Snapshot A 45-year-old man presents for management of hypercholesterolemia. His past medical history includes type 2 diabetes, hyperlipidemia, and hypertension. A few months ago, he started a new medication for his elevated LDL cholesterol. On laboratory evaluation, he is found with elevated liver enzymes. He is switched to another medication in the same class, as it is the most effective medication for lowering LDL levels. (HMG-CoA reductase inhibitors) Introduction Key enzymes in lipid physiology login to view 10 more bullets Lipid-lowering agents login to view 9 more bullets Relative Effects of Lipid-Lowering Agents on LDL, HDL, and TGDrugLDLHDLTGHMG-CoA Reductase Inhibitors↓↓↓*↑↓PCSK9 Inhibitors↓↓↓↑↓Fibrates↓↑↓↓↓*Niacin↓↓↑↑*↓Bile Acid Resins↓↓↑↑Ezetimibe↓↑/-↓/-* = best therapy HMG-CoA Reductase Inhibitors Drugs login to view 1 more bullet Mechanism login to view 2 more bullets Clinical use login to view 4 more bullets Toxicity login to view 6 more bullets PCSK9 Inhibitors Drugs login to view 1 more bullet Mechanism login to view 3 more bullets Clinical use login to view 1 more bullet Toxicity login to view 4 more bullets Fibrates Drugs login to view 1 more bullet Mechanism login to view 3 more bullets Clinical use login to view 2 more bullets Toxicity login to view 3 more bullets Niacin (Vitamin B3) Mechanism login to view 2 more bullets Clinical use login to view 2 more bullets Toxicity login to view 7 more bullets Bile Acid Resins Drug login to view 1 more bullet Mechanism login to view 2 more bullets Clinical use login to view 1 more bullet Toxicity login to view 2 more bullets Ezetimibe Mechanism login to view 2 more bullets Clinical use login to view 2 more bullets Toxicity login to view 3 more bullets