Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2011;84(5):561-562

See related article on hyperlipidemia medications.

What is cholesterol?

Cholesterol is a substance that your liver makes. It is also found in some foods, such as eggs, meats, and dairy. Your body needs cholesterol to make cells and certain hormones. But too much cholesterol can cause problems with your heart and blood vessels.

There are different kinds of cholesterol. When your cholesterol is measured, your doctor will usually tell you your total cholesterol. Total cholesterol includes your levels of bad cholesterol (LDL), good cholesterol (HDL), which protects your heart and blood vessels, and triglycerides (fats that your body uses for fuel and to make more cholesterol).

How can I lower my cholesterol?

You can lower cholesterol and reduce your risk of heart problems by leading a healthy lifestyle. You should eat a low-fat diet, exercise regularly, and stay at a healthy weight. You shouldn't smoke.

If you already have heart or blood vessel problems or are at high risk of getting them, your doctor will probably recommend cholesterol-lowering medicines. Even if you are taking medicine, a healthy lifestyle is still important.

What are common cholesterol-lowering medicines?

Several medicines are used to lower cholesterol. You might need more than one.

Statins. These medicines slow down your body's production of cholesterol. They also help remove cholesterol that has built up in the arteries of your heart. Statins are usually the first choice to reduce the risk of heart disease, or to keep it from getting worse if you already have it.

Fibrates. These medicines help lower your cholesterol by lowering the amount of triglycerides in your body. These are typically used for people who cannot take statins or who need extra medicine for lowering cholesterol.

Niacin. In large doses, niacin can lower triglycerides and bad cholesterol, and increase good cholesterol in your blood. Niacin is available over the counter, but you should talk to your doctor before taking it.

Resins. These medicines bind cholesterol together to help your body digest and get rid of it. They are usually used with other medicines that lower cholesterol.

Cholesterol absorption inhibitors. These medicines lower the amount of cholesterol that is absorbed by your intestines. They also are usually used with other medicines.

Do these medicines have side effects?

All medicines can cause side effects. It is important to talk to your doctor before taking cholesterol-lowering medicines to make sure they are right for you. Common side effects include:

  • Diarrhea or constipation

  • Stomach pain, cramps, or bloating

  • Nausea

  • Vomiting

  • Headaches

  • Drowsiness

  • Dizziness

  • Muscle aches or weakness

  • Flushing

  • Sleep problems

It is important to tell your doctor if you have any side effects. You should also tell your doctor if you are taking other prescription or over-the-counter medicines. Some other medicines can cause side effects if taken with cholesterol-lowering medicine.

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