If you have high cholesterol, lifestyle changes are usually the first treatment. But if these steps don't bring the numbers low enough, your doctor may recommend medications to help. The most commonly used cholesterol-lowering medications are called statins.
How they work
Statin drugs inhibit an enzyme called HMG-CoA reductase, according to the National Heart, Lung, and Blood Institute (NHLBI). This enzyme helps control how much cholesterol the body makes.
By inhibiting this enzyme, statins slow the body's cholesterol production and help the liver filter more LDL (bad) cholesterol out of the blood.
According to the NHLBI and other experts, research shows that statins can:
- Lower LDL cholesterol by as much as 25% to 55%.
- Lower high levels of triglycerides—fats in the blood that can increase the risk of heart disease.
- Slightly increase HDL (good) cholesterol.
Statins should start lowering your cholesterol readings within a few weeks.
Part of the reason statins are the first choice among cholesterol-lowering drugs is because they are safe for most people, according to the NHLBI.
Some people do have problems with upset stomach, gas, constipation, and abdominal pain or cramps. These side effects are usually mild to moderate and lessen with time.
Rarely, people taking statins develop rhabdomyolysis, a serious condition that damages muscle tissue. Symptoms include muscle soreness, pain, weakness, fever, nausea, vomiting and brown urine.
Liver problems are another rare side effect.
Statins may also cause problems when taken along with other medications. According to the U.S. Food and Drug Administration (FDA), people should use statins with caution if they are also taking gemfibrozil, amiodarones, verapamils or blood thinners. People should also talk with their doctors about the risks of using a statin along with HIV medicines, birth control pills, nefazodone and niacin.
Finally, drinking more than 8 ounces of grapefruit juice or eating more than half a grapefruit each day could affect statins, according to UpToDate.
People who have side effects may be switched to a different statin or to a different cholesterol-lowering drug.
Pregnant women or people with liver disease shouldn't take statins, according to the American Heart Association.