High Blood Cholesterol

Medicines

There are two main ways to lower your cholesterol -- through Therapeutic Lifestyle Changes (TLC) and with medicines. This section discusses medicines.

If TLC Isn’t Enough

The second way to lower your cholesterol is with drug treatment. If TLC (Therapeutic Lifestyle Changes) cannot lower your LDL cholesterol level enough by itself, you may need to add cholesterol-lowering drugs. These medicines are used together with TLC to help lower your LDL (bad) cholesterol level.

Even if you begin drug treatment, you will need to continue the TLC lifestyle changes. TLC can not only lower your cholesterol, it can also do other things that reduce your risk of coronary heart disease (CHD). And, it can let you use a lower dose of your cholesterol-lowering medicine.

Take Your Other Medications Too

While under treatment, you should continue to take any other medicines that your doctor has prescribed for other health problems -- for example, high blood pressure or diabetes. It is important that you take ALL medicines as your doctor prescribes. The combination of medicines may lower your risk for heart disease or heart attack.

Drug treatment does not "cure" high blood cholesterol. It simply controls it. You must continue taking your medicine to keep your cholesterol level in the recommended range.

Five Cholesterol-lowering Medicines

The five major types of cholesterol-lowering medicines are

  • statins
  • ezetimibe
  • bile acid sequestrants
  • nicotinic acid
  • fibrates.

Statins

  • are very effective in lowering LDL (bad) cholesterol levels
  • are safe for most people
  • have side effects that are infrequent, but potentially serious such as liver and muscle problems.

Ezetimibe

  • lowers LDL (bad) cholesterol.
  • may be used with statins or alone.
  • acts within the intestine to block absorption of cholesterol.

Bile acid sequestrants

  • lower LDL (bad) cholesterol levels
  • are sometimes prescribed with statins
  • are not usually prescribed alone to lower cholesterol.

Nicotinic acid

  • lowers LDL (bad) cholesterol and triglycerides, and raises HDL (good) cholesterol
  • should be used only under a doctor's supervision.

Fibrates

  • mainly lower triglycerides
  • may increase HDL (good) cholesterol levels
  • may increase the risk of muscle problems when used with a statin.