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          Cholesterol Medicines GuideWomen's Health Topics Cholesterol Medicines Guide
  
  					From the FDA Office of Women's Health
	
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    PrintCholesterol Medicines

Cholesterol, hdl and ldl. Medical form on a desk.
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Cholesterol is a kind of fat in your blood. Your body makes its own cholesterol, but you also get it from the foods you eat, such as meat; foods fried in animal fat, like lard, butter, or margarine; dairy products; or other foods.

Most people do not show any signs of high cholesterol. The only way to know your cholesterol levels for sure is to ask your healthcare provider for a cholesterol test. A cholesterol test can tell you about your:

**LDL (low-density lipoprotein) cholesterol**: LDL is commonly called “bad” cholesterol. LDL can clog your arteries, and high LDL levels may make you more likely to have a heart event, such as a heart attack or stroke. A healthy LDL blood level is less than 100 mg/dL.
	**HDL (high-density lipoprotein) cholesterol**: HDL is sometimes called “good” cholesterol. People with high HDL blood levels may be less likely to have a heart event. A healthy HDL blood level is 60 mg/dL or higher.
	**Total Cholesterol (TC)**: TC includes LDL, HDL, and other kinds of cholesterol. A healthy TC is less than 200 mg/dL.
	**Triglycerides**: Triglycerides are another type of fat measured as part of the cholesterol test. Triglyceride levels lower than 150 mg/dL are healthy. High triglycerides may increase your chance of having a heart attack or stroke. People with very high triglyceride levels (500 mg/dL or higher) are at risk for other health problems. Very high triglyceride levels are discussed in a separate section below.High Cholesterol Levels

Some people have too much cholesterol in their blood. Cholesterol can build up on the inside of the blood vessels in your heart as well as other blood vessels in your body. If too much cholesterol builds up in the blood vessels in your heart, the blood cannot flow through to your heart and may lead to a heart attack. People with high cholesterol, especially high LDL, are more likely to have a heart event, such as a heart attack or stroke, or need surgery or a procedure to open up the blood vessels of the heart (bypass surgery, angioplasty, or stent placement).

A heart-healthy lifestyle may help lower your cholesterol and your chance of having a heart event at all ages. A heart-healthy lifestyle includes reducing the amount of total and saturated fat in your diet, participating in regular aerobic exercise, and losing weight (if you are overweight or obese).

Lowering LDL with certain medicines may decrease your chance of having a heart event. But not everyone with high cholesterol needs medicine. Whether or not you should start a cholesterol-lowering medicine depends on a few things: if you already have heart (cardiovascular) disease, your age, your cholesterol levels, and other factors. Your healthcare provider can help you decide about taking a cholesterol-lowering medicine, such as a statin.

In most cases, if you need to take a cholesterol-lowering medicine, your healthcare provider may consider prescribing a statin first. You can discuss this more with your healthcare provider.

Very High Triglyceride Levels (Severe Hypertriglyceridemia)

People with very high triglyceride levels (500 mg/dL or higher) may be more likely to develop acute pancreatitis. Acute pancreatitis is swelling and irritation of the pancreas that feels like sudden, severe stomach pain. In some cases, the pain may get better, but in other cases you could have a fever, severe dehydration, and get very sick and need to go to the hospital for care to save your life. The most common causes of acute pancreatitis are gallstones, excess alcohol use, and taking certain medicines. Very high triglycerides may cause acute pancreatitis even in people who do not have gallstones or drink alcohol.

Many things can cause very high triglyceride levels, such as genetic causes (passed down from a parent), uncontrolled diabetes, taking certain medicines, being obese or overweight, alcohol use, pregnancy, and thyroid disease. People with high triglycerides should follow a low-fat diet with a goal of weight loss (if overweight or obese) and should not drink alcohol or take certain medicines. People with diabetes are typically instructed to follow a meal plan and take their diabetes medicine as prescribed to improve control of their blood sugar levels.

Some people may need to take medicine in addition to lifestyle changes (diet and exercise) to lower their triglyceride levels. If you have high triglyceride levels, you should talk to your healthcare provider.

