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How Does Cholesterol Medicine Work

Who Can And Cannot Take Simvastatin

How Statins Work to Reduce Cholesterol

Simvastatin can be taken by adults and children over the age of 10 years.

Simvastatin is not suitable for some people. Tell your doctor if you:

  • have ever had an allergic reaction to simvastatin or any other medicine
  • have liver or kidney problems
  • are trying to get pregnant, think you might be pregnant, you’re already pregnant, or you’re breastfeeding
  • have severe lung disease
  • have, or have had, a muscle disorder

Effect Of Mipomersen On Clinical Outcomes

There are no clinical outcome trials but it is presumed that lowering LDL-C levels in patients with Homozygous Familial Hypercholesterolemia will reduce cardiovascular events. In a study comparing cardiovascular events in patients with Homozygous Familial Hypercholesterolemia in the 24 months prior to initiating mipomersen therapy and after initiating mipomersen revealed a decrease in events . In this trial mipomersen resulted in a mean absolute reduction in LDL-C of 70 mg/dL , non-HDL cholesterol of 74 mg/dL , and Lp of 11 mg/dL .

What Statins Are Available To Treat High Cholesterol

Available statin drugs

  • Increased blood glucose levels.
  • Reversible memory issues.

If youre unable to take statins because of the side effects, youre said to be statin-intolerant. If you are taking a statin, you should avoid grapefruit products because they can increase side effects. You should limit the amount of alcohol that you drink because combining alcohol and statin usage can increase your risk of liver damage. You may want to talk with your provider or pharmacist if you are concerned about any other types of interactions.

PCSK9 inhibitors

PCSK9 inhibitors are designed to attach to a particular liver protein, which results in lowered LDL cholesterol. This class of drug can be given with statins and is usually for people at high risk of heart disease who have not been able to lower their cholesterol enough through other means.

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Effect Of Pcsk Inhibitors On Lipid And Lipoprotein Levels

There are a large number of studies that have examined the effect of PCSK9 inhibitors on lipid and lipoprotein levels. A meta-analysis of 24 studies comprising 10,159 patients reported a reduction in LDL-C levels of approximately 50% and in an increase in HDL of 5-8% . Notably, in 12 RCTs with 6,566 patients, Lp levels were reduced by 25-30% . The higher the baseline Lp the greater the reduction with treatment . It should be recognized that most LDL-C lowering drugs do not lower Lp levels. PCSK9 inhibitors have not been shown to decrease hs-CRP levels .


Both alirocumab and evolocumab have been studied as monotherapy vs. ezetimibe. In the Mendel-2 study patients were randomly assigned to evolocumab, placebo, or ezetimibe . In the evolocumab group, LDL-C levels decreased by 57% while in the ezetimibe group LDL-C levels decreased by 18% compared to placebo. Additionally, non-HDL-C was decreased by 49%, apolipoprotein B by 47%, triglycerides by 5.3% , and Lp by 18.5% while HDL levels increased by 5.5% in the evolocumab treated subjects. In a study of alirocumab vs. ezetimibe, LDL-C levels were reduced by 47% in the alirocumab group and 16% in the ezetimibe group . In addition, alirocumab decreased non-HDL-C by 41%, apolipoprotein B by 37%, triglycerides by 12%, and Lp by 17% and increased HDL by 6%. Thus, PCSK9 monoclonal antibodies are very effective in lowering pro-atherogenic lipoproteins when used in monotherapy and have a more robust effect than ezetimibe.

How Do Statins Work


Statins work by slowing down the production of LDL-cholesterol in the liver, where its made. Because the liver isn’t making so much cholesterol, it then takes cholesterol out of your blood to make bile with, so your blood cholesterol levels fall.

Statins slow down LDL-cholesterol production by blocking an enzyme called HMG-CoA-Reductase the medical name for statins is HMG-CoA Reductase inhibitors. Enzymes are proteins in the body which speed up normal processes. In this case, LDL production.

Statins can lower your triglycerides

As well as lowering your LDL-cholesterol, statins can lower your triglycerides too, and high triglycerides are linked to liver disease, heart disease and diabetes.

Statins can raise HDL cholesterol

Statins can sometimes raise your HDL-cholesterol the type of cholesterol which helps to clear the fat from of your arteries.

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What If I Forget To Take It

If you occasionally forget to take a dose, take your next dose the next day at the usual time. Never take 2 doses at the same time. Never take extra doses.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

Statin Drug And Food Interactions

Some foods and medications donât mix well with statins and can make side effects worse:

  • Grapefruit juice, which has chemical that can change the way your body breaks down statins
  • A drug for irregular heart rhythms called amiodarone
  • Gemfibrozil , a cholesterol drug
  • Protease inhibitors, a type of HIV medication that includes saquinavir and ritonavir
  • Some antibiotic and antifungal drugs, such as clarithromycin and itraconazole
  • Certain medications, such as cyclosporine, that lower your immune system activity

There are other medications that can cause problems if you take them with statins. You should tell your doctor about all over-the-counter or prescription drugs, herbal supplements, or vitamins that you use.

