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Non Statin Cholesterol Lowering Drug Options

Dear Ask The Doctor:
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?


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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