Treatment Options for People With Statin Intolerance

Statins are medicines that help lower cholesterol. High cholesterol can lead to heart disease. Doctors prescribe statins to reduce the risk of heart attacks and strokes by preventing the development and progression of plaque in your arteries. They work by blocking a substance your body needs to make cholesterol. This helps lower the "bad" cholesterol (LDL) in your blood.^1-3

However, some people cannot take statins due to side effects. This is called statin intolerance. It means your body does not handle statins well.^2,3

What is statin intolerance?

Statin intolerance means someone cannot tolerate the side effects of statin medicines. These side effects can be uncomfortable and can include:^2,4

• Muscle aches or weakness
• Muscle pain
• Feeling tired
• Digestive problems
• Liver problems

Muscle-related symptoms are the most frequent reason people stop taking statins.²

Treatment options for people with statin intolerance

If you have statin intolerance, there are other ways to manage your cholesterol. Doctors can suggest different medicines along with lifestyle changes.^2-4

Different statins or lower doses

Sometimes, changing the type of statin or lowering the dose can help. Some people tolerate one statin better than another. If you are having side effects from a statin, tell your doctor. Experts typically recommend trying a few different statins to see if that helps with side effects.^2-4

Non-statin medicines

If you cannot take any statins, your doctor might suggest other types of medicines. These medicines work in different ways to lower cholesterol.⁴

One example of an oral medicine which is an alternative to statins is bempedoic acid (Nexletol®). This is a newer drug that works to lower LDL (bad) cholesterol and has fewer muscle-related side effects. Bempedoic acid can also be used in combination with another cholesterol-lowering drug called ezetimibe (Nexlizet®). Both drugs are approved by the US Food and Drug Administration (FDA) to treat people with high cholesterol who are statin intolerant with cardiovascular disease or at high risk of having a cardiovascular event, such as a heart attack.^4-6

Some research suggests that taking a coenzyme Q10 (CoQ10) supplement, which is important for muscle function, might help prevent statin side effects, primarily muscle aches, however, more research is needed. Talk to your doctor to see if this is right for you.²

Lifestyle changes

Lifestyle changes are important for everyone, especially those with high cholesterol and statin intolerance. These changes can help lower cholesterol and improve heart health.^1-3

• Healthy diet – Eat a diet low in saturated and trans fats and avoid processed foods. Choose whole foods like fruits, vegetables, whole grains, and lean protein.
• Regular exercise – Aim for at least 30 minutes of moderate-intensity exercise 5 days a week.
• Exercise — Physical activity helps lower LDL cholesterol and raise HDL (good) cholesterol.
• Weight management – If you have overweight or obesity, losing even a small amount of weight can help lower cholesterol.
• Quit smoking – Smoking increases the risk of heart disease.
• Limit alcohol – Too much alcohol can raise cholesterol levels.

Work with your doctor

Talk to your doctor about statin intolerance. Do not stop taking your medicine without talking to them first. Your doctor can help you find the best treatment plan for you. They can monitor your cholesterol levels and adjust your medicines as needed.¹

Managing cholesterol is important for heart health. Even if you have statin intolerance, there are options to help you stay healthy. By working with your doctor and making healthy lifestyle changes, you can lower your risk of heart disease.¹