I. Zetia Fact File

Zetia was introduced by Merck Pharmaceuticals.

Merck & Co., Inc. is a global research-driven pharmaceutical company dedicated to putting patients first. Established in 1891, Merck discovers, develops, manufactures and markets vaccines and medicines in over 20 therapeutic categories.

II. Zetia Medication

Zetia medication works in a manner unique to cholesterol medications in the way it reduces the amount of cholesterol that is absorbed from the digestive tract.

If you're taking a Statin, Zetia medication can boost your results when added to your current therapy.

Cholesterol comes from 2 sources. It's produced naturally in your body, and it's found in the food you eat.

You may not know is that the amount of LDL (Bad) Cholesterol in your blood is controlled in 2 important places:

• Your liver - which produces cholesterol and uses it to make digestive (or bile) acids.
• Your digestive tract - which absorbs cholesterol both from food and from bile made by the liver.

A statin works in the liver to lower LDL (Bad) Cholesterol. Zetia medication lowers LDL (Bad) Cholesterol in a different way. It works in the digestive tract to reduce the absorption of cholesterol.

So, if you are dieting and taking a statin, adding Zetia medication can help lower LDL (Bad) Cholesterol even further. If you're not taking a statin, Generic Zetia along with diet and exercise is still an effective way to reduce your LDL (Bad) Cholesterol if diet alone has not lowered your cholesterol enough.

In a clinical study, people who added ZETIA to their statin medication reduced their LDL (Bad) Cholesterol by an additional 25% (36 points), compared with 4% (6 points) in people who added a placebo (a pill with no medication). These are average results; your individual results may vary.

In other clinical studies, Zetia medication lowered LDL (Bad) Cholesterol in patients who weren't taking a cholesterol-lowering medicine and couldn't control their high cholesterol with diet and exercise alone. So, even when taken by itself, Zetia medication along with diet still can help lower your cholesterol.

Cholesterol Reducing Drugs: Information

Cholesterol-reducing drugs are medicines that lower the amount of cholesterol (a fat-like substance) in the blood.

There are four different classes of cholesterol lowering drugs:

1. Bile acid sequesterants are drugs that act by binding with the bile produced by the liver. Bile helps the digestion and absorption of fats in the intestine. By blocking the digestion of fats, bile acid sequesterants prevent the formation of cholesterol. Drugs in this class include: cholestyramine (Questran); colestipol (Colestid); and colesevalam (Welchol).
2. HMG-CoA inhibitors, often called "statins," are drugs that block an enzyme called "3-hydroxy-3-methyl-glutaryl-coenzyme A reductase." This blocks one of the steps in converting fat to cholesterol. These are the most effective cholesterol lowering agents available and in recent years have received increased attention for their benefits beyond helping patients with high cholesterol. In 2003, researchers reported that people with heart failure but no coronary artery disease received benefits after only 14 weeks of statin therapy. In addition, some research has connected the drugs to reduced risk for depression and dementia. Drugs in this group include: atorvastatin (Lipitor); cerivastatin (Baycol); fluvastatin (Lescol); lovastatin (Mevacor); pravastatin (Pravachol); simvastatin (Zocor); and the newest approved drug rosuvastatin (Crestor).
3. Fibric acid derivatives include clofibrate (Atromid-S); gemfibrozil (Lopid); and fenofibrate (Tricor). Although these drugs are less effective than the statins at lowering total cholesterol, they may be able to lower the low density lipoprotein (LDL) cholesterol while raising the high density lipoprotein (HDL) cholesterol. They probably act by inhibiting lipoprotein lipase activity.
4. Niacin, or vitamin B-3, also is effective in lowering cholesterol levels. Although the normal vitamin dose of niacin is only 20 mg, the dose required to reduce cholesterol levels is at least 500 mg each day. Niacin probably helps reduce cholesterol by inhibiting very low density lipoprotein (VLDL) secretion in the bloodstream.

Cholesterol: Information

Cholesterol is a chemical that can do both good and harm in the body. On the good side, cholesterol plays important roles in the structure of cells and in the production of hormones. But too much cholesterol in the blood can lead to heart and blood vessel disease. To complicate matters, not all cholesterol contributes to heart and blood vessel problems.