Medicines to Control Cholesterol and Triglycerides

**There are different kinds of medicines to lower high cholesterol, triglycerides, or both.**

HMG-CoA Reductase Inhibitors (also called statins)
	Cholesterol Absorption Inhibitors
	Proprotein Convertase Subtilisin Kexin Type 9 (also called PCSK9 inhibitors)
	Adenosine Triphosphate-Citrate Lyase (ACL) Inhibitors
	Cholesterol-Lowering Combination Medicines
	High Blood Pressure and Cholesterol-Lowering Combination Medicines
	Omega-3-Acid Ethyl Esters
	Bile Acid Sequestrants
	Fibric Acid Derivatives (also called fibrates)
	Niacin**Use this information as a guide to help you talk with your healthcare provider about your cholesterol or triglyceride medicine.**Ask your healthcare provider about the benefits and risks of taking your medicine. This information only talks about some of the risks.

Tell your healthcare provider about any problems you are having. Your healthcare provider will help you find the medicine that is best for you.

Also, tell your healthcare provider if you are pregnant, breastfeeding, or planning to become pregnant. Ask your healthcare provider to tell you about the benefits and risks of taking medicine when you are pregnant.

The different kinds of cholesterol and triglyceride medicines are listed below. The medicines are listed in groups. The brand names and generic names are given for the medicines in each group.

**For the most complete and up-to-date information about the risks and side effects for each medicine, check Drugs@FDA.**

HMG-CoA Reductase Inhibitors (also called Statins)

Generic Name
			Brand Nameatorvastin
			Lipitorfluvastatin
			Lescol XLlovastatin
			Altoprevpravastatin
			Pravacholpitavastatin
			Livalo and Zypitamagrosuvastatin
			Crestor and Ezallor Sprinklessimvastatin
			Flolipid and Zocor**Statins: What You Should Know**

These medicines treat high cholesterol and high triglycerides. Certain statins have been shown to reduce the risk of some heart problems or procedures in people who have heart disease or are at high risk of heart disease because of other conditions, such as diabetes or high blood pressure. These problems can include heart attack, stroke, or other heart problems requiring hospitalization (including congestive heart failure). Certain statins may reduce the risk of or need for heart procedures, such as bypass surgery, angioplasty, or stent placement. Certain statins have also been shown to reduce the risk of dying from a heart attack, stroke, or other heart event.

**Before taking these medicines, tell your healthcare provider if you:**

Have any allergies, including allergies to medicines
	Are pregnant or planning to become pregnant
	Are breastfeeding or planning to breastfeed
	Have liver problems
	Have kidney problems
	Have diabetes
	Have unexplained muscle aches or weakness
	Drink more than two glasses of alcohol daily
	Have thyroid problemsTell your healthcare provider and pharmacist about all the medicines you take, including prescription and non-prescription medicines, vitamins, herbal supplements, or other nutritional supplements. Especially tell your healthcare provider if you are taking medicines for your cholesterol, any infections, your immune system, heart failure, seizures, diabetes, heartburn or stomach ulcers, or birth control pills.

**Warnings**

Statins can cause serious side effects, including:

Muscle problems that can sometimes lead to serious kidney problems, including kidney failure.
	Liver problems. Your healthcare provider should do blood tests to check your liver before starting these medicines.Common Side Effects

Headache
	Nausea
	Diarrhea
	Constipation
	Muscle pain
	Back pain
	Upset stomach
	Abdominal pain
	Weakness
	Joint pain
	Flatulence
	Stomach pain
	RashWarning Signs

**If you are taking a statin, get medical help right away if you have any of these signs or symptoms:**

Allergic reaction, including hives, rash, or swelling in other parts of your body
	Brown or dark-colored urine
	Changes in urination
	Muscle problems, like weakness, tenderness, or pain that happens without a known reason (like exercise or injury)
	Skin or eyes look yellow
	Skin rash, itching, or redness (moderate to severe)
	Weakness in part of your bodyCholesterol Absorption Inhibitors

Generic Name
			Brand Nameezetimibe
			ZetiaCholesterol Absorption Inhibitors: What You Should Know

This medicine treats high cholesterol.

**Before taking this medicine, tell your healthcare provider if you:**

Have any allergies, including allergies to medicines
	Are pregnant or planning to become pregnant
	Are breastfeeding or planning to breastfeed
	Have liver problems
	Experience unexplained muscle pain, tenderness, or weaknessTell your healthcare provider and pharmacist about any prescription and non-prescription medicines you are taking or plan to take, including natural or herbal remedies.

