Ezetimibe

Ezetimibe inhibits the absorption of cholesterol from the small intestine, resulting in lower levels of cholesterol. Adding ezetimibe to a statin is an option if the required reduction in non-HDL cholesterol is not achieved, despite the maximum tolerated dose of statin, and will result in a further 15-20 per cent reduction in HDL-C. Ezetimibe is approved by NICE for use in combination with a statin or as monotherapy if there is a contraindication to or complete intolerance to statins.

Other lipid lowering drugs

These are not routinely used, but include fibrates, bile acid sequestrants (e.g. cholestyramine, colestipol and colesevelam), fish oils and the monoclonal antibodies alirocumab and evolocumab.