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Monday, November, 23, 2009
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SW55,   Thanks for your question.  Well, it certainly sounds like your symptoms are from the statin medication.  Switching to other statins is a good idea, as some drugs may not cause this side effect in some people.  Niacin, or nicotinic acid, has been shown to reduce the cholesterol levels (total and LDL) and increase good cholesterol levels (HDL).  It is available as a drug called Niaspan, which is available as a short acting drug, as well as a long acting formulation.  The major side effect of Niaspan is flushing due to dilatation of blood vessels caused by the drug.  This effect usually lasts for the first two to four weeks as the system becomes accustomed to the medication.  Other side effects include stomach irritation and nausea.  Patients with peptic ulcer disease should exercise caution and discuss this with their physician.  Alcohol should be avoided as this can also irritate the stomach and cause its own flushing.  Many doctors feel that the long acting formula has less incidence of flushing.   Another option is Zetia (ezetimibe) which is a cholesterol lowering drug that works differently than statins.  This drug works in the intestinal track and avoids the absorption of cholesterol from the gut.  Muscle problems are also described as possible side effects, but most doctors feel this is less likely than with statins.   If statins continue to cause problems for you, discuss Niaspan and Zetia as possible drugs to try next.   I hope this has been helpful.   Martin Cane, M.D.
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