Statins

These include atorvastatin (Lipitor®), fluvastatin (Lescol®), lovastatin (Mevacor®), pravastatin (Pravachol®), rosuvastatin (Crestor®) and simvastatin (Zocor®).

Statins are safe and effective drugs that have become standard therapy for patients with elevated LDL-C levels or risk factors for heart attack or stroke. If you already have coronary heart disease or diabetes your doctor will recommend statin therapy.

**A reduction in coronary events, stroke and death from all causes has been demonstrated for individuals with and without clinically evident CHD and with or without elevated LDL-cholesterol concentrations.

Resins (bile acid sequestrants)

These include colesevelam (Lodalis®) and cholestyramine (Questran® and Colestid®).

Resins are used to lower LDL-C levels, often in combination therapy with other blood lipid medications. These medications lower LDL-C moderately (15% to 30%) and raise HDL-C very little (3% to 5%). These drugs may decrease the absorption of other drugs.

Cholesterol absorption inhibitors

This product currently available is known as ezetimibe [Ezetrol®]). These drugs reduce cholesterol absorption in the intestine and lower LDL-C by 15 to 20%. They are often used in combination with a statin.

PCSK9 inhibitors

These include evolocumab (Repatha®) and alirocumab (Praluent®).

These medications are administered by injection every 2 to 4 weeks and lower LDL-C by an additional 60 to 70%. They are mainly used in combination with statin and ezetimibe for patients with extremely high levels of LDL-C due to a mutation in the LDL receptor (familial hypercholesterolemia).