Debra Wood, RN
The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included. Ask your doctor if you need to take any special precautions. Use each of these medications only as recommended by your doctor, and according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.
Be sure to tell your doctor what other prescribed or over-the-counter medications, supplements, or herbs you are taking; they could interact with your medications.
If your cholesterol level is elevated, your doctor may recommend medication in addition to diet and lifestyle changes. The decision to start cholesterol-lowering drugs depends not only on your cholesterol level but also on your overall heart-disease risk. Heart disease risk factors include age, obesity, family history, smoking, diabetes, and high blood pressure.
The following medications may be used to treat lipid disorders.
(HMG CoA Reductase Inhibitors)
Bile Acid Sequestrants
Fibric Acid Derivatives
Selective Cholesterol Absorption Inhibitors
(Proprotein Convertase Subtilisin-Kexin Type 9)
Common names include:
Statins lower total blood cholesterol, LDL cholesterol, and triglyceride levels. They also lower heart disease risks. The drugs are usually taken daily with dinner or in the evening. Your doctor may measure your blood cholesterol levels regularly while you are taking these drugs.
Even if you currently have no known coronary heart disease (CHD), you may benefit from taking statin (cholesterol-lowering) medications, particularly if your cholesterol levels are elevated. The medication may reduce the incidence of
stroke, and death.
Significant side effects that have been reported with the use of statin medications include:
Bile acid sequestrants lower cholesterol levels by changing the way that cholesterol is metabolized. The drugs are in powder form and are taken with meals to decrease side effects. They should not be taken within hours of any other medications. Usually you should take other medications either one hour before or four hours after taking this medication.
Possible side effects include, but are not limited to:
Niacin is a B vitamin. At higher doses, it can lower cholesterol levels and triglycerides. It is not known how it works. Niacin should be taken with meals, 2-3 times per day, or once a day with the extended-release pill.
Possible side effects can include, but are not limited to:
Fibric acid derivatives are usually taken to lower triglyceride levels and increase HDL (good) cholesterol. They may also help lower LDL cholesterol.
Ezetimibe lowers both total cholesterol and LDL (bad) cholesterol. It works by a different mechanism than the statins by decreasing the amount of cholesterol that your body absorbs.
PCSK9 inhibitors are a class of medications that can lower LDL cholesterol levels. The medications are only available in injection form and need to be given every 2 to 4 weeks under the skin. The experience with these drugs is still limited. They are expensive and some insurance companies do not cover them.
Common names include:
Follow these general medication guidelines:
American College of Cardiology/American Heart Association. 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults.
J Am Coll Cardiol. 2013: early online. Available at:
http://circ.ahajournals.org/content/early/2013/11/11/01.cir.0000437738.63853.7a. Accessed March 9, 2017.
How is high blood cholesterol treated?
National Heart, Lung, and Blood Institute
website. Available at:
http://www.nhlbi.nih.gov/health/health-topics/topics/hbc/treatment. Updated March 30, 2016. Accessed March 9, 2017.
Hypercholesterolemia. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114250/Hypercholesterolemia. Updated December 19, 2016. Accessed March 9, 2017.
Hypertriglyceridemia. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115419/Hypertriglyceridemia. Updated February 2 ,2017. Accessed March 9, 2017.
PCSK9 inhibitors. Heart UK website. Available at: https://heartuk.org.uk/healthcare-professionals/learning-resources/pcsk9-inhibitors. Accessed March 9, 2017.
Prevention and treatment of high cholesterol. American Heart Association website. Available at:
Updated August 30, 2016. Accessed March 9, 2017.
1/30/2009 DynaMed Plus Systematic Literature Surveillance
http://www.dynamed.com/topics/dmp~AN~T114250/Hypercholesterolemia Mills EJ, Rachlis B, et al. Primary prevention of cardiovascular mortality and events with statin treatments: a network meta-analysis involving more than 65,000 patients.
J Am Coll Cardiol.
3/5/2012 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T114250/Hypercholesterolemia FDA announces safety changes in labeling for some cholesterol-lowering drugs. US Food and Drug Administration website. Available at:
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm293623.htm. Updated March 2, 2012. Accessed March 5, 2012.
Last reviewed March 2017 by Marcin Chwistek, MD
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