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:
- 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)
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.
