Medications for High Cholesterol: Understanding Your Options

Without treatment, high cholesterol may increase your risk of heart attack and stroke. Luckily, there are many effective medications that can help you improve your cholesterol levels, according to Robert Segal, MD, Cardiologist at Manhattan Cardiology in New York City.

What medications can help treat high cholesterol?

“There [are] so many types of medications to treat high cholesterol that we can [generally] find one that’s tailored to you,” says Segal.

Statins

Statins are often the first line of treatment for high cholesterol. They tend to be affordable, effective, and well tolerated by many people. Statins work by reducing production of cholesterol in the liver, as well as removing LDL (low-density lipoprotein) cholesterol from the blood.

Bile Acid Sequestrants

These medications remove bile acid from blood. Your body needs bile acid, so it then breaks down LDL cholesterol in order to make more bile acids. This helps lower LDL cholesterol.

Niacin

Niacin is a prescription-grade B vitamin. It slows down the production of cholesterol in the liver. It may also help reduce triglycerides and increase HDL (high-density lipoprotein) cholesterol, which is the good kind.

Fibrates

Fibrates promote lipolysis, which is the breakdown of triglycerides. This medication can be particularly helpful for people with high triglycerides. Fibrates may also help raise HDL cholesterol.

Ezetimibe

Ezetimibe blocks the absorption of cholesterol in the intestines, which helps to lower the total amount of cholesterol within the body.

PCSK9 inhibitors

PCSK9 inhibitors are an injectable medication. They promote the breakdown of LDL cholesterol by blocking PCSK9 receptors in the liver. PCSK9 inhibitors may be particularly helpful for people with familial hypercholesterolemia, or a genetic form of high cholesterol.

siRNA therapy

siRNA therapy is typically an injectable medication. It lowers LDL cholesterol and removes it from the bloodstream. Like PCSK9 inhibitors, siRNA therapy can also help with genetic forms of high cholesterol.

How do you find the right medication?

The right medication for you depends on your condition, other health factors, if you experience side effects, budget, and preferences.

“It may take some trial and error to find the right medication for you,” says Segal. Luckily, most people are generally able to find a medication that helps lower their cholesterol with minimal side effects.

Why trust our experts?

Written by:

Lauren Smith, MA

Lauren Smith, MA, has worked in health journalism since 2017. Before joining GoodRx, she was the senior health editor and writer for HealthiNation.

Reviewed by:

Mera Goodman, MD, FAAP

Mera Goodman, MD, FAAP, is a board-certified pediatrician. Prior to practicing medicine, she worked as a management consultant.

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