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What About Using Red Rice Yeast Or Plant Stanols Instead Of Prescription Drugs To Lower Cholesterol

Many people say they prefer to take natural medicines over prescription drugs. However, just because something is natural doesnt mean that its safe. In the U.S., supplements are not regulated as closely as medicines. Supplements can also interfere in dangerous ways with medications that you already take.

However, red rice yeast extract does contain lovastatin, which is the same chemical that is in Mevacor. In some cases, you and your healthcare provider might agree that you should try the supplement with monitoring.

Plant stanols are another nonprescription choice for lowering cholesterol. Plant stanols work by stopping the body from absorbing cholesterol in the intestines. One brand is CholestOff® capsules, while plant stanols are also available in margarine substitutes like Benecol®.

How to take your cholesterol-lowering medicines

When you are taking medicines, it is important to follow your healthcare providers advice carefully. If you dont take medicines exactly as prescribed, they can harm you. For example, you could unknowingly counteract one medicine by taking it with another one. Medicines can make you feel sick or dizzy if not taken properly.

Taking your medicine

Dont decrease your medicine dosage to save money. You must take the full amount to get the full benefits. If your medicines are too expensive, ask your provider or pharmacist about finding financial assistance. Some companies provide discounts for certain medications.

A note from Cleveland Clinic

Statin Use Among Children

Mayo Clinic Minute: Do cholesterol medications work for older people?

Several statins are approved by the FDA for use in children. Some are approved for children over 8 years of age and others for children at least 10 years of age. Approved statins include: atorvastatin , fluvastatin , lovastatin , pravastatin , rosuvastatin , and simvastatin .

Statins are usually used to treat children with genetic conditions that cause hyperlipidemia, which is an excess of lipids like cholesterol and triglycerides in the blood. Short term studies in children show some improvement in measures like LDL cholesterol, blood flow, and thickness of the artery walls. However, statin research has not studied children for more than 2 years, so we dont know the long-term risks of statins for children, or if treatment in childhood actually improves health over a longer period of time or into adulthood. We also dont know which of the statins work better in children.

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How Well Do Cholesterol

Written By Michael Greger M.D. FACLM on November 8, 2016

One of the reasons people may undervalue diet and lifestyle changes is an overconfidence in the ability of pills and procedures to prevent disease. For example, people tend to wildly overestimate the power of things like mammograms and colonoscopies to prevent deaths from breast and bowel cancer, or the power of drugs like Fosamax to prevent hip fractures, or the power of cholesterol drugs to prevent fatal heart attacks. Patients believe statin drugs like Lipitor are about 100 times more effective than they actually are in preventing heart attacks. Studies show most people wouldnt take multiple blood pressure medications if they knew the truth.

For most people, the chance of benefit is normally less than 5 percent over five years for cholesterol, blood pressure, and blood thinning drugs. Patients dont want to take drugs unless they have at least a one in five chanceeven those who just had a heart attack. Its no wonder, then, that doctors seldom share these figures. Informing patients of the percentage chance of benefit from preventive drug strategies would likely substantially reduce the likelihood that patients would agree to take the drugs every day for the rest of their lives.

Now, thats something doctors may want to tell their patients.

What Are Some Possible Side Effects Of Pcsk9 Inhibitors

Possible side effects include pain, including muscle pain and back pain, or swelling at the injection site and cold-like symptoms. Another drawback may be cost as these products may be expensive.

Fibric acid derivatives

Fibric acid derivatives make up another class of drugs that reduce blood lipid levels, especially triglycerides. Triglycerides are fats that come from food that are created when you consume calories that are not spent.

Fibric acid derivatives may also increase the level of HDL, also called the good cholesterol, while lowering liver production of LDL, the bad cholesterol. People who have severe kidney disease or liver disease should not take fibrates.

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At What Cholesterol Level Is Medication Required

There is so much talk about the dangers of high cholesterol, you may start to think that all cholesterol is bad. In truth, your body needs cholesterol. This waxy fat, or lipid, is necessary for digestion, building cells, making certain hormones, and for ensuring normal organ function. However, as it is with many things that are good for you in the right amount, too much of it can cause serious health problems.

Your liver produces all of the cholesterol your body needs. Your body also absorbs cholesterol directly from certain foods you eat. When you intake some cholesterol from your diet, your body is normally able to adjust the amount produced by your liver to avoid having too much. Eating too many high-cholesterol foods, and having conditions that cause your liver to produce too much can lead to high blood cholesterol levels sometimes known as lipid disorder, hyperlipidemia, or hypercholesterolemia.

