Safest Medication for Cholesterol

Which medication for cholesterol is the safest?

You can lower harmful cholesterol levels in your system by taking statins. Depending on your health, cholesterol, and other drugs, your doctor may recommend a different statin.

Another name for the class of drugs known as statins is HMG CoA reductase inhibitors. They reduce the quantity of “bad” cholesterol, or low-density lipoprotein (LDL) cholesterol.

Waxy and fatty, low-density lipoprotein (LDL) cholesterol adheres to the walls of your arteries and the blood vessels of your heart. As a result, your arteries may stiffen or develop plaques that obstruct or lessen blood flow.

The primary mechanism of action of statins is to decrease the production of LDL cholesterol by your body. They could also help raise “good” HDL cholesterol and decrease blood triglycerides.

Statins are frequently prescribed by doctors to treat excessive cholesterol; in 2019, 92 million Americans reported using statins. The risk of cardiovascular disease, including atherosclerosis and heart attacks, can be significantly decreased by taking statins. Like any drug, adverse effects are possible for certain people.

No one safest statin works for everyone. An individual’s co-occurring diseases, other medications, and side effects will determine the best option.

If someone is unable to take a certain statin, changing to a different one might help or fix the issue. In addition to adverse effects, the possibility of myopathy, diabetes, and stroke are safety issues.

Doctors advise against taking statins for those with active liver disease, even if they are safe for the majority of people.

The first thing to do when you have high cholesterol is to make dietary and fitness changes, such as cutting back on sugar, trans fat, and saturated fat and increasing your physical activity.

Your doctor may advise you to take medication if that is insufficient to lower your “bad” (LDL) cholesterol. (You will still need to maintain those lifestyle choices.)

LDL can be decreased by a variety of prescription medications. Learn about the functions of each one and some advice on how to take them.

Statins: What are they?

A class of drugs known as statins reduces cholesterol by acting on the liver, which produces the majority of blood cholesterol. The medications stop cholesterol from developing by blocking an enzyme the liver employs to make it. Additionally, statins assist the liver in eliminating cholesterol that is already present in the blood.

What they are: When a doctor prescribes a medication to lower LDL, these are typically the first kind they recommend. They also raise your “good” (HDL) cholesterol slightly and lower triglycerides, another form of blood fat.

Statins are best in lowering low-density lipoproteins (LDL), a form of cholesterol. In addition, statins improve high-density lipoproteins (HDL) and lower triglycerides, or blood fat.

While HDL is the healthy kind of cholesterol since it aids in the body’s removal of cholesterol, LDL is the dangerous kind that can cause heart attacks and strokes.

One type of statin is:

• Lipitor, Atorvaliq, and atorvastatin
• Lescol (fluvastatin)
• Pitavastatin (Livalo) with Lovastatin
• Pravachol, or Pravastatin
• Crestor (rosuvastatin calcium)
• Zocor, or Simvastatin

It has been demonstrated that statins lower the chance of a “cardiovascular event,” such a heart attack.

Adverse effects:

These may include inflammation of the muscles, liver damage (occasionally), and digestive issues. Although the FDA states that the advantages of statins exceed the dangers, there is a 1 in 250 chance of developing high blood sugar and type 2 diabetes.

Additionally, statin medications may interact with other medications you use. Your physician ought to look into it first.

Some statin users have complained of disorientation and memory loss. According to the FDA, which is investigating those allegations, the symptoms were often not severe and disappeared a few weeks after the patient stopped using the medication.

When using statins, stay away from grapefruit and grapefruit juice. Your body has a tougher time using these medications if you eat grapefruit.

Medications That Act in Your Intestines

These are: These medications may be referred to by your physician as “bile acid resin” or “bile acid sequestrants.” what goes on inside your intestines? They cling to the liver’s bile and prevent it from returning to the bloodstream. Since cholesterol is a major component of bile, these medications reduce the body’s cholesterol levels.

Some examples are as follows:

• Prevalite, or cholesterol
• WelChol, or Colesevelam
• The Colestid, or Colestipol

Another kind of medication, ezetimibe (Zetia), reduces “bad” LDL cholesterol by preventing the small intestine from absorbing cholesterol. Research has shown that taking a statin can reduce the chance of heart “events,” like another heart attack, in individuals who have already experienced one.