One type, called high density lipoprotein (HDL) cholesterol, or "good cholesterol," actually lowers the risk of these problems. High-density lipoproteins (HDL) remove cholesterol from the bloodstream. The other type, low density lipoprotein (LDL) cholesterol, or "bad cholesterol," is the type that threatens people's health. Low-density lipoproteins (LDL) deliver cholesterol to the body. To travel through the bloodstream, cholesterol must attach itself to a protein. The combination of a protein and a fatty substance like cholesterol is called a lipoprotein.

Diagram 1:

The average person should try to maintain an LDL (Bad) Cholesterol level below 130 mg/dL. If you have heart disease or diabetes, your goal is less than 100 mg/dL.

Many factors may contribute to the fact that some people have higher cholesterol levels than others. A diet high in certain types of fats is one factor. Medical problems such as poorly controlled diabetes, an under active thyroid gland, an overactive pituitary gland, liver disease or kidney failure also may cause high cholesterol levels. And some people have inherited disorders that prevent their bodies from properly using and eliminating fats. This allows cholesterol to build up in the blood.

Treatment for high cholesterol levels usually begins with changes in habits. By losing weight, stopping smoking, exercising more and reducing the amount of fat and cholesterol in the diet, many people can bring their cholesterol levels down to acceptable levels. However, some may need to use cholesterol-reducing drugs to reduce their risk of health problems.

While some cholesterol is needed for good health, too much cholesterol in your blood can raise your risk of having a heart attack or stroke.

The extra cholesterol in your blood may be stored in your arteries (blood vessels) and cause them to narrow. (This is called atherosclerosis.) Large deposits of cholesterol can completely block an artery, so the blood cannot flow through.

If an artery that supplies blood to your heart becomes blocked, a heart attack can occur. If an artery that supplies blood to your brain becomes blocked, a stroke can occur.

Diagram 2: Normal artery versus blocked artery

Cholesterol Levels:

Total cholesterol level

• Less than 200 is best.
• Between 200 to 239 is borderline high.
• 240 or more means you're at increased risk for heart disease.

LDL cholesterol levels

• Less than 130 is best.
• Between 130 to 159 is borderline high.
• 160 or more means you're at higher risk for heart disease.

HDL cholesterol levels

• Less than 40 means you're at higher risk for heart disease.
• 60 or higher reduces your risk of heart disease.

Side effects of Cholesterol Reducing drugs

1. Gemfibrozil
   Studies in animals and humans suggest that gemfibrozil increases the risk of some types of cancer. The drug may also cause gallstones or muscle problems. Patients who need to take this medicine should ask their physicians for the latest information on its benefits and risks.
   
   Patients taking gemfibrozil should check with a physician immediately if any of these side effects occur:
   fever or chills
   - severe stomach pain with nausea and vomiting
   - pain in the lower back or side
   - pain or difficulty when urinating
   - cough or hoarseness
   
2. HMG-CoA reductase inhibitors
   These drugs may damage the liver or muscles. Patients who take the drugs should have blood tests to check for liver damage as often as their physician recommends. Any unexplained pain, tenderness or weakness in the muscles should be reported to the physician at once.
   
3. All cholesterol-reducing drugs
   Minor side effects such as heartburn, indigestion, belching, bloating, gas, nausea or vomiting, stomach pain, dizziness and headache usually go away as the body adjusts to the drug and do not require medical treatment unless they continue or they interfere with normal activities.
   
   Patients who have constipation while taking cholesterol-reducing drugs should bring the problem to a physician's attention as soon as possible.
   
   Additional side effects are possible. Anyone who has unusual symptoms while taking cholesterol-reducing drugs should get in touch with his or her physician.

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III. Useful links

http://www.cdc.gov/

http://www.fda.gov/

http://www.fda.gov/cder/ogd/

http://www.nih.gov/

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi

http://www.health.gov.on.ca/

National Library of Medicine

World Health Organization

MedicineNet.com

Drugdigest.org

Healthsquare.com

About.com Health section

http://www.avodart.com

http://www.gsk.com/about/about.htm

http://www.labtestsonline.org/understanding/conditions/bph.html

http://www.urologychannel.com/prostate/bph/index.shtml

http://www.urologychannel.com/prostate/bph/treatment_med.shtml

http://www.urologychan

Pharmacy sites

http://www.roche.com/home/company/com_hist.htm

http://www.healthdigest.org/Bactrim-DS(Oral)_2006_PRO.php

http://www.hsforum.com/stories/storyReader$1509

http://www.hsforum.com/stories/storyReader$1516

http://www.hsforum.com/stories/storyReader$1504

http://www.people.vcu.edu/~urdesai/atc.htm#Process%20of%20clotting

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