Treatment and management for high triglycerides (hypertriglyceridemia) is usually started when natural lowering measures such as a controlled diet and a daily exercise program have failed to lower the raised levels. Taking triglyceride lowering medicines then becomes necessary.

Treating triglycerides with drugs immediately becomes essential in presence of higher levels of triglycerides (500 mg/dl) and when the person has high-risk factors that make him prone to develop a heart attack or stroke.

Usually, there may be high cholesterol levels too, and in such cases, a combination of triglyceride drugs to reduce cholesterol and triglycerides will be necessary.

Triglyceride treatment has to be taken with the advice of the doctor and should be followed up with him or her regularly.

Lifestyle habits, diet, and exercises, as advised, have to be followed along with the triglyceride treatment and with the advice of your doctor. Avoiding foods that increase triglycerides also becomes mandatory.

The natural measures of diet and exercise will increase the efficacy of the TG lowering medicines and will even control your triglycerides with a lesser dose.

Medicines for high triglycerides – Guidelines

Besides controlling TG levels, medication for triglycerides (TG) will also aim to reduce the high LDL cholesterol and increasing the HDL cholesterol. This is because high TG levels are usually accompanied by high LDL levels. The following are the drug options to treat hypertriglyceridemia.

1. Statins to treat high triglycerides

According to an article of 1998 published in the “American Journal of Cardiology,” statins work best at lowering LDL cholesterol and triglycerides both.

They reduce triglyceride levels by 10% to 20% and higher the existing levels, the greater is the TG reducing effect. To exemplify, if your triglyceride levels stand at 250 mg/dL, statins have been seen with reductions ranging from 22% to 45%.

For complete information on statins regarding its uses, mode of action, side effects, types and brand names, you should read this article.

2. Fibrates to treat triglycerides

Fibrates, available on prescription, are derivatives of fibric acid, which are called hypolipidemic agents because they lower triglycerides. In addition, they increase HDL, the good cholesterol.

However, their action in lowering LDL is less effective. Fibrates may lower triglycerides by 25% to 50% and can increase HDL by 10% to 35%.

For complete information on fibrates regarding its uses, mode of action, side effects, types and brand names, you should read this article.

3. Niacin or Nicotinic Acid to treat high triglycerides

What is Niacin?

Niacin, also known as nicotinic acid or vitamin B3, is an organic compound, which is one of the necessary nutrients required by the body.

Niacin used for treating high triglycerides differs from the over the counter Niacin ( Nicotinamide) of  Vitamin B’ complex, which has no role in treating high cholesterol

Types and brand names

Niacin is known under the brand name of Niacor. Its sustained release form is known as Sio-Niacin while its extended release form is known as Niaspan.

Action of Niacin

Niacin lowers LDL or the bad cholesterol by 55 to 25% and the triglycerides by 20% to 50% and effectively raises HDL or the good cholesterol by 15% to 35%.

However, high doses are required. It is not clear how Niacin acts but it could be that Niacin inhibits the liver from producing LDL and triglycerides or Niacin could be reducing the production of proteins that transport cholesterol and triglycerides in the blood.

Side Effects of Niacin 

Side effects include hot flushes, gastrointestinal symptoms like nausea, vomiting, diarrhea and indigestion. Long-term treatment can cause peptic ulcer, liver toxicity, gout and increased blood sugar.

Caution when taking Niacin

Niacin should not be used by those who have a peptic ulcer, diabetes, liver disease, and bleeding disorders.

4. Omega 3 fatty acid supplements to treat high triglycerides

Omega 3 fatty acid supplements such as Lovaza may be prescribed to lower triglycerides.

  • By prescription: Lovaza
  • Over the counter (fish oil capsules)
  • Primary action is to lower TG, can also increase HDL

Fish oil in doses of 3.5 grams of omega-3 fatty acids per day, can effectively lower triglycerides.

Fish such as salmon, tuna, mackerel, and sardines are rich sources of omega 3 fatty acids. These supplements may be used along with other triglyceride lowering medicines such as statins.

LDL cholesterol levels have to be monitored periodically when taking these omega 3 supplements.

Treatment and medications for high triglycerides have to be taken under the strict guidance of your doctor and should not be self-prescribed.