Gas, upset stomach, and constipation are the most frequent adverse effects of bile acid medications. The three most frequent side effects of ezetimibe are diarrhea, abdominal pain, and muscle or back pain.

PCSK9 Inhibitors

What they are: People who are unable to control their cholesterol with lifestyle changes and statin therapy are prescribed these medications. To facilitate the body’s removal of low-density lipoprotein (LDL) from your blood, they block a protein known as PCSK9.

Adults with heterozygous familial hypercholesterolemia (HeFH), a genetic disorder that makes it difficult to lower cholesterol, or those with heart disease who require more than a statin are the primary users of these medications. They are administered as an injection every two weeks.

As examples:

Praluent (alirocumab) and Repatha (evolocumab)

Side effects: Since some medications are more recent, it will take longer to learn about their effects. Itching, swelling, soreness, or bruises where the injection was administered, together with cold and flu symptoms, are the most frequent side effects in alirocumab clinical studies. These include colds, flu, back pain, and skin reactions at the injection site for evolocumab.

Another choice is the PCSK9-siRNA inclisiran (Leqvio). It is not commonly used and is advised for people who have trouble using the pen injector or who are allergic to alirocumab and evolocumab.

Niacin

What it is: Nicotinic acid, another name for this B vitamin, is found in food and can also be obtained through prescription in large amounts. It increases HDL cholesterol while decreasing LDL cholesterol.

Among the examples are:

• Niacin (Niaspan)
• Niacor Studies have not demonstrated that taking niacin in addition to statins reduces the risk of heart disease.

The most common side effects include headache, tingling, itching, and flushing.

The Fibrates,

Medications called fibrates can increase your body’s “good” HDL cholesterol while reducing the amount of triglycerides it produces.

A few examples are:

Gelfibrozil (Lopid) fenofibrate

ACL Inhibitors of ATP Citrate Lyase

What it is: Bempedoic, also known as Nexletol, prevents your liver from breaking down fat. In adults with HeFH, it is intended to help reduce LDL. For those who suffer from atherosclerotic cardiovascular disease (ASCVD), it can also help reduce LDL.

Upper respiratory tract infection, muscular spasms, elevated liver enzymes, bronchitis, back pain, stomach pain or discomfort, and muscle spasms are some of the side effects.

The omega-3s

Some people are curious about whether taking omega-3 fatty acid-rich fish oil supplements will lower their risk of developing heart disease. There is no proof that they do. Prescription-strength omega-3 drugs, however, can help lower elevated triglycerides and lower the risk of heart disease in people who are at risk, report specialists. When trying to decrease triglycerides, they advise against using over-the-counter fish oil nutritional supplements.

Advice on How to Take Medications for Cholesterol

It’s important to pay close attention to what your doctor says when you take medicine to lower your LDL levels. They might not function as intended if you take them contrary to your doctor’s orders.

What is the best statin to take?

Most people can take statins without any problems. As the American Heart Association (AHA) points out, the advantages of statin medication far exceed the minimal dangers involved.

If you suffer from any particular medical problem, your doctor might suggest a particular statin drug. The reason for this is that certain kinds can interfere with other drugs you are taking. The best way to discuss the advantages and disadvantages of statin therapy as well as potential drug interactions is to speak with a doctor.

The dosage that a doctor will recommend for you also depends on how much of a statin is required to be effective. The likelihood of side effects is decreased by most statins at lower dosages.

If you are taking azole antifungal drugs

Azole antifungal medications are frequently recommended to treat vaginal yeast infections and thrush, among other fungal infections.

Combining the antifungal drugs itraconazole (Sporanox) and ketoconazole (Xolegel, Extina, Nizoral) with some statins can raise the risk of toxicity, according to experts. Among these are:

• In Lipitor, atorvastatin
• (Mevacor, Altoprev) lovastatin
• Zocor, or Simvastatin

If protease inhibitors are being used,

When using protease inhibitors to treat HIV, such as atazanavir (Reyataz), ritonavir (Norvir), or lopinavir/ritonavir (Kaletra), you might need to avoid or be closely watched when taking:

• (Mevacor, Altoprev) lovastatin
• Livalo has pitavastatin.
• Simvastatin (Zocor), atorvastatin (Lipitor), and rosuvastatin calcium (Crestor)
• Studies conducted in 2023 indicate that fluvastatin (Lescol) and pravastatin (Pravachol) are less likely than other medications to interact with protease inhibitors.

