Cholesterol medications: When diet and exercise aren't enough
If diet and lifestyle changes aren't enough to lower your blood cholesterol to healthy levels, your doctor may recommend a cholesterol-lowering drug. Knowing the pros and cons of the different types of medications used to lower cholesterol can lead to more informed decisions about your options.
These drugs, such as atorvastatin (Lipitor), rosuvastatin (Crestor) and simvastatin (Zocor), work by suppressing the activity of an enzyme that controls cholesterol production.
- Benefits. Statins lower low-density lipoprotein (LDL), or "bad," cholesterol by 20 to 55 percent — more than any other drug. They also raise high-density lipoprotein (HDL), or "good," cholesterol. LDL clogs the arteries, while HDL prevents cholesterol buildup in the arteries.
- Possible side effects. In rare instances, muscle pain and changes in liver enzyme levels may occur. People using statins have reported joint pain as well. Don't take statins if you're pregnant or have liver disease.
This drug lowers the amount of cholesterol absorbed by the body.
- Benefits. Ezetimibe lowers bad cholesterol by 18 to 25 percent. It can be taken in combination with statins to lower LDL levels even further. It can also raise good cholesterol.
- Possible side effects. Ezetimibe may cause diarrhea, joint pain and tiredness.
Bile acid resins
These drugs, such as cholestyramine (Prevalite), colestipol (Colestid) and colesevelam (Welchol), bind to bile acids in the intestine. These acids contain cholesterol, which are then eliminated from the body.
Sept. 03, 2015
- Benefits. Bile acid resins can lower LDL cholesterol by 15 to 30 percent.
- Possible side effects. Bile acid resins may need to be taken in combination with other cholesterol-lowering drugs to effectively lower LDL levels. They may cause stomach and intestinal issues such as constipation.
- Your guide to lowering your cholesterol with TLC. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/cgi-bin/search?q=TLC&site=NHLBI_Public&client=NHLBI_Public_frontend&proxystylesheet=NHLBI_Public_frontend&output=xml_no_dtd&getfields=description.keywords&oe=ISO-8859-1&ie=ISO-8859-1 . Accessed Feb. 5, 2014.
- Drug therapy for cholesterol. American Heart Association. http://www.heart.org/HEARTORG/Conditions/Cholesterol/PreventionTreatmentofHighCholesterol/Drug-Therapy-for-Cholesterol_UCM_305632_Article.jsp. Accessed Feb. 5, 2014.
- Third report of the Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Bethesda, Md.: National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/guidelines/cholesterol. Accessed Feb. 6, 2014.
- Zetia (prescribing information). Whitehouse Station, N.J. Merck and Co.; 2012. http://www.zetia.com/ezetimibe/zetia/consumer/prescribing-information/index.jsp?WT.svl=1. Accessed Feb. 6, 2014.
- How is high blood cholesterol treated? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/hbc/treatment.html. Accessed Feb. 5, 2014.
- High blood cholesterol: What you need to know. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health/public/heart/chol/wyntk.htm. Accessed Feb. 5, 2014.
- FDA approves Praluent to treat certain patients with high cholesterol. U.S. Food and Drug Administration. http://www.fda.gov/newsevents/newsroom/pressannouncements/ucm455883.htm. Accessed August 28, 2015.
- Praluent (prescribing information). Bridgewater, N.J.: Sanofi-Aventis; Tarrytown, N.Y.: Regeneron Pharmaceuticals; 2015. http://www.regeneron.com/Praluent/Praluent-fpi.pdf. Accessed July 28, 2015.
- Robinson JG, et al. Efficacy and safety of alirocumab in reducing lipids and cardiovascular events. New England Journal of Medicine. 2015;372:1489.
- FDA approves Repatha to treat certain patients with high cholesterol. U.S. Food and Drug Administration. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm460082.htm. Accessed August 28, 2015.
- Repatha (prescribing information). Thousand Oaks, Calif.: Amgen; 2015. http://pi.amgen.com/united_states/repatha/repatha_pi_hcp_english.pdf. Accessed August 28, 2015.