Statins, Cholesterol-Lowering Medicines

Your doctor may give you a cholesterol-lowering statin if you have high levels of total cholesterol or of LDL cholesterol (the "bad cholesterol") that cannot be lowered with a program of diet and exercise. You may also need to take this type of medicine if you have a medical condition that causes you to have high cholesterol.

Why do I need to take a cholesterol-lowering medicine?

Your doctor may give you a cholesterol-lowering medicine if you have high levels of total cholesterol or of LDL cholesterol (the “bad cholesterol”) that cannot be lowered with a program of diet and exercise. You may also need to take this type of medicine if you have a medical condition that causes you to have high cholesterol.

How do cholesterol-lowering medicines work?

There are 5 types of cholesterol-lowering medicines. Each type works in a different way.

  • Statins are also called HMG-CoA reductase inhibitors. HMG-CoA reductase is an enzyme that helps your body make cholesterol. Statins help to block this enzyme, which causes your body to make less cholesterol. When cholesterol production is slowed, it signals your liver to make more LDL receptors. These receptors attract the LDL particles in the blood and, in turn, reduce the amount of LDL cholesterol in your bloodstream. Lower LDL levels can lead to lower triglyceride levels and higher HDL (“good cholesterol”) levels.
  • Bile Acid Sequestrants or Resins. Your body uses cholesterol to make bile, an acid used in the digestive process. These medicines bind to bile, so it cannot be used during the digestive process. Your liver responds by making more bile. The more bile your liver makes, the more cholesterol it uses. So, less cholesterol is left to circulate through your bloodstream.
  • Nicotinic Acid, or niacin, is a form of vitamin B. It appears to slow the liver’s production of certain chemicals that help to make LDL (“bad”) cholesterol. Nicotinic acid has also been found to lower triglycerides and raise HDL (“good cholesterol”) levels.
  • Fibric Acid Derivatives or fibrates, are used to lower triglyceride levels. Fibrates break down the particles that make triglycerides and use them in other ways in your body. Lower triglycerides can lead to increased levels of HDL (“good”) cholesterol.
  • Cholesterol Absorption Inhibitors are used to lower levels of LDL (“bad”) cholesterol. This medicine can also be given in combination with a statin. Cholesterol absorption inhibitors work in the digestive tract by reducing the amount of cholesterol absorbed from foods you eat. It is important that you stay on a cholesterol-lowering diet while taking this medicine.

How much do I take?

There are many different kinds of cholesterol-lowering medicines. The amount of medicine you need to take may vary. Talk to your doctor or pharmacist for more information about how and when to take this medicine.

What if I am taking other medicines?

Other medicines that you may be taking can increase or decrease the effect of cholesterol-lowering medicines. These effects are called an interaction. Be sure to tell your doctor about every medicine and vitamin or herbal supplement that you are taking, so he or she can make you aware of any interactions.

The following are some of the medicines that can interact with cholesterol-lowering medicines. Because there are so many kinds of medicines within each category, not every type of medicine is listed by name. Tell your doctor about every medicine that you are taking, even if it is not listed below.

  • An anticoagulant such as warfarin. If you are taking warfarin and a cholesterol-lowering medicine, your dosages of each may need to be adjusted.
  • Certain antibiotic medicines.
  • Certain antifungal medicines.

Also, do not drink alcohol and take statins until you have talked about it with your doctor.

What else should I tell my doctor?

Talk to your doctor about your medical history before you start taking cholesterol-lowering medicines. The risks of taking the medicine need to be weighed against its benefits. Here are some things to consider if you and your doctor are deciding whether you should take a cholesterol-lowering medicine.

  • You have a history of liver problems.
  • You have other medical problems such as diabetes, gout, or ulcers. Nicotinic acid can make these conditions worse.
  • You have a history of kidney disease or gall bladder disease (especially if you may be taking a fibric acid derivative).
  • You are thinking of becoming pregnant or you are pregnant (especially if you may be taking a fibric acid derivative).
  • You are breastfeeding.

What are the side effects?

Sometimes a medicine causes unwanted effects. These are called side effects. Not all of the side effects for cholesterol-lowering medicines are listed here. If you feel any other effects, you should check with your doctor.


  • Diarrhea
  • Heartburn or indigestion
  • Upset stomach
  • Constipation
  • Stomach pain or stomach cramps
  • Muscle or joint pain
  • Extreme tiredness
  • Headache
  • Skin rash
  • Blurry eyesight
  • Sleep problems

Bile acid sequestrants

  • Constipation
  • Stomach bloating or the feeling of being full
  • Upset stomach
  • Heartburn

Nicotinic acid (niacin)

  • Flushing
  • Dry skin or a rash
  • Upset stomach
  • Throwing up
  • Diarrhea
  • High blood sugar
  • Headaches
  • Abnormal heart rhythm (arrhythmia)

Fibric acid derivatives

  • Upset stomach
  • Throwing up
  • Flatulence (gas)
  • Stomach pain
  • Headache
  • Dizziness
  • Extreme tiredness
  • Muscle pain and weakness
  • Skin rash
  • Hair loss
  • Abnormal heart rhythm (arrhythmia)

Cholesterol absorption inhibitors

  • Stomach pain
  • Tiredness

Many of these side effects are rare. Most people can take cholesterol-lowering medicines with few, if any, side effects. Tell your doctor right away if you have any of these side effects. Do not stop taking your medicine unless your doctor tells you to. If you stop taking your medicine without checking with your doctor, it can make your condition worse.

A consumer-based site by the American Society of Health-System Pharmacists that provides information about all types of medicines as well as safety tips for their proper use. The site’s search feature lets users search medicines by the brand or generic name.


The information in this Medicines for Cardiovascular Disease section has been taken from a number of sources. It is meant to give you information about certain medicines, but it does not cover all of the possible uses, warnings, side effects, or interactions with other medicines and vitamin or herbal supplements. This information should not be used as medical advice for individual problems. Please talk to your doctor and/or your pharmacist for prescription instructions.