Using macrolide antibiotics

You may need to stay away from lovastatin (Mevacor, Altoprev) and simvastatin (Zocor) if you are using macrolide antibiotics for bacterial infections.

Should you be taking pitavastatin or atorvastatin, a doctor may need to change your dosage.

When using cyclosporine

Psoriasis and rheumatoid arthritis are among the disorders that are treated with cyclosporine (Gengraf, Neoral, Sandimmune). After transplants, it’s also utilized to stop organ rejection.

If you are using cyclosporine, Experts advises against taking pitavastatin (Livalo) or lovastatin (Mevacor, Altoprev).

A doctor may need to change your dosage of other statins if you are taking cyclosporine.

What adverse effects could statins cause?

In most cases, statins are well tolerated. This indicates that a large number of people do not experience unpleasant side effects from using them.

Typical mild adverse effects could include:

• headache, rash, constipation, and diarrhea
• An allergic reaction is possible with any medicine, even statins. An itchy rash is a common sign of a drug allergy reaction.

Anaphylaxis, a medical emergency, can also be brought on by drugs, albeit this is uncommon. Seek medical help right away if you suffer from:

• lip, facial, or airway swelling
• disorientation when swallowing or having trouble breathing
• fainting rash that is blistering, swollen, or peeling

inflammation of the liver

Statins raise the enzymes the liver utilizes to aid with digestion in a limited percentage of persons. This may result in inflammation of the liver, which could cause harm. Liver problems can manifest as:

exhaustion and jaundice (eye and skin discoloration)
Urine that is tea-colored

Inflammation and discomfort in muscles
Statins may hurt muscles, leading to:

• weakness and pains
• An extremely rare condition is rhabdomyolysis. The muscles are damaged as a result of this serious adverse effect. Most frequently, it impacts those who have other risk factors for the disease, such as:

decreased thyroid performance
Reduced kidney function due to liver illness

Problems with cognition

While uncommon, some people may have memory and attention issues when using specific statin drugs. When discontinuing statins or moving to a different statin, these symptoms can be reversed and are not significant.

Risk for diabetes

While on statin therapy, your chance of getting newly diagnosed type II diabetes may be low. The majority of those who already have a higher risk of type II diabetes are affected by this adverse effect. This can include those who have prediabetes and metabolic syndrome. The exact mechanism by which statins raise risk is unknown.

In comparison to the amount of cardiovascular diseases that statins prevent, the American Heart Association states that this risk is quite low. Statins aid in the prevention of atherosclerotic cardiovascular disease, which is significantly increased by diabetes.

For diabetics who have cardiovascular disease or are at risk for it, doctors frequently prescribe statins.

Kidney danger

You might require a lower dosage of statins if you have kidney problems. For those who have kidney disease, some statin dosages may be excessive.

A hemorrhaging stroke

This kind of stroke occurs when a blood artery in the brain bursts and begins to bleed.

Results show that the risk of hemorrhagic stroke is between 5 and 10 cases per 10,000 people who have taken statins for five years. In people with cerebrovascular disease, or disorders that affect blood flow to the brain, the risk is increased.

Additional adverse effects

Other potential negative effects of using statins have been linked to the following:

a slight chance of liver damage cognitive and memory problems
A little chance of developing cancer

Drugs for cholesterol

Assist in limiting your cholesterol levels.

Some people may be able to avoid or treat harmful cholesterol levels by changing their lifestyle to include a healthier diet and increased physical activity. Medication may also be required for other people with high cholesterol.

Create a treatment plan that works for you in collaboration with your healthcare provider. Make sure you take any prescribed medication as directed. Including these drugs in your regular regimen is worthwhile due to the possible health benefits.

Types of medications that decrease cholesterol

Blood cholesterol can be lowered by a variety of drugs.

The majority of individuals are advised to take statins because they have been shown to lower the risk of heart attack and stroke. In the majority of situations, statins remain the most effective lipid-lowering medication.

According to guidelines, anyone in any of these groups should discuss the advantages and disadvantages of statin therapy with their healthcare provider:

• People with a history of atherosclerosis-related cardiovascular disease, including stroke, and those whose LDL-C level is more than 190 mg/dL
• Adult diabetics aged 40–75
• LDL-C levels between 70 and 189 mg/dL in adults aged 40 to 75 years, together with a 10-year risk of 5% to 19.9% for cardiovascular disease due to atherosclerosis and risk-enhancing variables
• LDL-C levels between 70 and 189 mg/dL in adults aged 40 to 75 who have a 10-year risk of cardiovascular disease due to atherosclerosis of 20% or higher

Statin treatment may also be helpful for some individuals who do not fit into these groups.

