Cholesterol-lowering Medicines – familydoctor.org

Your body produces good and bad cholesterol. Lowering bad cholesterol can reduce your risk of having a heart attack or stroke. Bad cholesterol is also called LDL or low-density lipoprotein. Lifestyle changes (diet and exercise) can improve your cholesterol level. Your doctor may ask you to try these changes for 6 months to 1 year. If they don’t help, your doctor may prescribe medications to lower your cholesterol.

Path to better health

Even if you take cholesterol-lowering medications, it is important to maintain your lifestyle changes. Eating healthy and being physically active can make your medication more effective. Your doctor can give you advice on choosing healthy foods. They can also suggest how to include physical activity in your daily routine.

Your doctor will likely prescribe cholesterol-lowering medications if:

  • Previously had a heart attack, stroke, or have peripheral artery disease (PAD)
  • Your bad cholesterol (LDL) level is 190 mg/dL or higher
  • You are between 40 and 75 years old, you are at high risk for heart disease or stroke, and your LDL cholesterol level is 70 mg/dL or higher.

What are some common cholesterol-lowering medications?

Several types of medications are used to treat high cholesterol levels. Your doctor will decide which type of medicine is right for you. You may be prescribed more than one of these medications at a time.

  • statins (also called HMG-CoA reductase inhibitors) decrease cholesterol production in the body. These medications also reduce the buildup of cholesterol in the arteries (blood vessels).
  • Resins (also called bile acid sequestrants) are lipid-lowering agents in the body that bind to bile acids. Bile acids are produced in the liver and help with digestion. When the resins bind to bile, the body eliminates them and tells it to use the excess cholesterol to produce more bile acids. This lowers your LDL cholesterol level.
  • Cholesterol absorption inhibitorsreduce the amount of cholesterol that is absorbed by the intestines. This type of medication is often prescribed in combination with a statin.
  • Fibrates Help lower cholesterol by reducing triglycerides (fats) in the body. Fibrates are also called fibric acid derivatives. They also increase the level of good cholesterol (also called HDL or high-density lipoprotein).
  • PCSK9 Inhibitors block a protein (called PCSK9). Blocking this protein helps the liver remove LDL cholesterol from the blood.

Things to consider

Like all medications, these medications can cause side effects. However, side effects are rare and generally not serious.

Common side effects of cholesterol-lowering medications include the following:

  • Diarrhea or constipation
  • Abdominal pain, cramps, bloating or gas.
  • Nausea
  • Vomiting
  • Headache
  • Drowsiness
  • Dizziness
  • Muscle pain or weakness
  • Redness (skin becomes red and warm)
  • Sleeping problems

Tell your doctor as soon as possible if your side effects become serious.

What is a drug interaction?

If you take 2 or more medications at the same time, the way your body processes each medication may change. When this happens, the risk of side effects from each medication increases. Additionally, each medication may not work as it should. This is called a drug-drug interaction. Vitamins and herbal supplements can also affect how your body processes medications.

Nutrients in certain foods or drinks can also prevent your medication from working as it should. They may also make side effects worse. This is called a drug-nutrient interaction.

Interactions between medications and between medications and nutrients can be dangerous. Tell your doctor everything you are taking. This includes all prescription and over-the-counter medications, vitamins, and herbal supplements. Do not take any new medicines without first talking to your doctor. This includes any new over-the-counter or prescription medications, vitamins, or herbal supplements.

It is important to take medications exactly as directed by your doctor. Ask your doctor if you need to avoid any foods or drinks while using your cholesterol-lowering medication.

Questions for your doctor

  • How often should I check my cholesterol?
  • What kind of side effects can I have while taking the medication?
  • What happens if I miss a dose of medication?
  • Does taking this medication mean I can eat whatever I want?
  • Should I also limit salt in my diet for heart health?
  • Can I drink alcohol while taking this medication?
  • Will I always have to take cholesterol-lowering medications?
  • Can any supplements or non-medicinal options help lower my cholesterol?

Resources

Centers for Disease Control and Prevention: Cholesterol-Lowering Medications

National Institutes of Health, MedlinePlus: Cholesterol Medications

Copyright © American Academy of Family Physicians

This information provides a general overview and may not apply to everyone. Talk to your primary care doctor to find out if this information applies to you and for more information on this topic.

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