Cholesterol, a fatty substance in our blood, plays a crucial role in our health. However, too much of it can lead to serious problems like heart disease. Thankfully, medications called statins and newer drugs can help manage high cholesterol levels effectively. There are older medications available for the treatment

Generic Names: Atorvastatin, Simvastatin, Rosuvastatin
Brand Names: Lipitor, Zocor, Crestor

How They Work:
Statins work by blocking a key enzyme in the liver that produces cholesterol. By reducing cholesterol production, they help lower the amount of LDL ("bad") cholesterol in the blood, which decreases the risk of heart disease.

Administration:
Statins are usually taken orally, in the form of a pill or tablet.

Dosing Schedule:
Typically, statins are taken once daily, often in the evening.

Side Effects:
Common side effects include muscle pain although studies have shown that at least 90% of people who report muscle pains on these medications are experiencing something called the "Nocebo" effect, This is the opposite of the placebo effect. Patients have been told by friends or have heard that  these drugs can cause muscle pains and once they hear that they pay more attention to aches and pains that they otherwise might have ignored. Despite this it is essential to inform your doctor if you experience severe muscle pain or weakness, as this could be a sign of a very rare but serious side effect.. Occasionally liver enzyme abnormalities but this rarely requires discontinuation of the medication..

Cost Comparison:
Statins are generally available as affordable generic drugs, making them accessible for most patients.

PCSK9 INHIBITORS:
Generic Names: Alirocumab, Evolocumab
Brand Names: Praluent, Repatha

How They Work:
PCSK9 inhibitors work differently from statins. They help the liver remove LDL cholesterol from the blood by targeting a specific protein that regulates LDL receptors. By increasing these receptors' activity, PCSK9 inhibitors lower LDL cholesterol levels effectively.

Administration:
These drugs are given through injections under the skin. Usually, patients learn how to self-administer them or visit a healthcare provider for injections.

Dosing Schedule:
They are typically administered once or twice a month, depending on the specific drug and dosage prescribed.

Side Effects:
Common side effects include injection site reactions (like redness or pain), flu-like symptoms, and occasionally allergic reactions. These medications are generally well-tolerated, but it's crucial to follow your doctor's instructions carefully.

Cost Comparison:
PCSK9 inhibitors are newer and much more expensive than statins. While most statin drugs can be purchased for less than $200 a year even without insurance PCSK9 inhibitors on average cost more than $10,000 per year. Their cost may be higher than statins, even with insurance coverage and often preauthorization is required by a patients insurance company before they will approve these drugs. , but financial assistance programs may be available to help manage expenses.

NEXLETOL:
Generic Name: Bempedoic acid
Brand Name: Nexletol

How Nexletol Works:

Nexletol works by inhibiting an enzyme in the liver called ATP citrate lyase. This enzyme plays a role in the production of cholesterol in the body. By blocking ATP citrate lyase, Nexletol reduces the production of cholesterol, which in turn lowers LDL cholesterol levels in the blood.

How It is Administered:

Nexletol comes in the form of an oral tablet, which means it is taken by mouth.

Dosing Schedule:

Typically, Nexletol is taken once daily with or without food. It's essential to take it exactly as prescribed by your healthcare provider.

Side Effects:

Like all medications, Nexletol can cause side effects. Common side effects may include:

• Muscle pain
• Back pain
• Increased uric acid levels (which could lead to gout)
• Tendon rupture or injury (rare but serious)
• It's crucial to inform your healthcare provider if you experience any unusual symptoms while taking Nexletol. They can help determine whether any adjustments are needed or if an alternative treatment might be more suitable.

Cost Comparison:
The cost of Nexletol can vary depending on factors such as insurance coverage, pharmacy discounts, and patient assistance programs. Generally, newer medications like Nexletol may be more expensive than generic statins. Without insurance Nexletol would cost about $4,500 per year but may still be affordable through insurance coverage or manufacturer discounts.

Choosing Nexletol:
Nexletol provides a new option for individuals who need additional help managing their cholesterol levels despite lifestyle changes or other cholesterol-lowering medications. It offers a different mechanism of action compared to statins and may be considered if statins are not suitable or sufficient for controlling cholesterol levels.

When it comes to managing cholesterol, the choice between statins and newer drugs depends on several factors:

• Cholesterol Levels: If your LDL cholesterol remains high despite statin therapy, your doctor may consider adding a PCSK9 inhibitor.
• Health Conditions: Certain medical conditions or intolerances to statins may make PCSK9 inhibitors a better option.
• Cost and Accessibility: Discussing with your healthcare provider about insurance coverage and financial assistance can help you choose the most affordable option.

Understanding cholesterol medications empowers you to take control of your health. Whether you start with statins or require newer treatments like PCSK9 inhibitors or Nexletol, working closely with your doctor ensures you receive the best care. Remember, managing cholesterol is about more than just taking medications; it also involves a healthy lifestyle with regular exercise and a balanced diet. By taking these steps, you can effectively manage your cholesterol levels and reduce your risk of heart disease.

By staying informed and proactive, you're taking an important step towards a healthier future.