Warnings

This medicine can cause serious side effects when taken with other cholesterol-lowering medicines, including:

Abnormal blood tests for liver function
	Serious muscle problemsCommon Side Effects

Diarrhea
	Joint pain
	Feeling tiredWarning Signs

**If you are taking ezetimibe, get medical help right away if you have any of these signs or symptoms:**

Allergic reaction, including hives, rash, or swelling in other parts of your body
	Muscle problems, like weakness, tenderness, or pain that happens without a good reason (like exercise or injury)
	Brown or dark-colored urine
	Skin or eyes look yellowProprotein Convertase Subtilisin Kexin Type 9 (also called PCSK9 Inhibitors)

Generic Name
			Brand Namealirocumab
			Praluentevolocumab
			RepathaPCSK9 Inhibitors: What You Should Know

These medicines treat high cholesterol and decrease the chances of having a heart attack, stroke, or certain types of heart problems requiring hospitalization in people with known heart (cardiovascular) disease.

**Before taking these medicines, tell your healthcare provider if you:**

Have any allergies, including allergies to medicines
	Are pregnant or planning to become pregnant
	Are breastfeeding or planning to breastfeedTell your healthcare provider and pharmacist about all the medicines you take, including prescription and non-prescription (over-the-counter) medicines, vitamins, and herbal supplements.

**Warnings**

These medicines can cause serious side effects, including:

Serious allergic reactionsCommon Side Effects

Back pain
	Common cold symptoms, or flu or flu-like symptoms
	Redness, itching, swelling, pain, or bruising at the injection site
	Runny nose
	Sore throatWarning Signs

If you are taking a PCSK9 inhibitor, get medical help right away if you have any of these signs or symptoms:

Allergic reaction, including hives, rash, or swelling in other parts of your body
	Trouble breathing or swallowingAdenosine Triphosphate-Citrate Lyase (ACL) Inhibitors

Generic Name
			Brand Namebempedoic acid
			NexletolACL Inhibitors: What You Should Know

This medicine treats high cholesterol.

**Before taking this medicine, tell your healthcare provider if you:**

Have any allergies, including allergies to medicines
	Have gout
	Have tendon problems
	Are pregnant or planning to become pregnant
	Are breastfeeding or planning to breastfeed
	Have kidney problems
	Have liver problemsThis medicine may affect the way other medicines work, and other medicines may affect how this medicine works. Tell your healthcare provider and pharmacist about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your healthcare provider and pharmacist if you take or plan to take other cholesterol-lowering medicines, fluoroquinolones, or cortisone medicines.

Warnings

This medicine may cause serious side effects, including:

Increased levels of uric acid in your blood. High levels of blood uric acid may lead to gout.
	Tendon rupture or injury.Common Side Effects

Common cold symptoms, flu, or flu-like symptoms
	Bronchitis
	Back pain
	Stomach pain
	Abnormal laboratory test for liver function
	Muscle spasms
	Shoulder, arm, or leg pain (mild)
	Anemia
	Increased liver enzymesWarning Signs

**If you are taking an ACL inhibitor, get medical help if you have any of these signs or symptoms:**

Bruising, pain or swelling in an arm, shoulder, or ankle
	Fast or irregular heartbeat
	Joints red, tender, or swollen, severe foot pain
	Sudden joint snapping or “popping” sound
	Unable to move or put weight on joint or limbCholesterol-Lowering Combination Medicines

Generic Name
			Brand Nameezetimibe and bempedoic acid
			Nexlizetezetimibe and rosuvastatin
			Roszetezetimibe and simvastatin
			VytorinCholesterol-Lowering Combination Medicines: What You Should Know

These medicines are made up of two different kinds of cholesterol medicines. Some of these medicines appear alone on other lists in this guide. Look for the generic or brand names on the other lists.

