Non Statin Cholesterol Lowering Drug Options

Patient

Q: Is there a drug available to lower high cholesterol LDL without using statin drugs that have undesireable side effects. If not, what is the best statin drug to use?

Doctor

A:   The statins are the most widely used drugs to target LDL Cholesterol, with reductions of 18% to 55%, depending on which statin is used. Studies have shown that atorvastatin is slightly superior in action, in comparison to the other statins, without increasing the side-effect profile. There are several alternatives available to target LDL with different modes of action. Ezetemibe(Zetia)  inhibits the absorption of cholesterol from the intestine; and Bile acid sequestrants such as Cholestyramine, prevent the reabsorption of cholesterol-containing bile acids from the intestine. Nicotinic acid raises HDL cholesterol, with a small reducing effect on LDL cholesterol. This may be difficult to tolerate due to unwanted side-effects. However all these drugs are less effective than statins, in lowering LDL cholesterol, and are often used in addition to a statin for dual-therapy.

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