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Your Guide to Lowering High Cholesterol

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What to Expect When Trying a New Cholesterol Treatment

Medically Reviewed By Jennie Olopaade, PharmD, RPH

Cholesterol medications work in specific ways to bring your numbers into a healthy range. Your doctor will monitor your cholesterol levels to adjust medication or recommend a new treatment plan.


There are many positive reasons to improve your cholesterol levels. One major reason is that by lowering your low-density lipoprotein (LDL) cholesterol level, you’ll reduce your risk of a heart attack or stroke. 

Several medications improve cholesterol levels, including statins, bile acid sequestrants, niacin, and fibrates. They each work in slightly specific ways. If the first drug you try doesn’t improve your numbers, your doctor can add on another medication.

Before you try a new cholesterol medication, consider what to expect from the drug.

How cholesterol medicines work

Most people with high cholesterol Trusted Source American Heart Association Highly respected national organization Go to source levels start with one of these statin medications: 

  • atorvastatin (Lipitor)
  • fluvastatin (Lescol XL)
  • lovastatin (Altoprev, Mevacor)
  • pitavastatin (Livalo, Zypitamag)
  • pravastatin (Pravachol)
  • rosuvastatin (Crestor, Ezallor)
  • simvastatin (Zocor)

Statins block an enzyme that your liver uses to make cholesterol. Blocking this enzyme reduces the amount of cholesterol released into your blood. Statins also help your liver remove more cholesterol from your blood. These medications may reduce the risk Trusted Source Centers for Disease Control and Prevention (CDC) Governmental authority Go to source  of heart attack and stroke.

If a statin doesn’t lower your cholesterol levels enough or at all, your doctor might add one of these medications:

  • Ezetimibe (Zetia): It blocks the absorption of cholesterol in your intestine.
  • PCSK9 inhibitors: Alirocumab (Praluent) and evolocumab (Repatha) turn off a protein on specific liver cells to reduce the production of LDL cholesterol. These medicines come as an injection that you get once every 2 to 4 weeks.
  • Bile acid sequestrants: Cholestyramine (Questran), colestipol (Colestid), and colesevalam Hcl (WelChol) help your body get rid of more cholesterol.
  • Small interfering RNAs (siRNAs): The Food and Drug Administration approved inclisiran (Leqvio) to help decrease low-density lipoprotein (LDL) cholesterol in adults.

How soon you can expect results

Each cholesterol medicine takes a different amount of time to start working.

Statins may start to lower your cholesterol within 4 weeks if you take them as prescribed. PCSK9 inhibitors work within a month, too. Bile acid sequestrants and Zetia work faster, in about 2 weeks

Your doctor will do a blood test 1 to 3 months after you begin taking the drug to see if it’s lowering your cholesterol. If your numbers don’t improve, your doctor may add another cholesterol-lowering drug or switch medicines.

Possible side effects

Each of these medications comes with its own possible side effects:

  • Statins can cause muscle pain, high blood sugar, liver damage, and memory loss or confusion. 
  • Zetia can cause an upset stomach, gas, and diarrhea. 
  • PCSK9 inhibitors may cause muscle aches, tiredness, and back pain. 
  • Bile acid sequestrants may lead to constipation, stomach pain, bloating, vomiting, and appetite loss.

Not everyone who takes cholesterol drugs will experience side effects. Still, it’s important to let your doctor know if you have any changes from your medication.

Sticking with your treatment plan

Managing high cholesterol is a long-term practice. You can work with your doctor to create a treatment plan that fits your health goals. Also, consider lifestyle changes such as a balanced diet and regular physical activity to keep your numbers in a healthy range. 

Some people stop taking their cholesterol medication because of side effects. Stopping could increase your risk of a heart attack, stroke, or other heart problems. Instead, talk with your doctor about adjusting the dose or switching to a different medication that doesn’t cause the same side effects.


Cholesterol medications are essential for people with very high LDL cholesterol or high LDL cholesterol and other heart disease risks.

If the first drug you try doesn’t lower your cholesterol enough, your doctor can add another medication to boost its effectiveness. If you experience side effects, your doctor can adjust the dose or recommend a different cholesterol medication.

Follow the treatment plan your doctor prescribes. Managing your cholesterol protects your heart and blood vessels and can help you avoid long-term health complications.

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Medical Reviewer: Jennie Olopaade, PharmD, RPH
Last Review Date: 2024 Jan 11
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