Table 6. Major effects of current medications for dyslipidemia

Type of medication	Major effects	Adverse effects	Medications	FDA approval in pediatrics
HMG-CoA reductase inhibitors	↓LDL-C, TG, VLDL synthesis↑Hepatic LDL receptors, HDL-C	Increased liver enzyme and creatine kinase, myopathy, rhabdomyolysis	Lovastatin 20–80 mg/daySimvastatin 20–80 mg/dayPravastatin 20–80 mg/dayAtorvastatin 5–80 mg/day	Approved
Bile acid sequestrants	↓LDL-C, bile excretion↑TG	Trouble of gastrointestinal tract; gas, bloating, constipation, cramps	Cholestyramine 8–16 g/dayColestipol 2.5–20 g/dayColesevelam 1.25–4.375 g	Evidence-based studies in children are lacking but used in clinical practice
Cholesterol absorption inhibitors	↓LDL-C↑HDL-C	Trouble of gastrointestinal tract, myopathy, headache	Ezetimibe 10 mg/day	Not approved
Fibric acid derivatives	↓TG↑HDL-C	Dyspepsia, constipation, myositis, anemia	Gemfibrozil 1,200 mg/dayFenofibrate 48–145 mg/day	Not approved
Nicotinic acid	↓TG and LDL-C	Flushing, hepatic tocixity	Niacin 1,000–2,250 mg/day	Not approved
Omega-3-fish oil	↓TG, VLDL production	Gastrointestinal trouble	DHA 2–4 g (adults)	Not approved

FDA, Food and Drug Administration; HMG-CoA, 3-hydroxy-3-methylglutaryl coenzyme A; LDL-C, low-density lipoprotein cholesterol; TG, triglycerides; VLDL, very-low-density lipoprotein; HDL-C, high-density lipoprotein cholesterol; DHA, docosahexaenoic acid.