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What are the common side effects of cholesterol medication Medically reviewed by Alexandra Perez, PharmD, MBA, BCGP — By Lauren Hellicar on August 15, 2022Doctors prescribe cholesterol medications to help reduce harmful cholesterol levels in the blood. Although most people report no side effects, some may experience adverse effects.
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Cholesterol is essential for maintaining several body functions, such as hormone production and cell membrane formation. Low-density lipoproteins (LDLs) carry cholesterol from the liver to the rest of the body through the arteries.
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High-density lipoproteins (HDLs) carry cholesterol back to the liver, where the liver then removes any excess. When a person has too much LDL cholesterol relative to HDL cholesterol, it can build up and block the arteries.
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In some people, this can lead to a heart attack or stroke. Doctors recommend people take steps to manage high cholesterol using dietary and lifestyle changes. However, many people also require cholesterol medications.
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These medications may cause side effects, which can be minor or, in rare cases, serious. This article outlines side effects of cholesterol medicines, who may be at the highest risk, and alternative ways to help reduce cholesterol. What are the side effects of cholesterol medicines
Share on Pinterestrobert reader/Getty ImagesBelow are some of the main types of cholesterol medicines and their potential side effects.
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A person should talk with a doctor if they experience side effects that are bothersome, severe, or last a long time. Statins
Doctors commonly prescribe statins to help lower high cholesterol. According to a study, almost 30% of adults ages 40 years and older in the United States take statins.
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The Food and Drug Administration (FDA) allows doctors to prescribe the following statins. The generic version of the medication appears first, followed by the brand-name version in brackets.atorvastatin (Lipitor)fluvastatin (Lescol)lovastatin (Mevacor, Altoprev)pravastatin (Pravachol)rosuvastatin (Crestor)simvastatin (Zocor)
Drug manufacturers list the possible side effects of each statin on the medication label. The following side effects are common with atorvastatin:diarrheaheartburngasjoint painforgetfulness or memory lossconfusion
Less common, potentially serious side effects of atorvastatin include:muscle pain, tenderness, or weaknesslack of energyfeverchest painnauseaextreme tirednessweaknessunusual bleeding or bruisingloss of appetitepain in the upper-right part of the abdomenflu-like symptomsdark-colored urineyellowing of the skin or eyesrashhivesitchingdifficulty breathing or swallowingswelling of the face, throat, tongue, lips, eyelids, hands, feet, ankles, or lower legshoarseness
If statins do not help lower a person’s cholesterol levels or the side effects are not manageable, a doctor may prescribe a different medication or a combination of cholesterol medications.
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Ezetimibe
Ezetimibe (known as the brand-name drug Zetia) is a cholesterol absorption inhibitor. This means it stops the intestines from absorbing cholesterol.
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It is the most commonly prescribed cholesterol-lowering medication after statins. Common side effects of ezetimibe include:headachedizzinessdiarrheasore throatrunny nosesneezingjoint pain
Less common, potentially serious side effects include:hivesrashitchingdifficulty breathing or swallowingswelling of the face, throat, tongue, lips, eyelids, hands, feet, ankles, or lower legshoarsenessupset stomachextreme tirednessunusual bleeding or bruisinglack of energyloss of appetitepain in the upper-right part of the abdomenyellowing of the skin or eyesflu-like symptomsmuscle pain or weaknessfeverchillsfatty or pale stoolschest pain
Bile acid sequestrants
Bile acid sequestrants bind to bile acid to help the intestine remove more cholesterol.
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Doctors in the U.S. have regulatory permission to prescribe the following bile acid sequestrants:cholestyramine (Prevalite, Locholest, Locholest Light)colestipol (Colestid)colesevelam (Welchol)
Common side effects of bile acid sequestrants include:constipationheartburngas and bloatingloss of appetiteindigestionnausea and vomitingstomach ache
PCSK9 inhibitors
PCSK9 inhibitors disable a protein on specific liver cells to lower LDL cholesterol.
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A person can read about the possible side effects of each drug on the medication label or discuss them with a doctor before taking it. Evolocumab injections may cause:discoloration, itching, swelling, pain, or tenderness at the injection siteflu-like symptoms, runny nose, sore throat, fever, or chillsburning or pain during urinationmuscle or back paindizzinessstomach pain
Other more serious side effects that need medical attention include:itchingrashhivesdifficulty breathing or swallowingswelling of the face, throat, tongue, lips, and eyelids
Adenosine triphosphate-citrate lyase ACL inhibitors
ACL inhibitors prevent the liver from producing cholesterol.
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Doctors may recommend that people with certain conditions take them alongside statins and make dietary and lifestyle changes to help reduce their LDL levels. This includes people with a type of hereditary high cholesterol known as familial hypercholesterolemia and people with heart disease who need to lower their LDL further. Doctors may prescribe bempedoic acid (Nexletol) or bempedoic acid and ezetimibe (Nexlizet).
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Bempedoic acid may cause:muscle spasmsback painpain in the hands or feet
More serious side effects can include:severe pain, warmth, discoloration, or swelling of the joints, particularly in the big toe hearing or feeling a snap or pop in a tendonbruising after an injury to a tendoninability to move or bear weight on an affected tendon area
Fibrates
Fibrates can help reduce LDL and are good at reducing fats in the blood, known as triglycerides. Doctors in the U.S.
