Lipid-lowering Agents

🫀 Lipid-Lowering Agents: Cholesterol Management Drugs

🔹 Introduction

High cholesterol (dyslipidemia) India mein ek major health issue hai jo atherosclerosis, heart attack aur stroke ka risk badhata hai.

Doctors cholesterol control ke liye Lipid-lowering drugs prescribe karte hain.

🔹 1. Main Classes of Lipid-Lowering Drugs

(A) Statins (HMG-CoA Reductase Inhibitors)

  • Examples: Atorvastatin, Rosuvastatin, Simvastatin
  • MOA: Liver mein cholesterol synthesis block → LDL ↓
  • Benefits: First-line therapy, proven to reduce mortality
  • Side effects: Muscle pain, liver enzyme rise

(B) Ezetimibe

  • MOA: Intestinal cholesterol absorption block
  • Use: Add-on with statin for target LDL

(C) PCSK9 Inhibitors (Injectable, Advanced)

  • Examples: Evolocumab, Alirocumab
  • Use: Resistant cases, familial hypercholesterolemia
  • Note: Very costly, limited India use

(D) Fibrates

  • Examples: Fenofibrate, Gemfibrozil
  • Use: High triglycerides (TG > 500 mg/dl)
  • Side effects: Muscle toxicity with statins

(E) Others

  • Niacin – Rarely used (side effects)
  • Omega-3 fatty acids – TG lowering
  • Bempedoic acid – Newer option, limited India use

🔹 2. Combination Therapy

  • Atorvastatin + Ezetimibe
  • Rosuvastatin + Fenofibrate
  • Statin + Antiplatelet (Aspirin/Clopidogrel) for CAD patients

🔹 3. Prescribing Trends in India

  • Statins (Atorvastatin, Rosuvastatin) → Most common, first-line
  • Ezetimibe → Add-on when LDL not at target
  • Fibrates → For very high triglycerides
  • PCSK9 inhibitors → Rare, only in resistant/familial cases

📝 Conclusion

Statins remain the cornerstone of cholesterol management. Add-on therapies jaise Ezetimibe aur PCSK9 inhibitors un patients ke liye use hote hain jaha statin se target achieve nahi hota.

⚠️ Disclaimer

This article is for educational purposes only. It does not replace medical consultation. Always follow your doctor’s advice for treatment decisions.

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