The principal pharmacologic agents used in the treatment of hyperlipidemia are statins, fibric acid derivatives, niacin, ezetimibe, bile acid sequestrants, and sitastanol esters.
STATINS Statins (HMG CoA reductase enzyme inhibitors) are the most commonly prescribed lipid-lowering medications and are potent agents to reduce LDL cholesterol. These medications act by inhibiting the synthesis of cholesterol in the liver and promoting increased uptake and degradation of LDL cholesterol from the blood. Statins are competitive inhibitors of HMG CoA reductase, the rate-limiting step in cholesterol biosynthesis. Reduced hepatic cholesterol biosynthesis leads to an increase in LDL receptor turnover and increased hepatic LDL receptor cycling.