**Before taking these medicines, tell your healthcare provider if you:**

Have any allergies, including allergies to medicines
	Are pregnant or planning to become pregnant
	Are breastfeeding or planning to breastfeed
	Experience unexplained muscle pain, tenderness, or weakness
	Have tendon problems
	Have gout
	Have liver problems
	Have kidney problems
	Have thyroid problems
	Have diabetes
	Drink more than two servings of alcohol dailyThese medicines may affect the way other medicines work, and other medicines may affect how these medicines work. Tell your healthcare provider and pharmacist about all the medicines you take, including prescription and non-prescription medicines, vitamins, herbal supplements, or other nutritional supplements. Especially tell your healthcare provider and pharmacist if you are taking medicines for your cholesterol, fluoroquinolones, medicines for any infections, your immune system, heart failure, seizures, diabetes, heartburn or stomach ulcers, birth control pills, or cortisone medicines.

Warnings and Side Effects

The warnings and side effects for these medicines are the same as those listed for each of the generic medicines.

High Blood Pressure and Cholesterol-Lowering Combination Medicines

Generic Name
			Brand Nameamlodipine and atorvastatin
			CaduetHigh Blood Pressure and Cholesterol-Lowering Combination Medicines: What You Should Know

This medicine is made up of two different kinds of medicines. This medicine is used to treat both high blood pressure and high cholesterol.

**Atorvastatin** is a cholesterol-lowering medicine. Look for the **other names** of **atorvastatin** on the list of **HMG-CoA Reductase Inhibitors (“statins”)** above. The **warnings** and **side effects** for atorvastatin are the same as those listed earlier for “statins.”

**Amlodipine** is a blood pressure medicine. Some of the **warnings** and **side effects** for **amlodipine** are listed below.

**Before taking this medicine, tell your healthcare provider if you:**

Have any allergies, including allergies to medicines
	Are pregnant or planning to become pregnant
	Are breastfeeding or planning to breastfeed
	Have liver or kidney problems
	Have a heart condition
	Have unexplained muscle aches or weakness
	Have diabetes
	Have thyroid problems
	Drink more than two glasses of alcohol daily**Tell your healthcare provider and pharmacist about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your healthcare provider and pharmacist if you take medicines for:**

Your immune system
	Infections
	Cholesterol
	Hepatitis C virus
	Birth control
	Heart failure
	HIV (AIDS)
	Other virusesWarnings

**This medicine can cause serious side effects, including:**

Serious muscle problems that can lead to kidney problems, including kidney failure.
	Serious liver problems. Your healthcare provider should do blood tests to check your liver before starting this medicine.
	Low blood pressure or dizziness.
	Muscle rigidity, tremor, and abnormal muscle movement.Common Side Effects

Diarrhea
	Swelling of your legs or ankles
	Nausea
	Upset stomach
	Muscle and joint pain
	Changes in some laboratory blood testsWarning Signs

**If you are taking a high blood pressure and cholesterol-lowering combination medicine, get medical help right away if you have any of these signs or symptoms:**

Chest pain
	Serious rashes
	Swelling of the face, eyes, lips, tongue, arms, or legs
	Fainting
	Muscle problems like weakness, tenderness, or pain that happens without a good reason (like exercise or injury)
	Skin or eyes look yellowOmega-3-Acid Ethyl Esters (also called Omega-3 fatty acids)

Generic Name
			Brand Nameomega-3-acid ethyl esters
			Lovazaicosapent ethyl
			Vascepa**Omega-3-Acid Ethyl Esters: What You Should Know**

These medicines lower very high triglycerides in adults.

Icosapent ethyl is used along with other medicines (statins) to reduce the risk of heart attack, stroke, and certain types of heart issues requiring hospitalization in adults with heart (cardiovascular) disease or diabetes and two or more additional risk factors for heart disease.

**Before taking these medicines, tell your healthcare provider if you:**

Have any allergies, including allergies to medicines
	Are pregnant or planning to become pregnant
	Are breastfeeding or planning to breastfeed
	Have diabetes
	Have thyroid problems
	Have a liver problem
	Have a pancreas problem
	Are allergic to fish or shellfish
	Have gout
	Have an irregular heartbeatTell your healthcare provider and pharmacist about all the medicines you take, including prescription and non-prescription (over-the-counter) medicines, vitamins, and dietary or herbal supplements. These medicines can interact with certain other medicines that you are taking. Especially tell your healthcare provider if you take medicines that affect your blood clotting (anticoagulants or blood thinners).

