Cholesterol medications: Consider the options

Statins
Atorvastatin (Lipitor)
Fluvastatin (Lescol XL)
Lovastatin (Altoprev)
Pitavastatin (Livalo)
Pravastatin (Pravachol)
Rosuvastatin (Crestor)
Simvastatin (Zocor) Decrease LDL and triglycerides; slightly increase HDL Muscle pain, increased blood sugar levels, constipation, nausea, diarrhea, stomach pain, cramps, elevation of liver enzymes Cholesterol absorption inhibitor
Ezetimibe (Zetia) Decreases LDL; slightly decreases triglycerides; slightly increases HDL Stomach pain, diarrhea, fatigue, muscle soreness; avoid during pregnancy and lactation PCSK9 inhibitors
Alirocumab (Praluent)
Evolocumab (Repatha) Decrease LDL; usually reserved for people who have a genetic condition that causes very high LDL levels or people with heart disease who cannot tolerate statins or other cholesterol lowering drugs Itching, swelling, pain or bruising at injection site Citrate lyase inhibitors
Bempedoic acid (Nexletol)
Bempedoic acid-ezetimibe (Nexlizet) Decrease LDL Muscle spasms and joint pain, including acute gout Bile acid sequestrants
Cholestyramine (Prevalite)
Colesevelam (Welchol)
Colestipol (Colestid) Decrease LDL; may slightly increase HDL Constipation, bloating, nausea, gas, heartburn Combination cholesterol absorption inhibitor and statin
Ezetimibe-simvastatin (Vytorin) Decreases LDL and triglycerides; increases HDL Stomach pain, fatigue, gas, constipation, abdominal pain, cramps, muscle soreness, pain and weakness Combination calcium channel blocker and statin
Amlodipine-atorvastatin (Caduet) The statin component decreases LDL and triglycerides; the calcium channel blocker lowers blood pressure Facial and neck flushing, dizziness, heart palpitations, muscle soreness and pain, increased blood sugar levels, constipation, nausea, diarrhea, stomach pain, cramps, elevation of liver enzymes Fibrates
Fenofibrate (Antara, Lipofen, others)
Gemfibrozil (Lopid) Decrease triglycerides; modestly decrease LDL; increase HDL Nausea, stomach pain, muscle pain Niacin
Prescription niacin (Niacor, Niaspan) Decreases LDL and triglycerides; increases HDL Facial and neck flushing, itching, stomach upset, increase in blood sugar Omega-3 fatty acids
Prescription versions include Lovaza, Omacor and Vascepa Decrease triglycerides; may increase HDL Belching, fishy taste, indigestion; may increase risk of bleeding

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