14
Management
4.2. Medical Management
4.2.1. Pharmacological Therapy
Table 5. Characteristics of Common Lipid-Lowering
Medications to Treat Dyslipidemia*
Class Mechanism of Action Medications
Typical Dose
Range
LDL-C–Lowering Medications
HMG-CoA
reductase
inhibitors (aka
statins)
Competitively inhibits
HMG-CoA reductase (rate-
limiting step of endogenous
cholesterol production);
increases LDL receptor
expression on the surface of
hepatocytes
Atorvastatin 10–80 mg
Fluvastatin 20–80 mg
Lovastatin 10–80 mg
Pitavastatin 1–4 mg
Pravastatin 10–80 mg
Rosuvastatin 5–40 mg
Simvastatin 5–40 mg
Cholesterol
absorption
inhibitor
Blocks the sterol transporter
protein, NPC1L1, to inhibit
intestinal and biliary sterol
absorption; increases LDL
receptor expression on
the surface of hepatocytes
secondary to reduced
hepatic sterol levels
Ezetimibe 10 mg
PCSK9
inhibitor:
monoclonal
antibodies
Fully human monoclonal
antibodies: binds to PCSK9
in the circulation and
decreases degradation of
LDL receptors
Alirocumab
75–150 mg
or
300 mg
Evolocumab 140 mg
ATP citrate lyase
inhibitor
Inhibits ATP citrate lyase
in the liver to decrease
cholesterol production
upstream of HMG-Co
reductase in the cholesterol
synthesis pathway; increases
LDL receptor expression on
the surface of hepatocytes
Bempedoic
acid
180 mg
