Cholesterol medicine includes simvastatin, ezetimibe, and alirocumab that help lower levels of total cholesterol, LDL ("bad") cholesterol, VLDL, and triglycerides to decrease the risk of cardiovascular problems like heart attack or stroke.
These medications can be taken alone or in combination to boost their effects. Cholesterol medicine is associated with certain side effects and contraindications and should only be taken under the supervision of a doctor or other healthcare professional.
Lifestyle modifications are also recommended to help lower cholesterol, such as following a healthy, well-balanced diet, exercising regularly, and cutting back on smoking and alcohol consumption.
Common medications
Medications that may be prescribed to help lower cholesterol include:
1. Simvastatin
Simvastatin, like pravastatin, is part of a class of medications called statins that inhibit cholesterol production in the liver and help lower levels of total cholesterol and LDL ("bad") cholesterol.
This medication also helps lower triglycerides and increase levels of HDL ("good") cholesterol.
How to take: Simvastatin is an oral medication (taken by mouth) typically taken once a day, at night, following a meal. Pravastatin is also taken at night, with or without a meal.
Atorvastatin, rosuvastatin, and fluvastatin can be taken at any time of day, with or without food.
2. Rosuvastatin
Rosuvastatin is another statin indicated to help lower levels of LDL ("bad") cholesterol, total cholesterol, and triglycerides, and also increases levels of HDL ("good") cholesterol.
This medication inhibits the action of the HMG-CoA reductase enzyme to hinder production of cholesterol and triglycerides in the body.
Other statins with a similar effect include atorvastatin and fluvastatin.
How to take: Atorvastatin, rosuvastatin, and fluvastatin are oral medications (taken by mouth) that can be taken at any time of day, with or without food. They are typically taken once a day, at night.
3. Cholestyramine
Cholestyramine, like colesevelam, is a bile acid sequestrant that binds to bile acids in the intestines and inhibits fat absorption in the gut.
This results in greater elimination of fat in the stool, helping to lower high cholesterol.
These medications should only be used when prescribed by a doctor and can be taken as a single medication or in combination with other cholesterol-lowering medications like statins or ezetimibe.
How to take: Cholestyramine and colesevelam are oral medications (taken by mouth) prescribed by a healthcare provider. Dosing will vary based on whether these medications are prescribed as a single medication or in combination with other cholesterol-lowing medications.
In general, cholestyramine should be taken in the morning and at night, with meals. It should be taken only as prescribed by a doctor in order to avoid interactions with other medications. Colesevelam should be taken with food, once or twice a day, or as prescribed by a doctor or other advanced practice provider.
4. Ezetimibe
Ezetimibe is a medication that helps lower levels of total cholesterol, LDL ("bad") cholesterol, and triglycerides, in addition to increasing HDL ("good") cholesterol by decreasing fat absorption in the gut.
This medication may be recommended by a provider to be taken on its own when other medications have been ineffective at lowering cholesterol levels.
A provider may also prescribe ezetimibe to be taken along with fenofibrate or in combination with simvastatin when treatment with statins alone is not enough to lower cholesterol.
How to take: The typical recommended dose for adults is one 10 mg pill taken by mouth once a day, before or after a meal, or as prescribed by a doctor or other healthcare provider.
5. Nicotinic acid
Nicotinic acid, or niacin, is a B-complex vitamin (vitamin B3) that inhibits the production of triglycerides in the liver, lowers levels of total cholesterol and LDL ("bad") cholesterol, and increases HDL ("good") cholesterol.
This medication can also be found under the brand names Niaspan and Niacor and should only be taken under the supervision of a doctor or other healthcare provider.
How to take: Nicotinic acid should be taken at night following a light meal that is low in fat and not spicy. Dosing and duration of treatment should be determined by a healthcare provider on a case by case basis.
6. Alirocumab
Alirocumab is a monoclonal antibody indicated to help lower cholesterol and decrease the risk of cardiovascular disease in people with atherosclerosis.
Alirocumab is usually prescribed for people who cannot tolerate statins or in cases where statins are not enough to sufficiently lower cholesterol levels.
Alirocumab is sold under the brand name Praluent and works by blocking a specific protein called PCSK9 produced by the liver cells, helping eliminate "bad" cholesterol from the body and lowering levels of bad cholesterol in the blood.
How to use: Alirocumab is a subcutaneous injection administered under the skin of the belly, thigh, or upper arm. The usual recommended dose is 75 mg once every 2 weeks, or as prescribed by a healthcare provider.
7. Evolocumab
Evolocumab is a monoclonal antibody that also blocks PCSK9. It can be used as a singular medication or combined with a statin and helps lower levels of LDL ("bad") cholesterol.
This medication, sold under the brand name Repatha, comes in the form of an injection and should only be taken under the supervision of a doctor or other healthcare provider.
How to take: Evolocumab is a subcutaneous injection administered under the skin of the belly, thigh, or upper arm. Dosing is either 140 mg every 2 weeks or 420 mg once a month.
8. Omega-3s
Omega-3 fatty acids are a type of "good" fat with anti-inflammatory properties that help lower levels of LDL ("bad") cholesterol and triglycerides when taken along with other medications prescribed by a healthcare provider.
Omega-3s also maintain healthy blood vessels by helping to increase levels of HDL ("good") cholesterol, control blood pressure, and reduce cellular damage.
How to use: Omega-3 supplements can be purchased at pharmacies and drugstores, both over the counter and by prescription.
Dosing will vary based on a person's age and nutritional needs. The typical recommended dose of ALA (a type of omega-3) for adults is 1600 mg a day for men and 1100 mg a day for women. Speak to your pharmacist, doctor or a registered dietitian about the other forms of omega-3s you can take.
9. Inclisiran
Inclisiran (Leqvio) is a cholesterol-lowering medication that acts on the liver to reduce levels of LDL ("bad") cholesterol in the blood.
How to take: Inclisiran is administered as a subcutaneous injection given in a single 284 mg dose for adults, followed by a second dose 3 months later and then every 6 months after that.
Natural remedies
Natural remedies like green tea and artichoke tea have antioxidant properties that help lower levels of cholesterol and triglycerides in the blood and can be used as complementary therapies to other treatments prescribed by a doctor or other healthcare provider.
Another natural way to lower cholesterol is by eating foods high in omega-3s, such as salmon, tuna, or sardines at least three times a week or chia seeds, flax seeds, chestnuts, walnuts, and olive oil daily.
It is important to emphasize that these natural remedies should not be used as a substitute for medications or other treatments recommended by a doctor or other healthcare professional.
In addition to natural remedies, it is also important to stick to a diet low in fatty and fried foods to help lower cholesterol.
Also recommended: 8 Natural Ways to Lower Cholesterol (Teas, Juices & More) tuasaude.com/en/natural-ways-to-lower-cholesterol