Which medications in the drug class Antilipemic agents are used in the treatment of Low HDL Cholesterol (Hypoalphalipoproteinemia)?

Updated: May 21, 2021
  • Author: Vibhuti N Singh, MD, MPH, FACC, FSCAI; Chief Editor: George T Griffing, MD  more...
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Answer

Antilipemic agents

These medications usually lower low-density lipoprotein (LDL) cholesterol levels. In addition, they sometimes lower triglyceride (TG) levels and may modestly elevate high-density lipoprotein (HDL) cholesterol levels. Antilipemic agents may be of value to patients with hypoalphalipoproteinemia (HA).

Niacin, nicotinic acid (Niacor, Nicobid, Nicolar, Niaspan)

Source of niacin used in tissue respiration, lipid metabolism, and glycogenolysis. Nicotinic acid has lipid-lowering properties, but nicotinamide and niacinamide do not.

Gemfibrozil (Lopid)

Fibric acid antilipemic agent that effectively reduces serum TGs and favorably alters lipoprotein levels; the mechanism of action is unknown, but gemfibrozil may inhibit lipolysis, the secretion of VLDL, and hepatic fatty acid uptake.

Fenofibrate (Tricor)

Fibric acid antilipemic agent that lowers LDL cholesterol more effectively than do older fibrates (ie, clofibrate, gemfibrozil). Fenofibrate is primarily indicated for TG reduction and for use in mixed dyslipidemia. This agent increases plasma catabolism and the clearance of TG-rich particles by lipoprotein lipase induction and the suppression of the hepatic production of apo C-III through the activation of PPARs. Fenofibrate activates acetyl-CoA and other enzymes, increasing fatty acid oxidation. TG production is also decreased via the inhibition of acetyl-CoA carboxylase and fatty acid synthase. Clinically, a marked reduction in plasma TGs and VLDL is observed, as is an increase in HDL cholesterol levels.


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