Medications for High Cholesterol

Statins are drugs that decrease LDL (bad cholesterol) and triglycerides (a type of fat in the blood that increases the risk of heart disease). These medications also slightly increase HDL (good cholesterol) levels. Examples include atorvastatin (Lipitor), simvastatin (Zocor), pravastatin (Pravachol), lovastatin (Altoprev), fluvastatin (Lescol XL), rosuvastatin (Crestor), and pitavastatin (Livalo).

Cholesterol absorption inhibitors like ezetimibe (Zetia) decrease the absorption of cholesterol from food in the intestines and decrease the delivery of dietary cholesterol to the liver.

Bile acid sequestrants include medications like cholestyramine (Prevalite), colestipol (Colestid), and colesevelam (Welchol) that increase the production of bile acids in the liver. The body uses cholesterol to make bile acids, thereby reducing LDL cholesterol levels in the blood.

Citrate lyase inhibitors decrease bad cholesterol (LDL) by blocking an enzyme that is essential for cholesterol synthesis. Examples include bempedoic acid (Nexletol) and bempedoic acid – ezetimibe combination (Nexlizet).

PCSK9 inhibitors are a class of drugs that are prescribed to people with very high LDL levels due to a genetic condition or those who cannot tolerate statins and other cholesterol-lowering medications. They are administered by subcutaneous injection every 2-4 weeks. Examples include evolocumab (Repatha) and alirocumab (Praluent).

Combination cholesterol-lowering medications include ezetimibe – simvastatin (Vytorin) which decreases LDL and triglycerides and increases HDL. Caduet, which is a combination of amlodipine and atorvastatin, includes a blood pressure-lowering drug and a cholesterol-lowering drug.

Other medications used to lower LDL cholesterol and triglyceride levels and increase HDL levels include fibrates (fenofibrate Lipofen and gemfibrozil Lopid), niacin (Niaspan, Niacor), and omega-3 fatty acids (Omacor, Lovaza).