Is Your Cholesterol Medication Working?

Only testing by your doctor can tell whether the drug you're taking is lowering your cholesterol levels.

With most medications, such as antibiotics or antidepressants, it is easy for people to know if their medication is working because they will start to feel better. With cholesterol-lowering medications, you won’t feel any differently, so it is even more important to remember to take it every day and routinely follow up with your doctor. Your doctor is your best guide for what tests you need and when visits are necessary, but here are some tips as you get started.

Taking a Statin?

It takes several weeks of taking a statin before your doctor can see a change in your cholesterol levels. You may be wondering when to get your cholesterol checked and if there is anything else that should be checked if you have been prescribed a statin drug.

When it comes to the statins, the most important things your doctor will monitor is your cholesterol (too see if the drug is working) and your liver function (to make sure the drug isn’t causing any problems). If muscle pain, weakness or tenderness develops, additional tests may be performed. Exactly when your doctor will check your cholesterol levels and liver function tests will depend on which statin you are taking, but here is a general guide:

Cholesterol levels:

  • Before starting the statin
  • Approximately four weeks after beginning treatment or a change in dose
  • Periodically during treatment thereafter

Liver function tests:

  • Before starting the statin
  • Approximately 12 weeks after beginning treatment or a change in dose
  • Periodically during treatment thereafter

Taking a Fibric Acid Derivative?

Monitoring of cholesterol levels with fibric acid derivatives is a little different from statins, because your doctor also needs to monitor your complete blood counts (CBC) to watch for anemia or a low white blood cell or platelet count that can occur with fibric acid derivatives. When you first start taking a fibrate drug, your doctor will probably want to periodically check your cholesterol levels so you can take the lowest effective dose. As with the statins, if you experience any muscle pain, weakness or tenderness, your doctor will perform additional testing.

Cholesterol levels:

  • Before starting treatment
  • Periodically during treatment as determined by your doctor

Liver function tests:

  • Periodically during treatment with fenofibrate

Complete Blood Cell counts (CBC):

  • Periodically during the first 12 months of treatment

Taking Nicotinic Acid?

If you have just started taking a nicotinic acid drug for your cholesterol, your doctor probably explained to you that in addition to checking your cholesterol levels to make sure the drug is working, you would also need routine monitoring of your liver function tests and blood sugar levels to make sure the drug is not causing any side effects.

Cholesterol levels:

  • Before starting treatment
  • Periodically during treatment as determined by your doctor

Liver function tests:

  • Before starting treatment
  • Every 6 to 12 weeks for the first year of treatment
  • Periodically thereafter; approximately every six months

Blood sugar levels:

  • Periodically during treatment
  • More frequent monitoring may be required if you have diabetes

Taking Zetia?

Checking to see if Zetia is working properly to lower your cholesterol, and not causing any side effects, is very similar to the way your doctor checks up on you if are taking a statin. In addition, as with statins and fibric acid derivatives, if any muscle pain, tenderness or weakness develops your doctor will perform additional tests.

Cholesterol levels:

  • Before starting Zetia
  • Periodically during treatment

Liver function tests when Zetia is prescribed with a statin:

  • Before starting Zetia together with the statin
  • Thereafter according to the recommendations of the statin you are taking

Taking a Bile Acid Sequestrant?

When you take a bile acid sequestrant you do not require as much monitoring as with the other cholesterol-lowering drugs. Bile acid sequestrants work only in your gastrointestinal tract and are not absorbed into your body, so they don’t have the same side effects on the liver, but because of their binding properties, they can cause certain vitamin deficiencies.

Cholesterol levels:

  • Before starting a bile acid sequestrant
  • Frequently during the first few months of treatment
  • Periodically thereafter
  • Signs and symptoms of vitamin A, D, E or K deficiencies
  • Only your doctor can know if your cholesterol-lowering medication is working. You won’t feel any differently after starting your new medication, so remember to take your medication every day and always keep your follow-up appointments with your doctor.

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