It’s critical to discuss your 10-year or lifetime risk with your healthcare provider. They will evaluate your risk variables to ascertain your level of risk and collaborate with you to select the most appropriate course of action.

Statins

This class of medications also referred to as HMG CoA reductase inhibitors, prevents the formation of cholesterol in the liver. As a result, there is less cholesterol in the blood. When it comes to reducing LDL (bad) cholesterol, statins work best. They also aid in increasing HDL (good) cholesterol and decreasing triglycerides (blood fats).

Before beginning statins, discuss potential side effects with your healthcare provider. The majority of adverse effects are minor and disappear as your body adapts. Although liver problems and muscle discomfort are infrequent, your healthcare provider may prescribe routine liver function testing. Pregnant women and others with active or chronic liver disease should talk to their healthcare provider about taking statins.

Guidelines for cholesterol medications

• Recognize the purpose of your medication.
• Every day at the same time, take your medication. Do not alter or stop taking it without first consulting your physician. Keep taking it even if you feel terrific.
• Maintain a regular medication schedule. Obtain a pillbox that has the days of the week printed on it. To make it easier to remember, fill the pillbox at the beginning of the week.
• Remember to keep a medication calendar. Whenever you take a dose, write it down on your calendar. On your calendar, note any adjustments your doctor makes to the medications.
• Do not reduce your dosage in order to save money. To receive all of the benefits, you must take the entire quantity. See your doctor about strategies to lower your medication costs if cost is an issue.
• Without first consulting your physician, avoid using any herbal remedies or over-the-counter medications. Such factors may alter the way your cholesterol medication functions.
• Except in cases where the next dose is practically due, take the missed dose as soon as you remember. What should you do in that situation? Consult your physician.
• Before you run out, fill your prescriptions. If you have any doubts concerning your medication, consult your pharmacist. If you have financial difficulties, difficulty getting to the pharmacy, or other issues that make it difficult for you to get your prescriptions filled, let your doctor know.
• Make sure you have your medications with you when you travel so you can take them when you need to. Bring copies of your medications and an additional week’s supply for lengthier excursions. In this manner, you can obtain a refill if necessary.
• Inform the doctor or dentist about your medications before undergoing anesthesia-assisted surgery, including dental procedures.
• Certain medications may have an impact on your heart rate. Find out from your doctor whether you should check your heart rate and how frequently.
• Since alcohol might exacerbate the negative effects of some medications, ask your doctor if you should abstain from it. It may also hinder their effectiveness.
• Inquire with your physician or pharmacist about ways to streamline your medication regimen.
• Seek assistance from a friend or loved one if you are having problems understanding your doctor or pharmacist.
• Inform your doctor if you believe that your medication isn’t working for you.

Advice on how to remember your prescription

• Create a self-instruction sheet. On a piece of paper, tape a sample of each medication you must take. Then, to serve as a reminder, write down everything you need to know about that medication.
• Make use of specialized pillboxes with divisions for the days of the week. They can assist you in monitoring your medications. Different kinds of pill containers exist. To remember when to take your medication, you can purchase timed caps for pill bottles. Inquire with your pharmacist about helpful reminders and packaging.
• To help you remember to take your medication, ask those who are close to you.
• Make a note each time you take your dose and keep a chart close to your medication.
• To make taking your medications easier, ask your pharmacist for assistance in creating a coding system.
• To make your process easier, get some colored labels and put them on your medication bottles. For instance, yellow can be used for nighttime, red for the afternoon, and blue for the morning.

FAQs

References:

• Hobbs, H. (2024, May 28). Which statin is safest? Healthline. https://www.healthline.com/health/high-cholesterol/statins-which-is-safest#the-right-statin-for-you
• West, M. (2023, November 29). What are the safest statins to take? https://www.medicalnewstoday.com/articles/safest-statins#safest-statin
• Which medicines lower “Bad” (LDL) cholesterol? (2023, July 19). WebMD. https://www.webmd.com/cholesterol-management/cholesterol-lowering-medication