High levels of low-density lipoprotein (LDL) cholesterol, also known as bad cholesterol, may harm your body. However, what you eat, how often you exercise, and medications can help lower your LDL levels.
Published January 30, 2023

Medically reviewed by Adam Bernstein, MD, ScD on January 30, 2023

When LDL levels are high, a buildup of fatty substances in arteries may occur, sometimes leading to a heart attack or stroke. However, you can take steps to protect yourself from high LDL levels, including lifestyle strategies or medications.

When you hear the term “good” cholesterol, it refers to high-density lipoprotein (HDL) that carries LDL to the liver, which will then break it down for removal. You can boost your HDL levels to help keep your cholesterol levels healthy.

How to lower LDL levels

Older adult couple sitting together at a dining table, focus on older adult male as they learn about LDL cholesterol medications
ZQZ Studio/Stocksy United

Eating a balanced diet and getting a good amount of exercise can help to prevent and lower high LDL levels, but sometimes you may need medication. The most common of these medicines are statins, which slow the liver’s cholesterol production and help break down existing LDL.

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Atorvastatin

Atorvastatin, typically combined with a healthy diet, works by reducing the amount of LDL and fat stored in cells (known as triglycerides) and increasing HDL amounts.

The Food and Drug Administration (FDA) approves this medication for preventing heart attack, stroke, and angina.

It’s most commonly prescribed if you have a coronary heart disease diagnosis and other conditions, including high cholesterol. It’s also used to reduce the risk of hospital admissions for those who may experience nonfatal heart attacks or strokes.

Rosuvastatin

Like atorvastatin, rosuvastatin reduces the amount of blood cholesterol and is also used to prevent heart disease.

Doctors may also offer you this drug if you have the following:

  • kidney disease
  • diabetes
  • a family history of rheumatoid arthritis

However, the FDA has not commented on prescribing rosuvastatin for these conditions.

Lovastatin

The body makes enzymes (types of protein) to speed up some processes, like making cholesterol. Statins work by blocking a specific enzyme (HMG Co-A reductase) that your body uses to create cholesterol, helping to lower LDL levels. This is how lovastatin and other statins work.

A doctor may also recommend this medication for managing the risk of stroke and heart-related complications during specific surgeries and for strokes not involving the heart. However, this is not yet FDA approved and is therefore considered “off-label” use.

Pravastatin

Pravastatin works the same way as other statins by blocking the enzyme HMG Co-A reductase.

Your doctor may also prescribe this drug off-label to help stop blood vessels in the brain from going into spasms, preventing blood flow. These types of spasms often occur after a specific type of brain hemorrhage.

Simvastatin

Simvastatin also works in the same way as lovastatin and pravastatin, by blocking MHG Co-A reductase. It, like all statins, is also used alongside a healthy diet and exercise regimen.

In some instances, doctors may also prescribe this medication off-label to prevent irregular heart rhythm (atrial fibrillation) and negative effects on the heart and blood vessels following sudden heart-related hospitalizations. The use of simvastatin in this way does not yet have FDA approval.

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Fluvastatin and fluvastatin ER

Fluvastatin reduces LDL and triglycerides while increasing HDL, helping you manage your total cholesterol.

Fluvastatin extended release (ER) is the same drug, but the dosage releases over time, keeping the effects stable for longer.

Common statins side effects

Statins can have some common side effects, including:

  • headaches and dizziness
  • nausea
  • tiredness or weakness
  • constipation or diarrhea
  • indigestion or passing gas
  • painful muscles
  • difficulty sleeping
  • low levels of blood platelets

Some rare side effects include:

  • muscle weakness (myopathy)
  • tingling hands and feet
  • tendon-related symptoms

Other medications

Other types of drugs treat high LDL levels, including:

  • Bile acid sequestrants: These medications work by helping the body remove cholesterol from the bloodstream. Examples include:
  • Niacin: Niacin, a B vitamin, helps reduce overall cholesterol, while nicotinic acid increases HDL levels. You will find niacin in common foods, including:
    • chicken breast
    • brown rice
    • whole wheat bread
  • PCSK9 inhibitors: These injectable medications lower the amount of LDL in the bloodstream. Examples include:
  • Fibrates: These drugs reduce fat stored in cells within the blood. Known as triglycerides, these fatty cells form and remain in place when you consume more calories than you burn. Some examples include:

When to contact your doctor

If your cholesterol is high, you are unlikely to notice any symptoms. You may not find you have high cholesterol until it leads to an emergency, such as stroke or heart attack, as it has built up over time.

If you feel you could benefit from additional exercise, trying different food types, or managing your weight, you could contact your doctor or healthcare professional for advice. All of these steps can help you manage cholesterol drug-free.

Your doctor may order blood tests to determine your cholesterol levels, and if the results are high, they may prescribe medications after discussing lifestyle strategies.

Summary

Statins are the most common medications for treating high cholesterol, and they do so by slowing the liver’s cholesterol production. Other drug types include bile acid sequestrants, niacin, PCSK9 inhibitors, and fibrates. Most of these medicines are prescription only.

Low-density lipoprotein (LDL) is often known as “bad” cholesterol. This is because high LDL levels can create fatty buildup in your arteries. This can become dangerous as it may lead to heart attack or stroke.

A balanced diet and regular exercise can help keep LDL levels manageable, but your doctor may recommend medications to ensure optimal LDL levels.

Download the free Optum Perks Discount Card to save up to 80% on some prescription medications.

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