Side Effects of Cholesterol Medications

Quincy AdamHigh Cholesterol Learn

Side Effects
Millions of Americans currently take cholesterol medications to lower their risk of heart disease.

It’s important to understand the possible side effects of these drugs. This article will discuss the most common side effects of each category. It is not a full list.

If you or a loved one develops any complications from medications, talk to your healthcare provider before stopping your medication or changing the dose. It’s possible that they will recommend a different medication or another change that will correct the problem.

The three main categories of cholesterol medications include statins, bile acid binders and fibrates.

Statin Side Effects

Muscle Pain

The most common side effect of statin drugs is muscle pain and/or–in some cases–muscle damage. This is known as myopathy. Any of the following symptoms should be discussed with your doctor:

  • Unexplained tiredness, aches or soreness in muscle tissues
  • Pain when climbing stairs or walking
  • Severe muscle pain, which can indicate the rare but serious condition known as rhabdomyolysis. If untreated, this condition can lead to liver and/or kidney failure, or even death

Increased Chance of Developing Type II Diabetes

Most healthcare professionals agree that the benefits of statin drugs outweigh the small chance of developing type II diabetes. However, it’s still important for patients to be aware of this increased risk. Also, when possible, make dietary and lifestyle changes that will lower your chances of developing both diabetes and heart disease.

Since statin drugs can raise blood sugar levels, reducing sugar intake and maintaining a gentle exercise routine can help keep blood sugar levels in a healthy range. Again, talk to your doctor for advice as to how to decrease this side effect.

Liver Damage

Before or shortly after you begin taking a statin, your doctor will perform a liver enzyme test. This test is to make sure your liver is working properly. In rare cases, statins have been known to cause liver damage, since they work by interacting with the liver.

In the past, patients taking cholesterol medications would receive regular liver enzyme tests. The FDA now states that the tests are not helpful in preventing liver damage. Therefore, any patient who experiences the following symptoms should promptly contact their doctor:

  • Excessive weakness or fatigue
  • Pain in the upper right area of your stomach area
  • Loss of appetite
  • Dark urine
  • Yellowing of the skin or the whites of the eyes

Neurological Side Effects Including Memory Loss

Memory loss and mental confusion occur in some patients taking statin medications. The effects may begin in as little as one day after starting the medication or can take years to show any mental effects. Talk to your doctor if you feel your mental judgment has become cloudy while taking cholesterol medications. Stopping these medications may pose a greater risk to your cardiovascular system.

Bile Acid Sequestrants Side Effects

Bile acid sequestrants cause the liver to convert cholesterol into bile acids which are excreted in the stool, lowering cholesterol levels in the blood. They are most often used in combination with a statin or niacin to lower LDL levels. Because bile acid sequestrants are not absorbed in the body, their side effects are mostly stomach related. Side effects may include:

  • Constipation
  • Stomach pain
  • Bloating
  • Vomiting
  • Diarrhea
  • Weight loss
  • Excessive gas
  • Heartburn
  • Gallstones

Bile acid sequesterants can also interact with other drugs, such as thyroid hormones, blood thinners or diuretics. Sequestrants can make it hard for your body to absorb these and other drugs. Your healthcare provider may suggest that you take other medications an hour before, or even four to six hours after other medication. Sequestrants also reduce absorption of vitamins A, D, E and K which could result in deficiency in these vitamins with long-term use. Be sure to discuss all medications and/or supplements you may be taking with your doctor.

Fibrates Side Effects

Fibric acid derivatives (fibrates) lower blood triglyceride levels and have a moderate effect on increasing HDL (or “good”) cholesterol in the blood. However, they are not very effective in lowering LDL (“bad”) cholesterol. Some possible side effects include:

Muscle Damage

When taken together with statin drugs, fibrates can interfere with the breakdown of statins in the blood, which can cause muscle damage.


Fibrates can cause gallstones when used long term (over several years).

Gastrointestinal side effects

Common side effects include nausea, upset stomach, diarrhea and in some cases, inflammation of the liver.


If you’re taking blood thinners, fibrates can increase their effectiveness and cause over-thinning of the blood (which can cause too much bleeding). Your doctor may want to adjust your blood thinner doses to avoid this problem.

Talk To Your Doctor

With any medication, clear communication with your healthcare provider is the key to correcting any problems and potential side effects. Talk to your doctor about other medications you’re taking. Also, if you or a loved one are taking one or more cholesterol medications, talk with your doctor right away if you develop any problems. He or she may be able to switch your medication, combine it with a different type, or adjust the dose to minimize side effects.