Understanding Your Medications
A guide for patients of The Sandusky Dyslipidemia Model clinic
Table of Contents
Why You Need Cholesterol Medication
When diet and exercise alone are not enough to bring your cholesterol to a safe level, medications can help. Cholesterol-lowering medications have been studied in large clinical trials involving hundreds of thousands of patients. They are proven to reduce heart attacks, strokes, and death from heart disease.
Your provider will choose the medication(s) that are best for your situation. You may need more than one medication to reach your goal.
Statins
Examples: Atorvastatin (Lipitor), Rosuvastatin (Crestor), Simvastatin (Zocor), Pravastatin (Pravachol), Pitavastatin (Livalo)
What They Do
Statins are the most commonly prescribed cholesterol medications. They block an enzyme in your liver that makes cholesterol, causing your liver to pull more “bad” cholesterol (LDL) out of your blood. Statins can lower LDL by 30–55%.
How to Take Them
- One pill by mouth, once a day
- Can be taken at any time of day (atorvastatin and rosuvastatin); some older statins work best in the evening
- Take at the same time each day for consistency
Common Side Effects
- Muscle aches (most common complaint; affects about 5–10% of patients)
- Mild stomach upset
- Slight increase in blood sugar over time
When to Call the Clinic
- Severe muscle pain or weakness
- Dark-colored urine
- Yellowing of the skin or eyes (very rare)
Important Notes
- Statins are very safe for the vast majority of patients
- Many side effects attributed to statins are also common in people not taking them
- If you have trouble with one statin, a different one may work better for you
Ezetimibe (Zetia)
What It Does
Ezetimibe blocks cholesterol absorption in your intestines. It lowers LDL by an additional 15–20% when added to a statin.
How to Take It
- One 10 mg pill by mouth, once a day
- With or without food
Common Side Effects
- Generally very well tolerated
- Rare: mild stomach upset, diarrhea
PCSK9 Inhibitors
Examples: Evolocumab (Repatha), Alirocumab (Praluent)
What They Do
These are injectable medications that help your liver remove much more LDL cholesterol from your blood. They can lower LDL by an additional 50–60% on top of other medications.
How to Take Them
- A small injection under the skin (like an insulin shot)
- Usually every 2 weeks or once a month, depending on the medication
- You will be trained to give yourself the injection at home
- The medication comes in a prefilled pen or syringe — keep it in the refrigerator
Common Side Effects
- Mild redness, swelling, or itching at the injection site
- Cold-like symptoms (uncommon)
Insurance Note
These medications usually require prior authorization from your insurance. Your care team will handle the paperwork. This process can take 1–4 weeks.
Inclisiran (Leqvio)
What It Does
Inclisiran works similarly to PCSK9 inhibitors but is given much less often. It can lower LDL by about 50%.
How to Take It
- An injection given by your provider at the clinic (you do not inject this at home)
- First injection at your visit, a second injection 3 months later, then one injection every 6 months
Common Side Effects
- Mild injection site reaction (brief)
Insurance Note
Like PCSK9 inhibitors, inclisiran usually requires prior authorization. Your care team will manage this process.
Bempedoic Acid (Nexletol) and Bempedoic Acid/Ezetimibe (Nexlizet)
What It Does
Bempedoic acid lowers LDL by blocking cholesterol production in the liver. Unlike statins, it does not affect your muscles, making it a good option if you cannot tolerate statins.
How to Take It
- One pill by mouth, once a day
- Nexlizet combines bempedoic acid and ezetimibe in one pill
Common Side Effects
- May raise uric acid levels (your provider will monitor this)
- Rare: tendon problems
- Generally well tolerated, especially regarding muscle symptoms
Icosapent Ethyl (Vascepa)
What It Does
Vascepa is a purified prescription fish oil (EPA) that lowers triglycerides and reduces heart disease risk. It is not the same as over-the-counter fish oil supplements.
How to Take It
- Two capsules twice a day, with food (4 capsules total per day)
Common Side Effects
- Joint pain
- Possible increased risk of irregular heartbeat (atrial fibrillation) — tell your provider if you feel your heart racing or skipping beats
Important Notes
- This is a prescription medication with proven heart benefits — it is different from store-bought fish oil supplements, which have not been shown to prevent heart disease
Other Medications
Your provider may occasionally prescribe fenofibrate (for very high triglycerides) or, rarely, niacin (for specific situations). These will be explained to you individually if prescribed.
What This Clinic Does NOT Recommend
Nutraceuticals such as plant sterols/stanols, red yeast rice, bergamot, berberine, and omega-3 supplements are not included in this clinic’s therapeutic plan. These products have not been proven in large clinical trials to prevent heart attacks or strokes. Some may also interact with your prescription medications.
If you are currently taking any of these products, please bring them up with your provider so they can be discussed.
Tips for Taking Your Medications
- Take them every day — cholesterol medications work best when taken consistently
- Set a reminder — use a phone alarm, pill organizer, or pair it with a daily habit (like brushing your teeth)
- Do not stop without asking — even if your numbers improve, stopping your medication will cause your cholesterol to go back up
- Refill on time — try to refill prescriptions before you run out
- Tell your provider about all medications — including over-the-counter drugs and supplements
Questions?
Bring your medication bottles or a complete list to every visit. Your care team is happy to answer questions about your medications.
This material is for informational purposes only and does not replace advice from your healthcare provider.