Cholesterol medications: Consider the options

By Mayo Clinic staff
A healthy lifestyle is the first defense against high cholesterol. But sometimes diet and exercise aren't enough, and you may need to take cholesterol medications. Cholesterol medications may help:

• Decrease your low-density lipoprotein (LDL) cholesterol, the "bad" cholesterol that increases the risk of heart disease
• Decrease your triglycerides, a type of fat in the blood that also increases the risk of heart disease
• Increase your high-density lipoprotein (HDL) cholesterol, the "good" cholesterol that offers protection from heart disease

Your doctor may suggest a single drug or a combination of cholesterol medications. Here's an overview of benefits, cautions and possible side effects for common classes of cholesterol medications.

Drug class and drug names	Benefits	Possible side effects and cautions
Statins Altoprev (lovastatin) Crestor (rosuvastatin) Lescol (fluvastatin) Lipitor (atorvastatin) Mevacor (lovastatin) Pravachol (pravastatin) Zocor (simvastatin)	Decrease LDL and triglycerides; slightly increase HDL	Constipation, nausea, diarrhea, stomach pain, cramps, muscle soreness, pain and weakness; possible interaction with grapefruit juice
Bile acid binding resins Colestid (colestipol) Questran (cholestyramine/ sucrose) Welchol (colesevelam)	Decrease LDL	Constipation, bloating, nausea, gas; may increase triglycerides
Cholesterol absorption inhibitor Zetia (ezetimibe)	Decreases LDL; slightly decrease triglycerides; slightly increase HDL	Stomach pain, fatigue, muscle soreness
Combination cholesterol absorption inhibitor and statin Vytorin (ezetimibe-simvastatin)	Decreases LDL and triglycerides; increases HDL	Stomach pain, fatigue, gas, constipation, abdominal pain, cramps, muscle soreness, pain and weakness; possible interaction with grapefruit juice
Fibrates Lofibra (fenofibrate) Lopid (gemfibrozil) TriCor (fenofibrate)	Decrease triglycerides; increase HDL	Nausea, stomach pain, gallstones
Niacin Niaspan (prescription niacin)	Decreases LDL and triglycerides; increases HDL	Facial and neck flushing, nausea, vomiting, diarrhea, gout, high blood sugar, peptic ulcers
Combination statin and niacin Advicor (niacin-lovastatin)	Decreases LDL and triglycerides; increases HDL	Facial and neck flushing, dizziness, heart palpitations, shortness of breath, sweating, chills; possible interaction with grapefruit juice
Omega-3 fatty acids Lovaza (prescription omega-3 fatty acid supplement) Vascepa (Icosapent ethyl)	Decrease triglycerides	Belching, fishy taste, increased infection risk

Most cholesterol medications lower cholesterol with few side effects, but effectiveness varies from person to person. If you decide to take cholesterol medication, your doctor may recommend periodic liver function tests to monitor the medication's effect on your liver. Also remember the importance of healthy lifestyle choices. Medication can help control your cholesterol — but lifestyle matters, too.