What Other Drugs Could Interact With This Medication

Cholesterol App

There may be an interaction between ezetimibe and any of the following:

  • cholestyramine
  • teriflunomide
  • warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter , and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source:

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My Doctor Put Me On A Statin So Im Fine Right

A statin is a type of drug that works to lower your cholesterol by restricting the enzyme involved in your own bodys cholesterol production.

As with any medication, statins do come with some side effects. The most common symptom, is muscle aches/pain, occurring in about 5 percent of people on a statin . Other less common side effects include increased blood sugar, inflammation in the liver, and confusion . Unfortunately, statins are also known for decreasing the levels of coenzyme q10 in the body, which is involved in many nerve and muscle pathways .

Statins can improve some cholesterol numbers and may reduce the risk of a heart attack . Doctors may recommend a statin to you for reasons like family history/risk, for example. For most of us, though, statins do not address the most common root causean unhealthy lifestyle! Improving diet, exercise, and stress may reduce your risk of heart attack by up to 80 percent !

My point in saying this isnt for you to go willy nilly and nix your statins. Instead, it is SO IMPORTANT to understand that we cannot take a drug and call it good. We have to make lifestyle modifications our primary focus in order to make REAL change in our health!

The most powerful medication you can take is at the end of your fork.

Disclaimer: Please talk to your doctor before starting or stopping any medication.

What Side Effects Are Possible With This Medication

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • back pain
  • sinus infections
  • throat infections

Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • abdominal pain
  • persistent muscle pain, aches, or weakness, or brown urine
  • signs of gallbladder problems
  • signs of pancreatitis
  • symptoms of liver damage

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • signs of a severe allergic reaction

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

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What Are Side Effects Of Statins

Common side effects include

  • Statins when taken together with itraconazole , erythromycin , protease inhibitors, nefazodone , cyclosporine , diltiazem , verapamil , and grapefruit juice could cause an interaction that blocks the enzymes in the liver that eliminate statins from the body.
  • This causes an increased level of statins that could result in an increased risk of myopathies and rhabdomyolysis.
  • Bile acid sequestrants prevent the absorption of statins into the body by binding to them in the intestine. It is recommended that statins be ingested one hour before or four hours after cholestyramine or colestipol .
  • Statins , when taken with warfarin , may cause an increased risk of bleeding. Atorvastatin and pravastatin do not have a clinically significant effect when given warfarin .
  • An increased risk of rhabdomyolysis or liver failure can occur when statins are taken with niacin , or fibric acids .
  • St Johnâs Wort decreases the levels of lovastatin and simvastatin and could possibly reduce the efficacy of the specified statins.
  • What Are Statins And Why Are They Used In The Treatment Of Lupus

    How Do Cholesterol Drugs Work?

    Statins are medications that lower the level of cholesterol in your blood by reducing the production of cholesterol in the liver. Cholesterol is a natural component of the fats in your blood stream and the cells of your body. However, people with high levels of cholesterol in their blood face an increased risk of cardiovascular disease, which can lead to chest pain, heart attack, stroke, and peripheral vascular disease.

    When too much cholesterol circulates in the blood, the substance can cause deposits to form on your artery walls. Plaque is dangerous because it can block the flow of blood to various parts of your body, including your heart and brain. Studies have shown that people with lupus are more likely to have clogged arteries that can lead to heart attack and stroke at a younger age. This increased risk is caused by elevated cholesterol levels, high blood pressure, diabetes, and inflammation, conditions that occur often in people with lupus. Certain medications, such as corticosteroids can provoke or compound these symptoms. For this reason, the cholesterol-lowering properties of statins are commonly called upon for lupus patients.

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    What Do Your Cholesterol Levels Tell You

    If you have high cholesterol, your doctor may recommend you take medication. This chart explains what your cholesterol levels tell you:

    If your Total Cholesterol level is:

    This is considered:

    OK, but less than optimal

    60 mg/dL and above

    Good, helps lower risk

    The numbers alone wont tell you or your doctor the entire story, however. If the only risk factor you have is high cholesterol, you may not need medication. Often high cholesterol can be lowered by exercise and a healthy diet. High cholesterol is only one of a number of risk factors for heart attack and stroke. Other risk factors include:

    • Family history of high cholesterol or cardiovascular disease
    • Inactive lifestyle
    • High blood pressure
    • Ageolder than 55 if youre a man, or older than 65 if youre a woman
    • Poor general health

    Inhibits production of triglycerides in the liver


    Belching, fishy taste, increased infection risk

    *Livalo became available on the market in mid-2010. Livalo is new and does not have the long track record of some of the other statins, so you may want to avoid this drug until more is known about it.


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