- Statins lower cholesterol by reducing liver production and removing LDL from blood
- Ezetimibe reduces cholesterol absorption in the intestine, lowering LDL by 15%-25%
- Doctors may prescribe statins alone or with ezetimibe based on patient needs and tolerance
Cholesterol is a waxy and fat-like substance that the body produces to build cells, produce hormones and digestion, among other functions. It is usually made by the liver, however, you also get it from certain animal-based foods. Cholesterol travels in the blood through lipoproteins, which makes them either LDL cholesterol or HDL cholesterol. LDL is low-density lipoprotein and is known as 'bad' cholesterol. On the other hand, HDL is high-density lipoprotein and is known to be the 'good' cholesterol. Bad cholesterol clogs arteries, forms plaque, and eventually leads to cardiovascular diseases. Good cholesterol collects the excess cholesterol from the blood vessels and takes it to the liver, from where it is removed. When you have excess LDL cholesterol in the blood, it can lead to heart attack, stroke, and other cardiovascular problems.
Both statin and ezetimibe are commonly prescribed medicines to manage high cholesterol levels. Speaking to NDTV, Dr Mukesh Goel, Senior Consultant, Cardiothoracic and Vascular Surgery, Heart and Ling Transplant Surgery, Indraprastha Apollo Hospitals, said, "While both help lower cholesterol, they work in different ways and have different side effect profiles. Understanding these differences can help patients and doctors choose the right option."
What Are Statins?
Statins are the most widely used drugs to lower cholesterol. They include medicines like atorvastatin and rosuvastatin. Statins work by reducing the amount of cholesterol made by the liver. They also help the liver remove "bad" cholesterol (LDL) from the blood. Statins are very effective. They can lower LDL cholesterol by 30% to 60%, depending on the dose. Because of this, they are usually the first treatment doctors recommend, especially for people who already have heart disease or are at a high risk of developing one.
What Is Ezetimibe?
Ezetimibe is a different type of cholesterol-lowering drug. Instead of affecting the liver, it works in the intestine. It reduces the absorption of cholesterol from food, which leads to lower cholesterol levels in the blood. On its own, ezetimibe lowers LDL cholesterol by about 15% to 25%. It is often prescribed along with a statin when cholesterol levels are not controlled enough by statins alone, or when a patient cannot tolerate high doses of statins.
Which One Is More Effective?
When it comes to lowering cholesterol, statins are clearly more powerful. They not only reduce LDL cholesterol significantly but also have strong evidence in preventing heart attacks and strokes.
Ezetimibe is less potent when used alone, but when combined with a statin, it can provide an additional reduction in LDL levels. This combination is often used in patients who need more aggressive cholesterol control.
Side Effects: Which One Is Safer?
Both medicines are generally safe, but they differ in their side effects. Statins are well tolerated by most people, but some may experience:
- Muscle pain or weakness
- Mild increase in liver enzymes
- Rarely, serious muscle damage
Muscle-related symptoms are the most commonly reported issue with statins, although not everyone experiences them.
Ezetimibe, on the other hand, tends to have fewer side effects. These may include:
- Mild stomach discomfort
- Diarrhoea
- Fatigue
Importantly, ezetimibe does not usually cause muscle problems, making it a good option for people who cannot tolerate statins.
So, Which One Should You Choose?
There is no one-size-fits-all answer.
- Statins are usually the first choice because they are more effective and have strong evidence in reducing heart-related risks.
- Ezetimibe is a good alternative for people who experience side effects with statins or need additional cholesterol lowering.
In many cases, doctors may prescribe both together for better results.
Final Takeaway
Statins remain the gold standard for treating high cholesterol due to their strong effectiveness and proven heart benefits. However, ezetimibe offers a safer and well-tolerated option with fewer side effects, especially for those who cannot handle statins.
"The best choice depends on your cholesterol levels, overall health, and how your body responds to medication. Always consult a doctor before starting or changing any treatment, as proper guidance is essential for safe and effective care," added Dr. Goel.
Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.
