

Also, before starting treatment, you need to make sure that the patient does not have hypothyroidism, hereditary muscle diseases, and does not abuse alcohol. In the event that everything is taken into account, and the treatment is controlled by a cardiologist, then this drug will help in many cases the patient get rid of 'bad cholesterol', heart attacks, strokes and the progression of coronary heart disease.

Review of other drug groups for lowering cholesterol

Statins have been isolated and reviewed separately because they are the most commonly prescribed statins. But apart from statins, there are other groups of drugs that lower the amount of unwanted cholesterol in the blood plasma. These are nicotinic acid, ion-exchange resins such as cholestyramine, fibric acid derivatives such as Clofibrate. Consider some of the drugs that are often prescribed by doctors in the complex therapy of hypercholesterolemia in patients with high cardiac risk.

Ezetrol (ezetemib)

Popularity rating: 4.9

Ezetrol is a drug that lowers 'bad' plasma cholesterol through a different mechanism. It does not affect liver enzymes, but prevents the absorption of cholesterol from food in the intestines. Thus, in the liver, cholesterol reserves are gradually depleted after the appointment of Ezetrol, and then its concentration in the blood also decreases. This drug is indicated for the treatment of atherosclerosis, hypercholesterolemia, and can be used both independently and in conjunction with statins under the supervision of a physician. But the main indication is severe hypercholesterolemia, which is genetically inherited and manifests itself in various familial cases.

Ezetrol is prescribed at any time of the day, regardless of food intake. The starting dosage of Ezetrol is 10 mg once a day. The cost of one package of 28 tablets, calculated for a monthly course, is on average 2,000 rubles, and Ezetrol is produced by the well-known pharmaceutical company Schering-Plow. Numerous generics have not yet been identified for this drug.

Advantages and disadvantages

The advantage of Ezetrol will be a unique mechanism of action, good tolerance. Adverse effects were mild and often resolved without dosage adjustment or treatment withdrawal. The most common side effects reported were headache and abdominal discomfort. Ezetrol may be contraindicated in severe liver failure, with hypersensitivity to the components, and it is also impossible to simultaneously use this drug with a drug from the fibrate group.

Ezetrol is not recommended for use in pregnant and lactating women, but only for the reason that no studies have been conducted, but this is a very sufficient argument for discontinuing the drug in the event that pregnancy occurs. But Ezetrol can be used in conjunction with statins, and then the speed of the onset of target cholesterol values ​​is significantly higher than with the appointment of separate treatment. However, even in the case of the appointment of Ezetrol, the patient must follow a diet aimed at reducing the amount of cholesterol supplied with food.

Omakor

Popularity rating: 4.8

Omacor lowers bad plasma cholesterol in a completely different way. These are no longer tablets, but soft gelatin capsules, which are transparent and contain a light yellow fatty liquid. The active ingredient of Omakor is Omega-3 unsaturated acids, namely a mixture of ethyl esters of two representatives of these acids.

Additionally, the capsules contain vitamin E, or alpha-tocopherol, which is fat-soluble. Omacor affects the concentration of very low density lipoproteins (VLDL), and reduces their amount. It reduces the concentration of free fatty acids, and numerous research results have shown that those patients who regularly took one capsule of Omakor daily for 3.5 years showed a decrease in overall mortality, and they also had fewer myocardial infarctions and strokes.

Omacor is used as a remedy for the prevention of heart attack, with high cholesterol levels, as an adjunct to drug therapy. Omacor can also be used independently, without prescribing drugs from the statin group. But at the same time, the patient, again, must first begin to observe a cholesterol-lowering diet. Omacor is produced by Banner Pharma pharmaceutical company located in Germany and the Netherlands, and one pack of 28 capsules, designed for a monthly intake, will cost 1,657 rubles at the pharmacy.

Advantages and disadvantages

A big plus of Omakor is the flexibility of prescription: in patients with low cholesterol levels, it can be prescribed alone, and in the case of severe hypercholesterolemia, it is used in conjunction with statins. Omacor has proven efficacy and is well tolerated. It will be contraindicated only during pregnancy, lactation and sensitivity to the components of the drug. Omacor is contraindicated with a significant intake of triglycerides along with food.

However, it should be used with caution in persons under 18 years of age, in the elderly, and in patients with severe liver and kidney problems. Also, special medical supervision is required in the case of application simultaneously with fibrates. Of the side effects, various dyspeptic phenomena, such as abdominal discomfort and bloating, most often arose. Omakor is a good, reliable, auxiliary agent for the treatment of any stages of hypercholesterolemia: from severe familial form as part of complex therapy, to mild.

Lipantil (fenofibrate)

Popularity rating: 4.7

Fenofibrate belongs to the derivatives of fibric acid, and reduces the concentration of triglycerides and very low density lipoproteins in the blood, which, in the end, are transformed into 'bad' cholesterol. This drug is available in capsules, each capsule contains 200 mg of fenofibrate. This is a means of influencing the metabolism of triglycerides. As a result of its use, the synthesis of fatty acids is disrupted and the concentration of cholesterol decreases. Lipantil also improves blood fluidity, and slightly lowers the plasma sugar concentration, so it can be prescribed in patients with diabetes.

Studies show that Lipantil lowers total cholesterol by 25%, and it is indicated in the complex therapy of hypercholesterolemia, which cannot be corrected by diet. Lipantil is prescribed with food, one capsule per day. The duration of the course is determined by the doctor. Lipantil is produced by the French company Rifarm, and a package of 30 capsules, designed for a monthly course, costs, on average, 1,000 rubles.

Advantages and disadvantages

Lipantil is contraindicated in the pathology of muscle tissue, including hereditary, in severe liver and kidney damage, as well as in fibrate intolerance. It is not used in children under 18 years of age, in pregnant women and in nursing mothers, in patients with lactase deficiency. The drug is well tolerated, but it should be prescribed by a doctor, since if it is combined with statins in the form of self-medication, then there may be complications in muscle tissue. If the patient uses warfarin after a heart attack or stroke, or other anticoagulants, there may be a risk of bleeding. Lipantil should not be administered with monoamine oxidase (MAO) inhibitors. All these precautions, if applied in a timely manner, including controlling the level of liver enzymes in the blood serum during treatment, can achieve a pronounced decrease in cholesterol.

Conclusion

In conclusion, one important but very simple thing must be said. The modern pharmaceutical industry produces a large number of expensive and cheap drugs to reduce cholesterol levels, their use, according to the results of numerous studies, significantly increases life expectancy and reduces the risk of vascular accidents. But in each case, it is necessary to use the drug, having prepared, and the preparation of the patient comes down to changing the lifestyle, giving up bad habits, and most importantly, adhering to a diet with low cholesterol content.

This should be remembered by anyone who thinks that taking pills can replace diet. Pills cannot replace diet, and a decrease in the risk of mortality and an increase in life expectancy appeared reliably only in the case when the patient not only took medications, but also deliberately worked on his own diet.

This is something to remember and not worth wasting money. Only if the patient is on a diet for at least three weeks or a month, and he does not have any changes in cholesterol analyzes, then it is necessary to connect medications. If the diet is paying off, then you need to continue it until cholesterol stops dropping. And if he does not reach the target on the diet, then only then it is necessary to connect the drugs included in the rating.

The popularity rating is based on the analysis of demand data from the wordstat.yandex.ru service.

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Attention! This rating is subjective and does not constitute an advertisement and does not serve as a purchase guide. Before buying, you need to consult with a specialist.