20
Management
Table 5. Characteristics of Common Lipid-Lowering
Medications to Treat Dyslipidemia*
Class Mechanism of Action Medications
Typical Dose
Range
Triglyceride-Lowering Medications (cont'd)
Niacin Reduces esterification of
hepatic TG, decreases release
of free fatty acids from
adipose tissue and increases
activity of lipoprotein lipase
to enhance removal of TG-
rich lipoprotein fatty acids
Extended-
release niacin
500–2000 mg
Immediate-
release niacin
250–6000 mg
ApoC-III
inhibitor: ASO
directed therapy
Binds to and degrades
apoC-III mRNA; reduces
the apoC-III protein,
leading to increased
clearance of plasma TG and
VLDL
Olezarsen 80 mg
* Dosages and administration from FDA-approved labeling.
†
Adverse effects are discussed in Section 5.1, "Medication Safety and erapy-Associated
Side Effects."
‡
Expected lipid-lowering based on estimations from the "2022 ACC Expert Consensus
Decision Pathway on the Role of Nonstatin erapies for LDL-Cholesterol Lowering in
the Management of Atherosclerotic Cardiovascular Disease Risk," the "2019 AHA Science
Advisory," or product labeling.
ANGPTL3 indicates angiopoietin-like protein 3; ApoC-III, apolipoprotein C-III; ASO,
antisense oligonucleotide; ATP, adenosine triphosphate; CVOT, cardiovascular outcome trial;
DHA, docosahexanoic acid; EPA, eicosapentaenoic acid; FH, familial hypercholesterolemia;
HMG-CoA, 3-hydroxy-3-methylglutaryl- coenzyme; mRNA, messenger ribonucleic acid;
NPC1L1, Niemann-Pick C1-Like1; PCSK9, proprotein convertase subtilisin/kexin type 9;
PPAR-alpha, peroxisome proliferator-activated receptor-alpha; RNA, ribonucleic acid; TG,
triglycerides; VLDL, very-low density lipoprotein; and XL, extended release.
(cont'd)
