The best cholesterol pills
Many people believe that lowering cholesterol with pills, dieting, or recommendations for adhering to a healthy lifestyle is an independent goal: cholesterol must be within the specified, normal range. Cholesterol is indeed “good” and “bad”, and “bad” cholesterol is gradually deposited in the lumen of blood vessels, forms plaques that cause an increased risk of developing vascular accidents - heart attack and stroke.
But the use of drugs that reduce cholesterol, or lipid-lowering drugs, is primarily shown not only to maintain cholesterol in normal conditions, but for the so-called secondary prophylaxis in patients with myocardial infarction. First of all, these drugs are needed in order to prevent re-infarction. There are many reliable clinical studies in which hundreds of thousands of volunteers have been identified that prolonged use of drugs from the group of statins reduces the risk of total mortality after a previous heart attack by at least 30%. Here it is really a long-term use, for 3 or 5 years.
Of course, elevated blood cholesterol, or hypercholesterolemia, is a risk factor not only for heart attack or coronary heart disease. It contributes to 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 must follow dietary recommendations, change his lifestyle, abandon bad habits, and only if all these measures fail, is medication prescribed.
It is very important to achieve targets for total cholesterol. As an example, a healthy person should have an indicator of total cholesterol lower than 6.2 mmol / l. In patients with coronary heart disease, the target level, that is, the plasma cholesterol concentration to be reached by prescribing the drug, should be below 5 mmol / l.
It has been reliably proven that long-term use of statins according to indications and achievement of target values of total cholesterol and its fractions can reduce the risk of heart attacks, strokes, as well as sudden cardiac death. This ranking includes the most modern and effective cholesterol pills. These are lipid-lowering drugs from the group of statins, fibrates, and sequestrants of bile acids.
Top cholesterol pill rating
| Nomination | a place | Name of product | price |
| Modern statins to lower cholesterol | 1 | Rosuvastatin - Crestor (Rosukard, Rosulip, Tevastor) | 583 ₽ |
| 2 | Atorvastatin - Liprimar (Tulip, Torvakard, Atoris) | 226 ₽ | |
| 3 | Fluvastatin - Lescol Forte | 1 750 ₽ | |
| The best drugs of other groups to reduce cholesterol | 1 | Ezetrol (Ezetemib) | 1 695 ₽ |
| 2 | Omacor | 1 546 ₽ | |
| 3 | Lipantil (fenofibrate) | 906 ₽ |
Modern statins to lower cholesterol
Currently, several generations of statins are known. And, although cholesterol reduces several classes of drugs, it is the statins that lead in the number of prescriptions throughout the world. All of them act according to the same mechanism; they inhibit a special enzyme called “HMG-CoA reductase”. He works in the liver, and is engaged in the synthesis of cholesterol. Consider first the most modern cholesterol remedy - the statin of the last, fourth generation.
Rosuvastatin - Crestor (Rosukard, Rosulip, Tevastor)
Rating: 4.9
Crestor is indicated for all patients to achieve target values of cholesterol, which have a high risk of developing vascular accidents. These patients include people with hypertension, diabetes, coronary 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 medication if the patient does not follow the diet, and consumes a large number of sources of cholesterol with food. Therefore, all drugs to reduce cholesterol require a diet.
The standard dosage of Crestor is from 5 to 10 mg per day, and the initial dose depends on the initial cholesterol concentration. You can increase the dose only in a month. The maximum daily dose is 40 mg per day. Do not chew the tablet, and you can take it at any time of the day without regard to meals.
Crestor is produced by the British company Astra Zeneca, and the packaging, with a minimum dosage (5 mg tablet) will cost 1835 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, it is possible to cite as an example other figures. The same package is four times higher dosage, 0.02 g will cost 3925 rubles, it is also designed for one month of intake. There are cheaper options. Thus, the packaging of the drug Rosart (Actavis) costs 535 rubles, the same 28 tablets of 5 mg.
Advantages and disadvantages
The advantage of the drug is high activity and proven effectiveness. The elderly do not require any dose adjustment, and usually this fact must be taken into account when administering many drugs to the elderly. You can also not change the dosage for mild manifestations of renal failure.
Although Crestor has a high efficacy proven by many studies, it has contraindications. This simultaneous treatment with cyclosporine, pregnancy and breastfeeding, the presence of different myopathies, and alcohol consumption. With caution, you can use Crestor with reduced thyroid function, as well as other severe endocrine disorders and epilepsy. However, with all the drawbacks, Crestor is one of the most effective and modern drugs to reduce the risk of sudden death and vascular accidents.
Atorvastatin - Liprimar (Tulip, Torvakard, Atoris)
Rating: 4.8
Liprimar is a high-performance cholesterol pill, but it does not belong 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 third-generation drugs just work well and reduce the amount of "bad" cholesterol, but 4-generation drugs, such as Crestor described above, also contribute to an increase in the blood "good" cholesterol. But Liprimar is a high-quality and original drug.
