Drug Therapy for Cholesterol

Updated:May 15,2014

Man Talking to DoctorIf you are concerned about preventing or treating unhealthy cholesterol levels, you should make diet and lifestyle changes. For some people, diet and lifestyle changes may be enough. For others, medication may also be needed.

Your doctor can assess your risk for a heart attack or stroke based on your cholesterol levels and other risk factors. From there, you can work with your doctor to develop a treatment and prevention plan that's right for you.

Cholesterol-Lowering Drugs

Various medications can lower blood cholesterol levels. Statins are recommended for most patients because they are the only cholesterol-lowering drug class that has been directly associated with reduced risk for heart attack and stroke. Your doctor may consider other medications as well, especially if you have serious side effects or don’t have an adequate response to statin therapy alone.

Cholesterol drugs illustrationThe guidelines recommend people talk to their doctor about the risks and benefits of statin therapy if they fall into one of the following groups:

  • Adults with LDL (bad) cholesterol of 70-189 mg/dL and a 7.5 percent or higher risk for having a heart attack or stroke within 10 years.
  • People with a history of a cardiovascular event (heart attack, stroke, stable or unstable angina, peripheral artery disease, transient ischemic attack, or coronary or other arterial revascularization).
  • People 21 and older who have a very high level of LDL (bad) cholesterol (190 mg/dL or higher).
  • People with diabetes and a LDL (bad) cholesterol level of 70-189 mg/dL who are 40 to 75 years old.

Some patients who do not fall into these four major categories may also benefit from statin therapy.

Any decision about treatment should be the result of you working with your doctor to decide the best preventive strategy.
View an animation to see how cholesterol drugs work.

*Some of the major types of commonly prescribed cardiovascular medications are summarized in this section. For your information and reference, we have included generic names as well as major trade names to help you identify what you may be taking; however, the AHA is not recommending or endorsing any specific products. If your prescription medication isn't on this list, remember that your healthcare provider and pharmacist are your best sources of information. It's important to discuss all of the drugs you take with your doctor and understand their desired effects and possible side effects. Never stop taking a medication and never change your dose or frequency without first consulting your doctor.

*Some cholesterol-lowering medications may interact with grapefruit, grapefruit juice, pomegranate and pomegranate juice. Please talk to your health care provider about any potential risks.


Learn more about cholesterol drugs

This class of drugs works in the liver to prevent the formation of cholesterol, thus lowering the amount of cholesterol circulating in the blood. Statins are most effective at lowering LDL (bad) cholesterol, but also have modest effects on lowering triglycerides (blood fats) and raising HDL (good) cholesterol. 
 
Most side effects are mild and generally go away as your body adjusts. Muscle problems and liver abnormalities are rare, but your doctor may order regular liver function tests. Patients who are pregnant or who have active or chronic liver disease should not take statins. Talk to your doctor about the possible side effects of statins before starting the drug.

Statins currently available in the U.S.include:

Atorvastatin (Lipitor®)**
Fluvastatin (Lescol®)**
Lovastatin (Mevacor®, Altoprev™)**
Pravastatin (Pravachol®)**
Rosuvastatin Calcium (Crestor®)**
Simvastatin (Zocor®)**
Statins are also found in the combination medications Advicor®** (lovastatin + niacin), Caduet®** (atorvastatin + amlodipine), and Vytorin™** (simvastatin + ezetimibe).
 

Clinical Trials

Clinical trials are scientific studies that determine if a possible new medical advance can help people and whether it has harmful side effects. Find answers to common questions about clinical trials in our Guide to Understanding Clinical Trials.





This content was last reveiwed on 04/21/2014.

Cholesterol

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