High Cholesterol: Medications
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Medications
Statins are the most effective and widely used medicines to treat high cholesterol. Evidence shows that statins can reduce the risk for heart attack, stroke, and death in people who are at high risk of a heart attack or stroke.3 Other medicines also lower cholesterol, and some may be used to lower triglycerides or raise HDL.
- Some people can try diet and exercise for at least 3 months before medicines are started. But people who have coronary artery disease (CAD) should start taking medicines immediately.1
- Other people who may need to start taking medicine as soon as possible include those who have a family history of early CAD, those who have inherited forms of high cholesterol, and those who have peripheral arterial disease or diabetes or who have had a previous heart attack or stroke.
Your doctor may follow NCEP and American Heart Association medicine guidelines in deciding whether you should take medicine to lower your cholesterol. The guidelines base treatment on your LDL level and your risk for CAD.
Cholesterol treatment guidelines will continue to evolve as experts learn more about how best to treat heart disease. But everyone can benefit from eating a balanced low-fat diet, getting regular exercise, and reducing other heart disease risks, such as smoking.
Medication Choices
The following medicines can be used to lower LDL and triglyceride levels in the blood and to raise HDL.
| Generic names | Brand names | How they work |
|---|---|---|
| atorvastatin, lovastatin, pravastatin, simvastatin, fluvastatin, rosuvastatin | Lipitor, Mevacor, Pravachol, Zocor, Lescol, Crestor, Altocor | Reduce how much cholesterol your liver makes |
Some statins are combined with another medicine.
| Generic names | Brand names | How they work |
|---|---|---|
| ezetimibe with simvastatin | Lower how much cholesterol your liver makes and affect how your body absorbs cholesterol | |
| atorvastatin with amlodipine | Lower how much cholesterol your liver makes and lower blood pressure | |
| niacin with lovastatin | Raise good HDL cholesterol and lower bad LDL cholesterol |
Your doctor may prescribe other medicines. Some are used with a statin.
Type of drug | Generic names | Brand names | How they work |
|---|---|---|---|
| cholestyramine, colestipol, colesevelam | Questran, Colestid, Welchol | Affect how your body removes cholesterol | |
| gemfibrozil, fenofibrate | Lopid, Tricor | Lower triglycerides and can raise good HDL cholesterol. LDL may go up slightly. | |
| niacin | Niacor, Niaspan, Nicolar | Raise good HDL cholesterol and lower triglycerides and LDL | |
| ezetimibe | Zetia | Lower how much cholesterol your body can absorb |
What to Think About
- Men younger than 35 and women who have not reached menopause are at lower risk for heart disease and often can try lifestyle changes before medicines.
- Medicine is always added to a diet and exercise plan (Therapeutic Lifestyle Changes), not substituted for it.
- Side effects are more likely and may be more severe when higher doses of statins are used.
- Doctors may also prescribe aspirin therapy if you have had a heart attack or have a high risk for heart attack.
To help you decide whether medicine to lower cholesterol is right for you, see:
| Last updated: | July 11, 2008 |
|---|---|
| Author: | Robin Parks, MS |
| Reviewed By: | E. Gregory Thompson, MD - Internal Medicine, Robert A. Kloner, MD, PhD - Cardiology |
| Editors: | Kathleen M. Ariss, MS, Pat Truman, MATC |
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