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What medications treat high cholesterol?

Taking a statin helps lower your LDL-cholesterol to lower your heart disease risk. It is important that you keep your doctor informed of how the medicine is working for you.

This answer is based on source information from National Heart, Lung and Blood Institute.

Results from large trials show that taking a statin reduces the chances of having a heart attack or stroke, needing bypass surgery or angioplasty, or dying of heart disease. Overall, for every 40-point reduction in low-density lipoprotein (LDL) achieved with a statin, the risk drops by 20 percent. The greater your chances of having a heart attack or stroke or dying of cardiovascular disease, the more a statin can help. In addition to lowering LDL, these drugs also help stabilize cholesterol-filled plaque in artery walls, promote the growth of new blood vessels, and calm inflammation.

Other cholesterol-lowering medications may be as beneficial for you, depending on your circumstances. Bile acid binders lower LDL cholesterol by 15 to 30 percent, depending on the daily dose and whether they are combined with a statin. If you have high triglycerides in addition to high LDL, fibric acid derivatives may help. They reduce triglycerides by 20 to 50 percent and raise high-density lipoprotein (HDL) levels by 10 to 15 percent, but have only a modest effect on LDL. If you have low HDL cholesterol, niacin is an option. Niacin alone can reduce LDL levels by 15 percent or so, lower triglycerides even more, and boost HDL by as much as 20 percent. Taken in addition to a statin, niacin lowers LDL another 10 percent. Another drug in a class of its own is ezetimibe (Zetia), which lowers LDL cholesterol by about 20 percent. Vytorin, a drug that combines ezetimibe with simvastatin, lowers LDL levels another 15 to 23 percent.

A variety of medications aim to lower high cholesterol in different ways. Statins block an ingredient your liver needs to make cholesterol and are the most popular drug. Bile-acid-binding resins help your liver to use up more cholesterol and prevent it from collecting in your blood. Cholesterol absorption inhibitors stop your small intestines from accepting cholesterol and distributing it to your blood stream. Fibrates and niacin lower triglyceride levels by slowing the production of LDL and VLDL cholesterol.

There are six medications in the statin class of drugs available to lower high cholesterol, including atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor, Altoprev), pravastatin (Pravachol), rosuvastatin calcium (Crestor) and simvastatin (Zocor). Statins are most effective at lowering low-density lipoprotein cholesterol, but they may also have modest effects on raising high-density lipoprotein cholesterol and lowering triglycerides. Statins are the most frequently prescribed cholesterol-lowering drugs, but there are other types of cholesterol-lowering drugs available, including bile acid sequestrants (resins), fibrates and cholesterol absorption inhibitors.

Sometimes changes in your diet, changes in your lifestyle and an increase in exercise are not enough to reduce your cholesterol.

If that is your situation, your doctor may consider prescribing medication to lower your cholesterol. The decision to medicate a patient is often based on high levels of bad cholesterol (LDL) and other risk factors for cardiovascular disease. Medication might be prescribed, for example, if your LDL level is high. If your LDL level is borderline but you have several risk factors for heart disease, your doctor also might put you on medication.

Drugs to reduce LDL blood levels can prevent the build-up of artery-blocking plaques. These medications also can limit the possibility of those plaques from breaking away into the blood as dangerous clots.

Several types of drugs can help reduce blood cholesterol levels. The most commonly prescribed by doctors are the statins, HMG-CoA reductase inhibitors, including: lovastatin (brand name Mevacor), simvastatin (brand name Zocor) and atorvastatin (brand name Lipitor).

These drugs work inside the liver to prevent the formation of cholesterol. They can lower bad cholesterol levels by as much as 40 percent.

Another major drug category is resins. These bind bile acids which causes the liver to produce more of them. In the process, the liver uses up cholesterol. Resins include: cholestyramine (brand name Questran) and colestipol (brand name Colestid).

High doses of the B vitamin Niacin, also can lower triglycerides and LDL levels and increase good cholesterol (HDL) levels.

Last are the drugs in the fibrates category. These lower triglycerides and can increase HDL levels. Fibrates include: gemfibrozil (brand name Lopid) and fenofibrate (brand name Tricor).

The decision to take medication to reduce cholesterol or lipids is not taken lightly by your doctor. The drugs can be expensive and often are required for many years—possibly even the rest of your life. Some of these drugs, you need to know, can have dangerous side effects, such as liver damage.

Dr. Merle Myerson, MD
Cardiologist (Heart Specialist)

The main medications used treat high cholesterol include a variety of statin drugs, PCSK9 inhibitors, and other medications. In this video, cardiologist Merle Myerson, MD, describes the different types of drugs available to treat high cholesterol.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.