Do Over-the-Counter Cholesterol Medications Work?

By Craig Sorkin, DNP, APN
Medically reviewed checkmarkMedically reviewed
November 14, 2022

Key takeaways

  • Around 71 million adults in the United States have high cholesterol.

  • There are several treatment options available for managing cholesterol, including lifestyle changes and medication.

  • In some cases, over-the-counter (OTC) medicines can also help, but it’s important to choose a product with evidence to support its use.

If you’re diagnosed with high cholesterol, treatment and management are essential to reduce your risk of developing heart disease and improve your overall health. Treatment may involve lifestyle changes, medication, over-the-counter (OTC) supplements, or a combination of approaches.

If you’re interested in taking an OTC product to help lower your cholesterol, it’s important to do your research first. Some OTC medicines have been shown to help lower cholesterol levels, while others may not work or be safe to use.

Here’s what you need to know about OTC cholesterol medicine, including which products are the most effective and tips for taking them safely.

Does Over-the-Counter Cholesterol Medicine Work?

There are several over-the-counter (OTC) medications marketed to help lower cholesterol. While some products have been shown effective for lowering cholesterol levels, others lack sufficient evidence to prove their efficacy.

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OTC Cholesterol Medicine Options

Below are some over-the-counter (OTC) cholesterol medications with evidence to support their use.

Niacin

Niacin is a B vitamin that lowers cholesterol levels by limiting the production of blood fats in the liver. Niacin is available via prescription in larger doses and as a supplement. Prescription niacin can help raise HDL (also known as “good cholesterol”) levels, and lower LDL (also known as “bad cholesterol”) and triglyceride levels.

Unfortunately, OTC niacin is not recommended for lowering cholesterol because of its risk of serious side effects. It’s also not regulated by the Food and Drug Administration (FDA) and can contain variable amounts of niacin.

Omega-3 Fatty Acids

Omega-3 fatty acids are originally derived from fish oils. The American Heart Association recommends omega-3 fatty acid ethyl esters, which are chemically altered and purified for use as a medication.

Omega-3 fatty acid ethyl esters are often used alongside lifestyle and dietary changes to help reduce high triglyceride levels. The AHA also recommends marine-derived omega-3 fatty acids in large doses to help lower triglyceride levels.

Red Yeast Rice

Red yeast rice is a culinary and medicinal product from China. Products containing red yeast rice may also contain significant amounts of monacolin K, which is chemically identical to the active ingredient in lovastatin (Altoprev)—a prescription medication used to lower cholesterol.

Though this ingredient can help lower cholesterol levels, it’s not regulated by the FDA—meaning there’s no guarantee of its quality, efficacy, or safety. Therefore, the FDA has ruled products with more than trace amounts of monacolin K as unapproved OTC supplements. Products with little-to-zero amounts of monacolin K have not been found to improve cholesterol levels.   

Stanol Esters

Stanol esters are compounds found in plant-based foods—like fruits, vegetables, whole grains, nuts, and legumes. Research shows that ingesting two grams of stanol esters each day in the form of foods or supplements is associated with an 8-10% reduction in LDL cholesterol levels.

Garlic

Research on using garlic for high cholesterol is mixed. Some studies show that taking garlic supplements can modestly lower total and LDL cholesterol levels, while others report no effect.

According to a randomized-controlled trial, there have been 25 published clinical trials on the effects of garlic on cholesterol since 1993. Eleven studies found garlic beneficial for reducing cholesterol levels, but fourteen studies showed no effect. Though garlic’s unlikely to impact your heart health negatively, there isn’t sufficient evidence to suggest its efficacy in lowering cholesterol levels.

Fiber

Diets high in fiber have been associated with lower cholesterol levels. Additional research suggests adding fiber to your diet while on statin therapy can help to lower your total and LDL cholesterol levels.Sources of fiber include beans, whole grains, legumes, and nuts.

Coenzyme Q10

Coenzyme Q10 (CoQ10) is an essential antioxidant that helps the body convert food into energy. As people age, levels of CoQ10 naturally decline. CoQ10 supplements may help several conditions, including congestive heart failure and high blood pressure.

Unfortunately, there isn’t sufficient evidence to suggest that CoQ10 supplements effectively reduce cholesterol levels. However, CoQ10 may help reduce some side effects of statin treatment, including muscle pain.

Are OTC Cholesterol Medications Safe?

OTC supplements marketed to help lower cholesterol levels are unregulated. Some of these supplements may interact with other medications—like blood thinners, statins, and blood pressure medications—and cause serious side effects.

Because of the potential risks, it’s important to speak with your healthcare provider before taking any OTC supplements—especially if you have heart disease, are pregnant or breastfeeding, or take prescription medications.

Tips for Taking OTC Cholesterol Medicine

Here are some recommendations for taking OTC cholesterol supplements.

Check with your healthcare provider first.

Even OTC supplements that seem safe can interact with other medications and cause serious side effects. Always talk to a healthcare provider before taking anything new. They can help advise you on your best and safest options.

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Read the labels carefully.

It’s also important to read the labels carefully before taking any OTC medication. Be sure to look for red flags, such as:

  • Inadequate information about the product
  • Dosage recommendations that are different from what’s on the label
  • Manufactured outside of the United States
  • Products that make claims that seem too good to be true

Stop taking the supplement if you have side effects.

If you experience any side effects after starting an OTC supplement—like muscle cramping, nausea, vomiting, diarrhea, constipation, headache, or dizziness—stop taking the product and speak to your healthcare provider.  

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Frequently Asked Questions

Is there over-the-counter medicine for high cholesterol?
There are several over-the-counter medicines marketed to lower cholesterol. However, not all OTC cholesterol products are proven effective. Some of the most promising OTC cholesterol medicines include omega-3 fatty acids, plant or stanol esters, and fiber.
What is the best medicine to reduce cholesterol?
The best medicine to reduce cholesterol varies depending on your unique health needs and circumstances. If you’re diagnosed with high cholesterol, speak with your healthcare provider about which treatment and medication options are best for you.
How do you lower your cholesterol without medicine?
Lifestyle and diet changes help many people lower their cholesterol levels. Some of the most effective lifestyle changes include eating a healthy diet, regular exercise, and managing stress. For more recommendations, reach out to your healthcare provider.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Craig Sorkin, DNP, APN

Craig Sorkin, DNP, APN is a board certified Family Nurse Practitioner with over 15 years experience. He received his Undergraduate and Graduate degrees from William Paterson University and his doctoral degree from Drexel University. He has spent his career working in the Emergency Room and Primary Care. The last 6 years of his career have been dedicated to the field of digital medicine. He has created departments geared towards this specialized practice as well as written blogs and a book about the topic.