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Statins block an enzyme in your liver that produces cholesterol. They lower “bad” LDL cholesterol and slightly increase “good” HDL cholesterol. The marked reduction in LDL due to statins can reduce the amount of cholesterol that has already been deposited in the arteries. This can stabilize the plaque from growing or help reduce the size of the plaque.

Statins also reduce triglycerides if these substances are not severely elevated.

Commonly prescribed statins include atorvastatin (Lipitor^®), rosuvastatin (Crestor^®), pitavastatin (Livalo^®), and simvastatin (Zocor^®).

Statins are taken once a day by mouth. They have been shown to reduce the incidence of heart disease and stroke and lower the need for heart surgery.

Statins can occasionally cause gastrointestinal discomfort, muscle pain, and, rarely, liver damage. You doctor may test your blood routinely to watch for any changes.

Cholesterol absorption inhibitors, such as ezetimibe, work by reducing the amount of cholesterol your body absorbs from the foods you consume. The medication is taken once a day and has very few side effects, but some people experience diarrhea and abdominal pain. When used alone, cholesterol absorption inhibitors are not as effective as statins in lowering LDL, so they may be prescribed with additional medications.

Bile acid resins bind to acids found in bile in the intestine, which contain cholesterol. These medications prevent the body from absorbing cholesterol from food. They have been prescribed for decades and are considered safe.

Bile acid resins are usually taken twice a day and must be taken separate from other medications so as not to decrease their absorption. The most common side effect is gastrointestinal discomfort.

Fibrates help reduce the body’s production of triglycerides. They may also increase the level of HDL “good” cholesterol. Fibrates are taken daily. The most common side effect is gastrointestinal upset, including nausea, diarrhea, and vomiting.