Using Medication for Cholesterol

Sometimes for an individual, lifestyle changes such as eating healthy and exercising isn't enough. If this is the case, your doctor may start you on some form of drug therapy to help fight your high cholesterol and prevention of heart disease.
Statins (also known as HMG CoA reductase inhibitors)
This class of drugs works in the liver to prevent the formation of cholesterol. Statins are most effective at lowering the LDL (bad) cholesterol, but also have modest effects on lowering triglycerides (blood fats) and raising HDL (good) cholesterol.

Most of statins' 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.

Selective cholesterol absorption inhibitors
This relatively new class of cholesterol-lowering medications works by preventing the absorption of cholesterol from the intestine. Selective cholesterol absorption inhibitors are most effective at lowering the LDL (bad) cholesterol, but may also have modest effects on lowering triglycerides (blood fats) and raising HDL (good) cholesterol.

The first medication of this class, ezetimibe (Zetia®)**, was approved in 2002 for the treatment of high cholesterol and certain inherited lipid abnormalities.

Resins (also known as bile acid sequestrant or bile acid-binding drugs)
This class of LDL-lowering drugs works in the intestines by promoting increased disposal of cholesterol. Your body uses cholesterol to make bile, an acid used in the digestive process. These medicines bind to bile, so it can't be used during digestion. Your liver responds by making more bile. The more bile your liver makes, the more cholesterol it uses. That means less cholesterol is left to circulate through your bloodstream.

Fibrates (fibric acid derivatives)
Fibrates are best at lowering triglycerides and in some cases increasing HDL (good cholesterol) levels. These drugs are not very effective in lowering LDL (bad) cholesterol. That's why fibrates are generally used in people whose triglycerides are high or whose HDL is low, after reaching LDL goal. Fibrates are most effective at lowering triglycerides (blood fats). Additionally, they act to raise the levels of HDL (good) cholesterol. Fibrates may be used in combination therapy with the statins.

Niacin (nicotinic acid)
This drug works in the liver by affecting the production of blood fats. Niacin is prescribed to lower triglycerides and LDL cholesterol and raise HDL ("good") cholesterol.

Niacin side effects may include flushing, itching and stomach upset. Your liver functions may be closely monitored, as niacin can cause toxicity. Nonprescription immediate release forms of niacin usually have the most side effects, especially at higher doses. Niacin is used cautiously in diabetic patients as it can raise blood sugar levels.

Niacin comes in prescription form and as “dietary supplements.” Dietary supplement niacin must not be used as a substitute for prescription niacin. It should not be used for lowering cholesterol because of potential serious side effects. Dietary supplement niacin is not regulated by the U.S. Food and Drug Administration (FDA) the same way that prescription niacin is. It may contain widely variable amounts of niacin — from none to much more than the label states. The amount of niacin may even vary from lot to lot of the same brand. Consult your doctor before starting any niacin therapy.

For more information on drug therapy Read the latest FDA Drug Safety Newsletter

Taking medicine may be new to you, and there may be a lot to remember. For example, why are you taking it? What time should you take it? How often do you take it and how many pills do you take? It's important to take medicine the right way — just as prescribed. For quick tips on how you should manage your medicines click here.

"Moving" your way to lowering your cholesterol

Physical inactivity is a major risk factor for heart disease!

For some people, regular physical activity affects blood cholesterol level by increasing the level of HDL (good) cholesterol. A higher HDL level is linked with a lower risk of heart disease. Physical activity can also help control other risk factors for heart disease: weight, diabetes and high blood pressure. Aerobic exercise (exercise that uses oxygen to provide energy to large muscles) raises your heart and breathing rates, which help your heart to work more efficiently at rest as well as during physical activity. Vigorous, regular physical activity such as brisk walking, jogging and swimming also condition your lungs.

Even mild activities, if done daily, can help. You can benefit from simple things like walking, gardening, housework or dancing. Talk to your doctor about getting started, especially if you've been inactive.

Here are 10 Tips for starting a physical activity program!

1. Wear comfortable clothes and sneakers or flat shoes with laces.
2. Start slowly. Gradually build up to at least 30 minutes of activity on most or all days of the week (or whatever your doctor recommends).
3. Exercise at the same time of day so it becomes a regular part of your lifestyle. For example, you might walk every Monday, Wednesday, Friday and Saturday from noon to 12:30 p.m.
4. Drink a cup of water before, during and after exercising (but check with your doctor, because some people need to limit their fluid intake).
5. Ask family and friends to join you — you'll be more likely to stick with it if you have company. Or join an exercise group, health club or the YMCA. Many churches and senior centers offer exercise programs too. (Remember to get your doctor's permission first.)
6. Note your activities on a calendar or in a logbook. Write down the distance or length of time of your activity and how you feel after each session. If you miss a day, plan a make-up day or add 10–15 minutes to your next session.
7. Use variety to keep your interest up. Walk one day, swim the next, then go for a bike ride on the weekend.
8. Look for chances to be more active during the day. Walk the mall before shopping, take the stairs instead of the escalator or take 10–15 minute breaks while watching TV or sitting for walking or some other activity.
9. Don't get discouraged if you stop for a while. Get started again gradually and work up to your old pace.
10. Don't exercise right after meals, when it's very hot or humid, or when you just don't feel up to it.

The American Heart Association recommends that all adults get at least 30 minutes of physical activity every day, or at least more days than not. If you're trying to lose weight or maintain weight loss, you should get at least 60 minutes each day. If you can't find 30 minutes or an hour in your schedule, break up your activity into 15-minute increments.

Here are some other great resources that will help you be on your way to lowering your cholesterol and to a healthy heart!

Physical Activity Tips for Older People

Tips for Raising Heart-Healthy, Active Children

Start! is the American Heart Association's movement that encourages everyone to live longer, more heart-healthy lives through walking and other healthy habits.

Choose To Move is a free 12-week physical activity program for women featuring a personal handbook, nutrition tips and new recipes, e-mails with physical activity tips to keep you motivated, workout clothing information and much more.

One-Mile Fitness Calculator

Real People with Real Stories

A lot of times in our life we put off making serious life changes, especially regarding our health. Usually when we do make those changes its because we personally know somebody that has been effected one way or the other, for the good or bad.
These stories are real, from real patients, people just like you and me. They suffered from high cholesterol or other related health conditions. They made a choice. Will you?


Sometimes a picture is worth a thousand words. Ron and Janie James made a commitment to their heart health after seeing a photo of themselves hugging at a party. "We looked like sumo wrestlers," Janie said. Read Ron and Janie's story.

Jim thought he was healthy until he had a cholesterol screening. Then he knew he had to make some changes. "A lot of people take the 'I don't want to know' approach with their health," Jim said. Read Jim's story.