Ezetimibe Alternatives – Simple Options to Lower Cholesterol

If you’re on ezetimibe but need something different, you’re not alone. Many people look for other ways to control LDL cholesterol because of side effects, cost, or doctor recommendations. Below are the most common medicines and non‑drug choices that can replace or work alongside ezetimibe.

Statins: The First Line Choice

Statins such as atorvastatin, rosuvastatin and simvastatin are usually the go‑to drugs for high cholesterol. They block the liver from making cholesterol, which can drop LDL by 20‑60%. Most patients tolerate them well, but muscle aches or slight liver changes can happen. If you stop ezetimibe because of a headache or stomach upset, a low‑dose statin might give you the same benefit with fewer complaints.

Other Prescription Options

PCSK9 inhibitors (evolocumab, alirocumab) are injectable drugs that dramatically cut LDL—up to 70% in some cases. They’re great for people who can’t use statins or need extra lowering after a heart attack.

Bile acid sequestrants like cholestyramine and colesevelam bind bile acids in the gut, forcing the liver to use more cholesterol to make new bile. This lowers LDL by about 10‑20% and works well with statins.

Fibrates (gemfibrozil, fenofibrate) target triglycerides more than LDL, but they can still give a modest LDL drop while raising good HDL cholesterol.

Niacin raises HDL and lowers LDL, though it often causes flushing. A slow‑release form can reduce that effect.

If you prefer not to add another prescription, lifestyle tweaks can make a real difference. Cutting saturated fat, eating more fiber, exercising 150 minutes a week, and losing even a few pounds can shave 5‑10% off LDL. Pairing these habits with a cheaper over‑the‑counter supplement like plant sterols (found in fortified spreads) adds another small boost.

When you talk to your doctor, bring up any side effects you’ve had on ezetimibe and ask which of the above fits your health profile and budget. Many pharmacies also offer coupons or discount cards for statins and PCSK9 inhibitors, so ask about savings options before you fill a script.

Bottom line: there are plenty of ways to replace ezetimibe—whether it’s switching to a low‑dose statin, trying an injectable PCSK9 inhibitor, using a bile acid binder, or leaning on diet and exercise. Choose the route that feels right for you, and keep your cholesterol numbers in check without unnecessary hassle.