It is available in four dosages: 10, 20, 40 and 80 mg.It is indicated for use at elevated levels of “bad” cholesterol - with hypercholesterolemia of different genesis, in the complex prevention of myocardial infarction and ischemic heart disease in patients with high risk, with both primary and secondary prevention.
Liprimar, like Crestor, is applied 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 prescribed by a doctor. It is worth Liprimar cheaper than Crestor. Packing 30 tablets, with a minimum dosage of 10 mg, calculated on a monthly course, can be found in pharmacies from 350 rubles, and the average price is 717 rubles per pack. Liprimar produces well-known pharmaceutical company Pfizer.
There are many much more affordable Liprimara analogues, including domestic atorvastatin. So, exactly the same packaging, only produced by Irbit Chemical Factory, will cost, on average, 135 rubles. for packaging, but if you wish, you can find it in pharmacies and at a price even cheaper than 60 rubles.
Advantages and disadvantages
The great advantage of Liprimar is its well-studied and international experience, high efficiency, convenient use once a day, and the ability to flexibly adjust the dosage. However, there are a large number of contraindications, side effects and special conditions, among which are numerous interactions of atorvastatin with other drugs. Thus, it is not allowed to prescribe Liprimar with a high level of liver enzymes, pregnant women and breastfeeding, persons under 18 years of age, as well as patients with severe impaired renal function, reduced thyroid function and with various muscular diseases.
Such side effects as headache and sore throat, constipation and abdominal distension, 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 the doctor must necessarily prescribe it, as well as monitor the treatment. But this drug, being prescribed by a specialist, taking into account all contraindications, does its job well and reduces the risk of heart catastrophes.
Fluvastatin - Lescol Forte
Rating: 4.8
Lescol forte is a highly effective drug to lower cholesterol. It is indicated for patients with ischemic heart disease, with the aim 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 him, 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 fluctuating during the night, this explains its high cost. The maximum effect of his appointment develops in a month, and then you can review the prescribed dosage and change it upwards. Before treatment, the patient should be on a diet aimed at lowering cholesterol, and this diet should be followed during the entire course of treatment. Pharmaceutical company Novartis produces this drug, and the cost of one pack of 28 tablets, calculated for one month, averages 2,800 rubles.
Advantages and disadvantages
The advantage of Lescol is its high quality, proven efficacy, sustained release, which prevents concentration fluctuations, as well as a lasting effect after discontinuation of the drug.But Lescol is contraindicated in pregnant and lactating women, in the presence of active pathological processes in the liver, which are accompanied by increased activity of liver enzymes. There are some side effects. Often there are symptoms such as headache, abdominal discomfort, nausea. Despite the high efficiency, it is necessary to evaluate the state of hepatic enzymes every three months during the course of treatment using biochemical blood tests. This is done to control the liver against the background of the prescribed drug.
Also, before starting treatment, you must make sure that the patient does not have hypothyroidism, a hereditary muscular disease, and that he does not abuse alcohol. In that case, if everything is taken into account, and the treatment is controlled by a cardiologist, then this drug will help the patient in many cases to get rid of "bad cholesterol", heart attacks, strokes and progression of coronary heart disease.
The best drugs of other groups to reduce cholesterol
Statins were isolated and reviewed separately, as they are prescribed most frequently. But besides statins, there are other groups of drugs that reduce the amount of undesirable cholesterol in the blood plasma. These are nicotinic acid, ion exchange resins such as cholestyramine, fibric acid derivatives, which include Clofibrate. Consider some tools that are often prescribed by doctors in the treatment of hypercholesterolemia in patients with high cardiac risk.
Ezetrol (Ezetemib)
Rating: 4.9
Ezetrol is a drug that reduces the "bad" cholesterol in the blood plasma according to another mechanism. It does not affect the liver enzymes, but prevents the absorption of cholesterol from food in the intestine. Thus, the cholesterol reserves are gradually depleted in the liver after the administration of Ezetrol, and then its concentration decreases in the blood. This drug is indicated for the treatment of atherosclerosis, hypercholesterolemia, and can be used both independently and in conjunction with statins under medical supervision. But the main indication is severe hypercholesterolemia, which is genetically inherited and manifests itself in various family cases.
Ezetrol is prescribed at any time of the day, without regard to meals. The initial dosage of Ezetrol is 10 mg once a day. The cost of one pack of 28 tablets, calculated on a monthly course, averages 2000 rubles, and the well-known pharmaceutical company Schering-Plow produces Ezetrol. Numerous generics of this drug has not yet been identified.
Advantages and disadvantages
The advantage of Ezetrol will be a unique mechanism of action, good tolerability. Undesirable effects were mild, and often took place without correction of the dosage and without discontinuation of treatment. The most common side effects were headache and abdominal discomfort. Ezetrol may be contraindicated in case of severe hepatic insufficiency, in case of hypersensitivity to the components, and it is also impossible to simultaneously apply this agent with the preparation from the group of fibrates.