Warnings

These medicines can cause serious side effects, including:
	Heart rhythm problems
	Possible allergic reactions if you are allergic to fish or shellfish
	Bleeding
	Changes in certain blood tests used to check your liver function and cholesterol levelsCommon Side Effects

Burping
	Joint or muscle pain
	Swelling of the hands, legs, or feet
	Constipation
	Gout
	Heart rhythm problems
	Upset stomach
	Change in sense of tasteWarning Signs

**If you are taking an omega-3 fatty acid, get medical help right away if you have any of these signs or symptoms:**

Allergic reaction, including hives, rash, or swelling in other parts of your body
	Fast or irregular heartbeat
	Increased or unusual bleeding
	Joints red, tender, or swollenBile Acid Sequestrants

Generic Name
			Brand Namecholestyramine
			Prevalitecolesevelam
			Welcholcolestipol
			ColestidBile Acid Sequestrants: What You Should Know

These medicines treat high cholesterol.

**Before taking these medicines, tell your healthcare provider if you:**

Have any allergies, including allergies to medicines.
	Are pregnant or planning to become pregnant. These medicines may interfere with how you absorb vitamins.
	Are breastfeeding or planning to breastfeed. These medicines may interfere with how you absorb vitamins.
	Have pancreas problems. Very high levels of triglycerides (more than 2,000 mg/dL) may increase the risk of pancreatitis.
	Have bleeding problems, chronic constipation, gallbladder problems, heart disease, hemorrhoids, phenylketonuria, previous intestinal surgery or bowel blockage, stomach ulcers, or thyroid disease.
	Bile acid sequestrants can bind to and slow down or reduce the absorption into the bloodstream of many medicines. Talk with your healthcare provider about how to schedule taking your other medicines around taking a bile acid sequestrant.
	To reduce the risk of constipation, drink plenty of fluids and increase the amount of fiber in your diet while using this medicine.
	Avoid slowly sipping or holding cholestyramine-containing liquid in your mouth for prolonged periods of time because it can damage tooth surfaces. Practice good oral hygiene while taking this medicine.**Tell your healthcare provider and pharmacist about all the medicines you take, including prescription and non-prescription medicines, vitamins, herbal supplements, or other nutritional supplements.** Especially tell your healthcare provider if you are taking any of the following:

Birth control pills
	Blood thinners
	Cyclosporine
	Diabetes medicines
	Heart or blood pressure medicines
	Mycophenolic acid
	Phenobarbital
	Phenytoin
	Thyroid hormonesCommon Side Effects

Increased burping
	Heartburn
	Constipation (mild)
	Gas
	Indigestion
	Nausea
	Diarrhea**Warning Signs**

**If you are taking a bile acid sequestrant, get medical help if you have any of these signs or symptoms:**

Constipation (moderate to severe)
	Prolonged period of time without having a bowel movement
	Abdominal or stomach pain
	Vomiting
	Sudden weight change
	Increased or unusual bleedingFibric Acid Derivatives (also called Fibrates)

Generic Name
			Brand Namefenofibrate
			Antara, Fenoglide, Lipofen, Tricor and Triglidefenofibric acid
			Fibricor and Trilipixgemfibrozil
			LopidFibric Acid Derivatives (Fibrates): What You Should Know

These medicines treat high cholesterol and high triglycerides.

**Before taking these medicines, tell your healthcare provider if you:**

Have any allergies, including allergies to medicines
	Are pregnant or planning to become pregnant
	Are breastfeeding or planning to breastfeed
	Have liver problems
	Have kidney problems
	Have heart problems
	Have muscle pain or tenderness
	Have gallbladder problems
	Have pancreas problems
	Have had a blood clot, like a DVT or PETell your healthcare provider and pharmacist about all the medicines you take, including prescription and non-prescription medicines, vitamins, herbal supplements, or other nutritional supplements.
Especially tell your healthcare provider and pharmacist if you are taking any medicines that affect your blood clotting (anticoagulants or blood thinners), medicines that suppress your immune system, other cholesterol-lowering medicines, or colchicine.

