Here are the basics about each of the medicines below. Only the most common reactions are listed. Ask your doctor if you need to take any special steps. Use each of these as advised by your doctor or the booklet they came with. Call your doctor if you have any questions.
Medicine is often used with changes to your diet and other lifestyle habits. The reasons to start medicines are based on your overall risk of heart disease as well as age, weight, family history, or other health problems.
Prescription Medications
- Fluvastatin
- Atorvastatin
- Lovastatin
- Pravastatin
- Simvastatin
- Rosuvastatin
- Pitavastatin
- Cholestyramine
- Colestipol
- Colesevelam
- Gemfibrozil
- Fenofibrate
Selective Cholesterol Absorption Inhibitors
- Ezetimibe
- Alirocumab
- Evolocumab
Common names:
- Fluvastatin
- Atorvastatin
- Lovastatin
- Pravastatin
- Simvastatin
- Rosuvastatin
- Pitavastatin
Statins lower bad and total cholesterol, and triglycerides. It slows how the body makes it. This lowers the risk of heart disease, heart attack, and stroke.
Some problems are:
- Headache
- Muscle pain or damage
- Rash
- Liver damage—rare
Common names:
- Cholestyramine
- Colestipol
- Colesevelam
Bile acid sequestrants lower cholesterol levels by changing the way the body uses cholesterol.
Some problems are:
- Heartburn
- Indigestion
- Constipation
Niacin is a B vitamin that lowers cholesterol and triglyceride levels when taken in higher doses. It slows how the body makes it.
Some problems are:
- Flushing
- Itching
- Rash
- Indigestion
Common names:
- Gemfibrozil
- Fenofibrate
Fibric acid derivatives are used to lower triglyceride and raise good cholesterol levels. They may also help lower the amount of bad cholesterol.
Some problems are:
- Belly pain
- Nausea
- Diarrhea
- Rash
- Itching
- Gallstones
- Muscle pain or inflammation—especially if taken with a statin
Ezetimibe
Ezetimibe lowers both total and bad cholesterol. It lowers the amount of cholesterol that your body absorbs.
Some problems are:
- Belly pain
- Feeling tired
- Joint aches
- Allergic reaction—swelling of face, lips, tongue, or throat that may cause breathing problems
Special Considerations
If you are taking medicine:
- Take medicine as directed. Do not change the amount or the schedule.
- Be aware of the side effects of your medicine. Tell your doctor if you have any.
- Talk to your doctor before you stop taking any prescription medicine.
- Do not share your prescription medicine.
- Medicine can be harmful when mixed. Talk to your doctor or pharmacist if you are taking more than one medicine. This includes over-the-counter products and supplements.
- Plan for refills as needed.
References
Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol. Circulation. 2018;Nov 10 [Epub ahead of print]. Available at: https://www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000000625.
Hypercholesterolemia. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114250/Hypercholesterolemia . Updated April 16, 2019. Accessed May 28, 2019.
Hypertriglyceridemia. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115419/Hypertriglyceridemia . Updated November 28, 2018. Accessed May 28, 2019.
Navarese EP, Robinson JG, Kowalewski M, et al. Association between baseline LDL-C level and total and cardiovascular mortality after LDL-C lowering. JAMA. 2018;319(15):1566-1579.
Prevention and treatment of high cholesterol (hyperlipidemia). American Heart Association website. Available at: https://www.heart.org/en/health-topics/cholesterol/prevention-and-treatment-of-high-cholesterol-hyperlipidemia. Accessed May 28, 2019.
Revision Information
- Reviewer: EBSCO Medical Review Board Marcin Chwistek, MD
- Review Date: 03/2019
- Update Date: 05/28/2019