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may prescribe the following fibrates:gemfibrozil (Lopid)fenofibrate (Antara, Lofibra, Tricor, and Triglide)clofibrate (Atromid-S)
A person can read about the possible side effects of each drug on the medication label or discuss them with a doctor before taking it. Fenofibrate may cause the following side effects:constipationdiarrheaheartburnpain in the back, arm, or legsheadachejoint pain
More serious side effects requiring medical attention include:muscle pain or tendernessskin reactions, such as rash, hives, or blisteringbreathing difficultypain in the upper back abdominal painswelling of the face, throat, tongue lips, or eyes
Learn more about cholesterol medications here. How to relieve side effects
Different people may experience different side effects from the same medication.
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A person who experiences bothersome side effects from one cholesterol medication may feel better taking another. Anyone experiencing persistent side effects should discuss their symptoms with a doctor, who may recommend a different type of medication or dose. Who is at risk of side effects
Statins are the most common medication doctors prescribe for high cholesterol.
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People generally tolerate them well, with 85–90% reporting no side effects. People who take multiple medications are at higher risk of developing side effects because the medications may interact with each other. Interactions may increase a person’s risk of developing serious side effects.
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Older people are more likely to take a combination of medications, so they may be most at risk of adverse effects. It is important to maintain regular communication with a doctor regarding all prescription medications. Alternative ways to lower cholesterol
While medications play an important role for some people, people can also help manage their cholesterol through dietary and lifestyle changes.
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These include:eating a diet rich in fiber and healthy fats such as olive oil, avocados, and nutsreducing intake of salt, sugar, and trans fatsreaching or maintaining a moderate body weightbeing physically activequitting smoking or vapinglimiting alcohol
Niacin, or vitamin B3, lowers triglycerides and LDL to some extent. Omega-3 fatty acids also help lower triglycerides in the blood. However, it is important to consult a doctor before taking these substances to lower cholesterol.
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Dietary supplements are not a substitute for prescribed medications, and it is important to note that the FDA does not regulate dietary supplements. Learn more about natural ways to lower cholesterol here. Outlook
Taking prescribed cholesterol medicines can help manage cholesterol levels, reducing the risk of a heart attack or other types of cardiovascular event.
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It is important to talk with a doctor about the benefits of taking each type of medication against its side effects. One 2018 review of the pros and cons of taking statins concluded that over 5 years, the medications are highly effective at lowering the risk of cardiovascular disease by 10% and reducing the impact of the disease by 5%. The authors acknowledged that 0.5–1% of people could also develop side effects.
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However, in most cases, the side effects are mild. Summary
Doctors may prescribe several different types of cholesterol-lowering medications, such as statins or bile acid sequestrants. These medications are often necessary to help maintain healthy cholesterol levels and prevent cardiovascular disease.
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However, as with any medication, they can cause side effects, some of which can be serious. It is important to discuss any ongoing or severe side effects with a doctor as soon as they arise.
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People can also make dietary and lifestyle choices that can help reduce cholesterol levels. Last medically reviewed on August 15, 2022CholesterolHeart DiseaseDrugs 13 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references.
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We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Atorvastatin. (2015).https://medlineplus.gov/druginfo/meds/a600045.htmlBempedoic acid.
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(2020).https://medlineplus.gov/druginfo/meds/a620020.htmlCholesterol medications. (2020).https://www.heart.org/en/health-topics/cholesterol/prevention-and-treatment-of-high-cholesterol-hyperlipidemia/cholesterol-medicationsEvolocumab injection. (2018).https://medlineplus.gov/druginfo/meds/a615043.htmlEzetimibe.
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(2020).https://medlineplus.gov/druginfo/meds/a603015.htmlFenofibrate. (2019).https://medlineplus.gov/druginfo/meds/a601052.htmlHla, D., et al.
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(2018). Assessing severity of statin side effects: Fact versus fiction.https://www.acc.org/latest-in-cardiology/articles/2018/04/09/13/25/assessing-severity-of-statin-side-effectsLent-Schochet, D., et al.
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(2022). Antilipemic agent bile acid sequestrants.https://www.ncbi.nlm.nih.gov/books/NBK549906/Omega-3 fatty acids. (2016).https://medlineplus.gov/druginfo/meds/a607065.htmlPinal-Fernandez, I., et al.
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(2018). Statins: Pros and cons.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6019636/Preventing high cholesterol.
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(2021).https://www.cdc.gov/cholesterol/prevention.htmSchultz, B. G., et al.
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(2018). The role of statins in both cognitive impairment and protection against dementia: A tale of two mechanisms.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5830056/Young, E. H., et al.
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(2021). Polypharmacy prevalence in older adults seen in United States physician offices from 2009 to 2016.
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[Abstract].https://pubmed.ncbi.nlm.nih.gov/34343225/FEEDBACK:Medically reviewed by Alexandra Perez, PharmD, MBA, BCGP — By Lauren Hellicar on August 15, 2022
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