Warnings

These medicines may cause serious side effects, including:

Serious muscle injury that can lead to kidney injury
	Abnormal laboratory tests of liver function
	Abnormal tests of kidney function
	Abnormal tests of blood cells
	Changes in other blood tests for cholesterol levels
	Gallstones
	Bleeding, when taken with certain blood-thinning medicines
	Pancreatitis
	Severe allergies
	Blood clotsCommon Side Effects

Abnormal blood tests of liver function
	Runny nose
	Stomach pain
	Back pain
	Headache
	Nausea
	ConstipationWarning Signs

**If you are taking a fibrate, get medical help right away if you have any of these signs or symptoms:**

Allergic reaction, including hives, rash, itching, redness, or swelling
	Shortness of breath, chest pain, or coughing up blood
	Warmth, pain, tenderness, swelling, or skin redness in leg or thigh
	Muscle problems like weakness, tenderness, or pain that happens without a reason (like exercise or injury)
	Brown or dark-colored urine
	Skin or eyes look yellow
	Severe and sudden pain in upper abdomen
	Nausea or vomiting (severe)
	Clay-colored stoolsNiacin

Generic Name
			Brand Nameniacin (nicotinic acid, vitamin B3)
			Niacor and NiaspanNiacin: What You Should Know

This medicine treats high cholesterol and high triglycerides.

**Before taking this medicine, tell your healthcare provider if you:**

Have any allergies, including allergies to medicines
	Are pregnant or planning to become pregnant
	Are breastfeeding or planning to breastfeed
	Have liver problems
	Have stomach ulcers
	Have bleeding problems
	Have diabetes
	Have gout
	Have kidney problemsTell your healthcare provider and pharmacist about all the medicines you take, including prescription and non-prescription medicines, vitamins, herbal supplements, or other nutritional supplements containing niacin or nicotinamide. Especially tell your healthcare provider and pharmacist if you take other medicines to lower cholesterol or triglycerides, aspirin, blood pressure medicines, medicines that affect your blood clotting (anticoagulants or blood thinners), or drink alcohol daily.

Warnings

**This medicine can cause serious side effects, including:**

Severe liver problems
	Unexplained muscle pain, tenderness, or weakness
	High blood sugar levelsCommon Side Effects

Flushing (redness of the face or neck)
	Diarrhea
	Nausea
	Vomiting
	Cough
	Skin rash or itchingWarning Signs

**If you are taking niacin, get medical help if you have any of these signs or symptoms:**

Fast or irregular heartbeat
	Fainting
	Dizziness
	Muscle problems like weakness, tenderness, or pain
	Brown or dark-colored urine
	Skin or eyes look yellowQuestions to Ask Your Healthcare Provider

What is the name of the medicine I am taking?
	What are the potential side effects?
	What other prescription medicines should I avoid while taking my cholesterol medicine?
	What foods (such as grapefruit juice), herbs (like St. John’s wort, ginkgo, goldenseal), or non- prescription (over-the-counter) medicines should I avoid?
	When should I take each medicine? How many times per day do I take each medicine?
	Can I take my medicine if I am pregnant or breastfeeding?Sign Up for a Pregnancy Registry

Pregnant Woman in Green
Pregnancy Exposure Registries are research studies that collect information from women who take prescription medicines or vaccines during pregnancy. Pregnancy registries can help women and their doctors learn more about how cholesterol medicines affect women during pregnancy. The FDA does not conduct pregnancy studies, but it keeps a list of registries.

**Check to see if there is a registry for your cholesterol medicine or other medicines at www.fda.gov/pregnancyregistries.**

Resources For You

**National Heart, Lung, and Blood Institute Health Information Center**
Phone: 1-877-NHLBI4Uhttps://www.nhlbi.nih.gov/health-topics/high-blood-cholesterol

**MedlinePlus**https://medlineplus.gov/cholesterol.html

This information should not be used in place of talking to your healthcare provider or reading the label on your medicine bottle. The medicine and risk information on this page may change and is not all inclusive.

Cholesterol medicines and information on this page are current as of June 2022.

For the most complete and up-to-date information about the risks and side effects of each medicine, check http://www.accessdata.fda.gov/scripts/cder/drugsatfda/.

                                                                                  Content current as of:
      08/29/2022Women's Health Topics

          
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          Uterine fibroids


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