Characteristics of the effects of other cholesterol-lowering drugs on blood lipids
What are the characteristics of other cholesterol-lowering drugs?
Ezetimibe effectively inhibits the absorption of cholesterol in the intestine and belongs to the cholesterol absorption inhibitor class. Studies have shown that adding ezetimibe to simvastatin in ASCVD patients can further reduce cardiovascular events. Research shows that the combination of ezetimibe and simvastatin has a good effect on improving the cardiovascular prognosis of patients with chronic kidney disease (CKD).
The recommended dose of ezetimibe is 10 mg/day. Ezetimibe has good safety and tolerability, with mild and mostly transient adverse reactions. The main adverse reactions are headache and gastrointestinal symptoms. Concomitant use with statins can also cause elevated transaminases and myalgia. It is contraindicated during pregnancy and lactation.
Probucol affects lipoprotein metabolism by incorporating into the core of LDL particles, making LDL more easily cleared through non-receptor pathways. Probucol's usual dosage is 0.5g twice daily, primarily used for hypercholesterolemia, especially in patients with xanthoma, and it can reduce the appearance of xanthoma. Common adverse reactions include gastrointestinal reactions, and it can also cause dizziness, headache, insomnia, and rash; a very rare serious adverse reaction is QT interval prolongation. It is contraindicated in patients with ventricular arrhythmias, QT interval prolongation, or hypokalemia.
Bile acid sequestrants are basic anion exchange resins that can block the reabsorption of cholesterol from bile acids in the intestine. Clinical usage: Cholestyramine 5g three times daily; Colestipol 5g three times daily; Colesvelam 1.875g twice daily. Combined use with statins can significantly improve their lipid-lowering efficacy. Common adverse reactions include gastrointestinal discomfort, constipation, and interference with the absorption of certain drugs. The absolute contraindications for this type of drug are abnormal β-lipoproteinemia and serum TG > 4.5 mmol/L (400 mg/dL).
Lipitor is a compound preparation of red yeast rice and traditional Chinese medicine (hawthorn, alisma, and atractylodes). The usual dosage is 0.24–0.48 g twice daily, and it has a mild to moderate cholesterol-lowering effect. Adverse reactions to this drug are rare.
Polyeicosanol is a mixture containing eight higher fatty alcohols purified from sugarcane wax. The usual dosage is 10–20 mg/day. Its lipid-regulating effect is slow to take effect, and adverse reactions are rare.
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