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 discontinuation of the drug in the event that pregnancy occurs. But Ezetrol can be used in conjunction with statins, and then the rate of onset of cholesterol targets is significantly higher than with the appointment of separate treatment. However, even in the case of the appointment of Ezetrol patient must follow a diet aimed at reducing the amount of cholesterol from food.
Omacor
Rating: 4.8
Omacor reduces bad plasma cholesterol in a completely different way. These are no longer tablets, but soft capsules made of gelatin, while transparent, and they contain a light yellow fatty liquid.The active ingredient of Omacor is Omega-3 unsaturated acids, namely a mixture of ethyl esters of two representatives of these acids.
Additionally, vitamin E, or alpha-tocopherol, which is fat soluble, is added to the capsules. Omacor affects the concentration of very low density lipoproteins (VLDL), and reduces their number. It reduces the concentration of free fatty acids, and numerous research results showed that those patients who regularly took one Omacor capsule daily for 3.5 years showed a decrease in overall mortality, as well as less frequent myocardial infarction and stroke.
Omacor is used as a remedy for the prevention of heart attack, with elevated cholesterol as an adjunct to drug therapy. Omacor can be used independently, without prescribing drugs from the group of statins. But at the same time, the patient must again begin to follow the cholesterol-lowering diet. Omakor pharmaceutical company Banner Pharma, located in Germany and the Netherlands, produces, and one pack of 28 capsules designed for a monthly intake will cost you 1,657 rubles in a pharmacy.
Advantages and disadvantages
The great advantage of Omakor is the flexibility of administration: in patients with low cholesterol, it can be administered alone, and in the case of severe hypercholesterolemia, it is used in conjunction with statins. Omacor has proven efficacy and is well tolerated. It is contraindicated only during pregnancy, lactation and sensitivity to the components of the drug. Omacor is contraindicated with a significant intake of triglycerides with food.
However, it should be carefully prescribed in patients under 18 years of age, in old age, and in patients with severe disorders of the liver and kidneys. Also, special medical control is required when used simultaneously with fibrates. Of the side effects, various dyspeptic phenomena most often occurred, such as abdominal discomfort and bloating. Omakor is a good, reliable, adjuvant for the treatment of any stages of hypercholesterolemia: from the severe family form in the complex therapy, to the light.
Lipantil (fenofibrate)
Rating: 4.7
Fenofibrate is a derivative of fibric acid and reduces the concentration of triglycerides and very low density lipoproteins in the blood, which, after all, 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 exchange of triglycerides. As a result of its use, the synthesis of fatty acids is disturbed and the concentration of cholesterol is reduced. Lipantil also improves the fluidity of blood, and slightly lowers the concentration of sugar in the plasma, 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. Appointed Lipantil with food, one capsule per day. The duration of the course is determined by the doctor. The French company Rifarm produces Lipantil, and a pack 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 lesions of the liver and kidneys, as well as intolerance to fibrates. It is not used in children under 18 years of age, in pregnant women and nursing mothers, in patients with lactase deficiency. The drug is well tolerated, but the doctor must prescribe it, because if in the form of self-treatment it is combined with statins, there may be complications in the muscle tissue. If the patient uses warfarin after a heart attack or stroke, or other anticoagulants, then there is a risk of bleeding. Lipantil should not be administered with monoamine oxidase (MAO) inhibitors.All these precautions, if applied in a timely manner, and including monitoring the level of liver enzymes in the blood serum during treatment, make it possible to achieve a marked reduction in cholesterol.
Conclusion
In conclusion, you need to say one important, but very simple thing. The modern pharmaceutical industry produces a large number of expensive and cheap drugs to reduce cholesterol, their reception, according to the results of numerous studies, significantly increases life expectancy and reduces the risk of vascular disasters. But in each case, use the drug, you must be prepared, and the preparation of the patient is reduced to a change in lifestyle, giving up bad habits, and most importantly - following a diet with low cholesterol.
This needs to be remembered by anyone who thinks that taking pills can be replaced with a diet. Tablets can not be replaced with a diet, and a reduction in the risk of mortality and an increase in life expectancy reliably appeared only when the patient not only took drugs but also consciously worked on his own diet.
It needs to be remembered, and it is not worth spending money in vain. Only if the patient is on a diet for at least three weeks or a month, and he has no changes in cholesterol analyzes, then medications should be included. If the diet is bearing fruit, then you need to continue it until cholesterol ceases to decrease. And if he does not reach the target indicators on a diet, then only then it is necessary to connect the drugs included in the rating.
Attention! This rating is subjective, is not advertising and does not serve as a guide to the purchase. Before buying, you should consult with a specialist.
