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COMMON SIDE EFFECTS OF CHOLESTEROL DRUGS

Common Side Effects of Cholesterol Drugs

Most side effects of cholesterol-lowering medicines are mild and transitory, but some can be serious. Here's what to look out for.

By Beth Isaac, PharmD
If you are among the millions of Americans who are prescribed cholesterol-lowering drugs each year, you are probably wondering about what kind of side effects might be caused by your new medication. Depending on which drug you have been prescribed, there are some side effects that are common and usually get better over time. There are other side effects that are rare but more serious. If you take a combination of cholesterol-lowering medications, your chances for side effects are increased.
Most people taking cholesterol-lowering drugs don’t experience bothersome side effects. If side effects occur, sometimes managing them is as easy as your doctor changing your dose. In some cases, a change in medication may be necessary or, rarely, some people have to stop taking their medication.
If you develop anything unusual or bothersome, or are unsure if you are experiencing side effects from your new medication, talk to your doctor. Never stop taking your cholesterol-lowering medication or change the dose without your doctor’s advice. Here are some of the common and not-so-common side effects, what you can expect and what you should know.
Statin Side Effects
Common side effects of statins are generally mild and most often improve with continued treatment as your body adjusts.
10 common side effects include:
  • Stomach pain
  • Stomach upset
  • Gas
  • Bloating
  • Cramping
  • Nausea
  • Diarrhea
  • Constipation
  • Headache
  • Mild muscle pain
More serious side effects rarely occur, but you should tell your doctor as soon as possible if you notice your urine is a dark color accompanied by unexplained tiredness or abdominal pain or if you experience any muscle pain, weakness or tenderness with fever or flu-like symptoms. Your doctor will monitor your liver function with a simple blood test periodically during treatment.
More serious side effects include:
  • Problems with your liver
  • Problems with your muscles
Fibrate Side Effects
Like statins, fibrates are generally well tolerated by most patients. The most common occurring side effects are related to the gastrointestinal system.
Five common side effects include:
  • Upset stomach
  • Indigestion
  • Nausea
  • Diarrhea
  • Higher risk of developing gallstones
More serious side effects include:
  • Problems with your muscles
  • Anemia, low white blood cell count or low platelet count
Niacin Side Effects
You may be wondering why you just can’t buy the over-the-counter version of niacin to help with your cholesterol. Remember, over-the-counter niacin supplements are not regulated by the U.S. Food and Drug Administration (FDA) in the same way prescription niacin products are and should not be taken in place of prescription medications without your doctor’s advice. The over-the-counter, immediate-release forms of niacin have more side effects. You should only take niacin under the supervision of your doctor so you can be closely monitored for side effects.
Nine common side effects include:
  • Flushing of the face and neck
  • Itching
  • Stomach upset
  • Nausea
  • Indigestion
  • Gas
  • Vomiting
  • Diarrhea
  • Peptic ulcers
The most common and bothersome side effects of niacin are flushing and itching. The good news is that most people become tolerant to these side effects over time. Here are some tips to help you manage them:
  • Start low and go slow! Your doctor will probably start you on a low dose and gradually increase it to lessen your chances for side effects. Talk to your doctor and make sure you are starting on a low dose. Extended-release forms of niacin also cause less flushing.
  • Take your dose of niacin with a snack.
  • If your doctor says it is safe, take aspirin 30 to 60 minutes before your dose of niacin.
More serious side effects include:
  • High blood sugar
  • Gout
  • Liver problems
Your risk for more serious side effects increases with higher doses of niacin. Niacin may not be right for you if you have diabetes or may require additional monitoring by your doctor. Your doctor will also monitor your liver function to make sure niacin isn’t causing any dangerous side effects.
Zetia Side Effects
Zetia is the newest category of cholesterol-lowering medication and, like the other types of cholesterol-lowering drugs, is generally well tolerated by most people.
Five common side effects include:
  • Mild stomach pain
  • Diarrhea
  • Runny or stuffy nose
  • Joint pain
  • Tired feeling
More serious side effects include:
  • Liver problems
  • Muscle problems
Some people have developed more serious side effects when taking just Zetia. However, your chances for more serious side effects are higher if you are also taking a statin.
Bile Acid Sequestrant Side Effects
The biggest complaints from people who take bile acid sequestrants are related to the gastrointestinal system. This is mainly because of the way these drugs work in your body to bind to and eliminate cholesterol.
Eight common side effects include:
  • Diarrhea
  • Constipation
  • Stomach irritation
  • Nausea
  • Gas
  • Bloating
  • Heartburn
  • Dizziness
More serious side effects of bile acid sequestrants are extremely rare because they are not absorbed from the gastrointestinal system into your body.
Muscle Pain vs. Muscle Damage: How to Tell the Difference
Many cholesterol-lowering drugs can cause muscle pain as a side effect; the most well-known are the statins. This side effect can occur at any time during treatment and ranges from mild muscle pain to a rare, but potentially life-threatening, condition known as rhabdomyolysis. Serious muscle damage occurs in less than one tenth of 1 percent, and fatal rhabdomyolysis occurs in less than one per million prescriptions with the currently available statins.
This side effect appears to be dose-related, and eating healthy and exercising will allow your doctor to prescribe the lowest dose possible to lower your cholesterol and prevent side effects. If you experience any muscle pain, tenderness or weakness while taking a cholesterol-lowering medication, tell your doctor as soon as possible.
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