Which Over-the-Counter Medications Can Help Your Cholesterol?

High cholesterol affects about 1 in 10 adults (25 million) in the U.S. And only about half of people who should be treating their high cholesterol take medications for it. This may be in part because many people may not even know they have it. Or if they do, they may not want to take prescription medications for it. 

When you think of the common medicines you can find at your local pharmacy, over-the-counter (OTC) cholesterol medication may not be the first thing that comes to mind. But nonprescription options may also help improve your cholesterol. And if you have high cholesterol, dietary changes and OTC medications may be a good place to start. 

What causes high cholesterol?

High cholesterol can be a result of several factors, some of which you can change and some you cannot. Common risk factors include:

• Genetics (high cholesterol can run in families)

• Diabetes and other medical conditions (like hypothyroidism)

• Medications (like beta blockers and diuretics)

• Lack of exercise

• Diets high in saturated fat and/or trans fat

• Age (your cholesterol can be higher as you get older)

• Menopause

• Smoking

• Heavier body weight

Regardless of what’s causing your high cholesterol, the choices you make every day can have a big impact on your numbers.

OTC cholesterol medications

For people with mildly raised cholesterol, OTC medications may be a good place to start. They’ll work best if you can also make changes to your diet, avoid smoking, and increase daily physical activity. We’ll go over this a little more later in the article. 

Below are some cholesterol treatments that you can buy over the counter. 

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Red yeast rice

Red yeast rice is a traditional Chinese medication that may help lower cholesterol. People take it as a supplement. But we listed this one as an OTC medication given it has the same active ingredient as lovastatin. This means it can have the same side effects as statins, like muscle aches and liver test abnormalities. This also means it’s important that you don’t take red yeast rice if you already take a statin, or if you take a medication that can interact with statins. If you’re considering trying it, it’s a good idea to talk with a healthcare professional first. 

Niacin

Niacin, also known as vitamin B3, improves cholesterol. It lowers LDL (low-density lipoprotein, or “bad” cholesterol) and increases HDL (high-density lipoprotein, or “good” cholesterol). It also lowers triglycerides (fats in the blood). Although it’s OTC, niacin also comes in higher strengths by prescription. 

But like red yeast rice, this one comes with serious risks and precautions. Most healthcare professionals no longer prescribe this as a cholesterol medication. That is because research shows that niacin actually increased the risk for heart disease or stroke. So even though it may lower your cholesterol numbers, it may not be good for your overall health. 

Fish oil (omega-3 fatty acids)

Fish oil reduces triglycerides. Triglycerides are a type of fat that can raise your risk of heart attack and stroke. In some cases, fish oil can lower triglycerides by up to 30%. But they have very little effect on LDL or “bad” cholesterol. Also, fish oil is more likely to work if your triglyceride levels are very high rather than moderately raised. It may also increase your risk for a heart rhythm problem called atrial fibrillation.

Fish oil medication is also available by prescription at higher doses (like Lovaza or Vascepa).

OTC cholesterol supplements

There are some OTC supplements that may improve your cholesterol as well. These are plant-based supplements that aren’t available as prescription medications. Though you can find them as supplements, they also have common dietary sources. 

People often use these supplements in addition to OTC and prescription medications to reduce cholesterol levels. But be sure to check with a healthcare professional before adding supplements to your daily routine. Sometimes interactions can occur due to existing health conditions or other medications. 

Plant sterols 

Plant sterols are in plant-based foods. They have a chemical structure like cholesterol. So they prevent the body from absorbing other types of cholesterol, likely LDL. You may find that switching to a plant-based diet is just as effective as the OTC supplements.

Psyllium 

Soluble fiber helps lower your LDL by acting like a sponge and absorbing the cholesterol from the foods you eat. It also helps to prevent the body from making its own cholesterol. OTC psyllium supplements are a great source of soluble fiber. And they may also reduce your risk of heart disease.

Soy 

Soy can help decrease total cholesterol,  LDL cholesterol, and triglycerides. And it might also improve HDL, your good cholesterol. Several types of OTC supplements contain soy. But there are also dietary sources of soy that may be more effective. 

Bergamot 

Bergamot naturally grows in Italy and may improve cholesterol in several ways. Data shows bergamot may decrease total cholesterol, LDL, and triglycerides — while increasing HDL. Bergamot is also in OTC supplements like Lipidene. 

Green tea

Green tea is well known for its various health benefits. And green tea extract is available as a supplement. There’s some evidence that green tea supplements may lower cholesterol by a small amount. But it’s important to approach green tea supplements with some caution. 

Some supplements contain very high doses of green tea extract, which could potentially cause harm like liver damage. Most products will dose their supplement based on a specific antioxidant in green tea called EGCG. Researchers are still trying to figure out what’s a safe dose of EGCG. But the results from current studies suggest you should stay below 300 mg of EGCG per day. (As a reference point, 1 cup of green tea has about 50 mg of EGCG.) Also keep in mind that some supplements contain caffeine as well. 

Does Garlique lower cholesterol?

Many people use garlic supplements to improve cholesterol. But do supplements like Garlique actually lower cholesterol? So far the evidence is mixed. They might work better for people with very high cholesterol levels. But even then, the effects are modest at best. 

Researchers have studied different forms of garlic. This includes raw cloves, garlic powder, and the extract in supplements. They haven’t figured out which dose or form of garlic offers the best benefit. But it appears supplements offer the highest amount of the active garlic compound.  

Let your primary care provider know if you’re considering garlic supplements. That’s because garlic supplements can interact with certain prescription medications. The same is true for eating garlic in your diet. But you’re unlikely to reach unsafe levels from diet alone. 

Be careful if you take any of the following medications:

• Protease inhibitors (medications that treat HIV)

• Anticoagulants (medications that thin the blood)

• Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin

• Medications to lower blood sugar (to treat diabetes)

What else can I do to get my cholesterol under control?

Whether you’re taking OTC treatments or prescription medications, it's important to make healthy lifestyle changes to improve your cholesterol. If your cholesterol is not very high, these changes might be enough to improve cholesterol without medication.

To get you started, here are some lifestyle changes for lowering cholesterol:

• Quit smoking, if you smoke.

• Avoid alcohol (if you do have alcohol, limit it to 1 to 2 drinks per day).

• Eat a nutritious diet (plant-based or Mediterranean diet).

• Get regular exercise (150 minutes per week of moderate-intensity activity).

• Maintain a balanced body weight.

• Manage any other medical conditions, like diabetes and thyroid disease.

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Written by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

Reviewed by:

Sarah A. Samaan, MD

Sarah Samaan, MD, FACC, FACP, FASE is a board-certified cardiologist who practiced clinical cardiology for nearly 30 years. She is a member of the American College of Cardiology, the American College of Physicians, and the American Society of Echocardiography.

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