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Best treatments for hypercholesterolemia (high cholesterol)

24 products may treat hypercholesterolemia (also known as high cholesterol), spanning FDA drug classes such as dietary cholesterol absorption inhibitor, hmg-coa reductase inhibitor, peroxisome proliferator receptor alpha agonist. The current highest-rated option is juxtapid. Ranked below by our independent recall-safety rating (rated where FDA data exists) — not medical advice; always consult a professional.

Quick answer: Of the 24 drugs we list for hypercholesterolemia, 18 are available as lower-cost generics, spanning classes such as dietary cholesterol absorption inhibitor, hmg-coa reductase inhibitor, peroxisome proliferator receptor alpha agonist. 17 of 24 carry a safety score, from 58 to 72 out of 100. They’re ranked by each drug’s FDA recall-safety record — not clinical effectiveness for hypercholesterolemia — so confirm the right choice with your prescriber.

Rated against independent regulatory sources·Last updated October 10, 2026·How we rate

Understanding hypercholesterolemia

High cholesterol (hypercholesterolemia) is a condition in which there is too much cholesterol — a waxy, fat-like substance — in the blood. According to the NHLBI, the body needs cholesterol for good health, but high levels of "bad" LDL cholesterol can create a buildup of plaque (fatty deposits) in the arteries. MedlinePlus notes there are usually no signs or symptoms of high cholesterol, so many people do not know they have it. The NHLBI states that this plaque buildup reduces blood flow and can lead to a heart attack, stroke, or other health problems. According to the CDC, the only way to know whether you have high cholesterol is to get your cholesterol checked by your health care team; this test — also called a lipid panel or lipid profile — usually checks levels of total cholesterol, LDL ("bad") cholesterol, HDL ("good") cholesterol, and triglycerides. The CDC describes management as a combination of adjusting certain lifestyle factors and taking cholesterol-lowering medicines prescribed by a doctor. This is general information, not medical advice; talk with a qualified healthcare professional about your own situation.

First-line treatment

The AAFP summary of the 2018 ACC/AHA Cholesterol Guideline states that a cornerstone of the guideline is to emphasize a heart-healthy lifestyle for all patients, and that a healthy lifestyle reduces atherosclerotic cardiovascular disease (ASCVD) risk at all ages. The CDC's lifestyle recommendations include choosing foods low in saturated and trans fat, getting regular physical activity, maintaining a healthy weight, and — for those who smoke — quitting. When drug therapy is used, the guideline recommends statins to lower LDL cholesterol: high-intensity statin therapy for many patients with established ASCVD, and moderate-intensity statin therapy for adults 40 to 75 with diabetes or those at intermediate risk. Nonstatin medicines are generally considered add-on options — for example, when LDL is not adequately lowered on maximally tolerated statin therapy. A clinician individualizes treatment based on each person's overall risk.

Top-rated picks for hypercholesterolemia: 1. Juxtapid · 2. Praluent · 3. Repatha

Top-rated treatments for hypercholesterolemia, ranked by pharmaranks score
#DrugRatingPharmacy pays
172/100—View →
272/100—View →
372/100—View →
472/100$2View →
572/100$1View →
670/100$1View →
770/100$3View →
870/100—View →
970/100$3View →
1068/100$86View →

Full ranking · 24 treatments

juxtapid

Boxed warning

PrescriptionFDA-sourced

72/100

Juxtapid (Lomitapide Mesylate) is a medication used to treat Hypercholesterolemia.

(5 data points)
hypercholesterolemia

Price varies

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praluent

PrescriptionFDA-sourced

72/100

Praluent (Alirocumab) is a medication used to treat Hypercholesterolemia, Atherosclerosis.

(3 data points)
hypercholesterolemiaatherosclerosis

Price varies

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repatha

PrescriptionFDA-sourced

72/100

Repatha (Evolocumab) is a medication used to treat Hypercholesterolemia, Atherosclerosis.

(12 data points)
hypercholesterolemiaatherosclerosis

Price varies

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ORGANON logo

zetia

PrescriptionFDA-sourced

72/100

Zetia (Ezetimibe) is a dietary cholesterol absorption inhibitor used to treat Hypercholesterolemia, Hyperlipoproteinemia Type II, Familial Combined Hyperlipidemia.

(3 data points)
dietary cholesterol absorption inhibitorhypercholesterolemiahyperlipoproteinemia type ii

Pharmacy pays

~$2.17 /30

View details →
ORGANON logo
#1 of 9 in HMG-CoA Reductase Inhibitor

zocor

PrescriptionFDA-sourced

72/100

Zocor (Simvastatin) is a HMG-CoA reductase inhibitor used to treat Coronary Artery Disease, Hypercholesterolemia, Hyperlipoproteinemias, Hypertriglyceridemia.

(3 data points)
hmg-coa reductase inhibitorcoronary artery diseasehypercholesterolemia

Pharmacy pays

From ~$0.84/30· 5 forms
View details →

crestor

PrescriptionFDA-sourced

70/100

Crestor (Rosuvastatin Calcium) is a HMG-CoA reductase inhibitor used to treat Coronary Artery Disease, Hypercholesterolemia, Hyperlipoproteinemias, Hypertriglyceridemia.

(1 data points)
hmg-coa reductase inhibitorcoronary artery diseasehypercholesterolemia

Pharmacy pays

From ~$1.04/30· 4 forms Save up to 32% in class
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Frequently asked

What is the best medication for high cholesterol?
high cholesterol is hypercholesterolemia. There isn't a single "best" medication for everyone — The AAFP summary of the 2018 ACC/AHA Cholesterol Guideline states that a cornerstone of the guideline is to emphasize a heart-healthy lifestyle for all patients, and that a healthy lifestyle reduces atherosclerotic cardiovascular disease (ASCVD) risk at all ages. The CDC's lifestyle recommendations include choosing foods low in saturated and trans fat, getting regular physical activity, maintaining a healthy weight, and — for those who smoke — quitting. When drug therapy is used, the guideline recommends statins to lower LDL cholesterol: high-intensity statin therapy for many patients with established ASCVD, and moderate-intensity statin therapy for adults 40 to 75 with diabetes or those at intermediate risk. Nonstatin medicines are generally considered add-on options — for example, when LDL is not adequately lowered on maximally tolerated statin therapy. A clinician individualizes treatment based on each person's overall risk.. Compare every option ranked above by our independent recall-safety rating (not an efficacy measure); this is general information, not medical advice.
What treats hypercholesterolemia?
Our catalog lists 24 products that may treat hypercholesterolemia, based on NIH RxClass (MED-RT “may treat”) drug-classification data — not the verbatim FDA label. They're rated where FDA recall-safety data exists; the current top-rated option is juxtapid.
What is the best-rated treatment for hypercholesterolemia?
By our independent recall-safety rating — not an efficacy measure — juxtapid ranks highest among the products we list for hypercholesterolemia. Always consult a professional.
How are these treatments ranked?
By our independent score, currently based on FDA regulatory recall-safety data (the methodology blends additional sources as they come online). See the How we rate page.
What types of drugs treat hypercholesterolemia?
Treatments for hypercholesterolemia span FDA drug classes including dietary cholesterol absorption inhibitor, hmg-coa reductase inhibitor, peroxisome proliferator receptor alpha agonist, bile acid sequestrant, nicotinic acid. Compare every option side by side, ranked by independent rating, above.

Treatment associations are derived from NIH RxClass (MED-RT “may treat”) drug-classification data — not the verbatim FDA label. This is general reference, not medical advice — always consult a licensed professional.

Sources

The clinical overview above is written from these authoritative public-health and medical-society sources, independently reviewed against each.