Atorvastatin alternatives: What can I take instead of atorvastatin?

In this article:

• Atorvastatin alternatives
• Other statins
• Colestid
• Zetia
• Tricor
• Repatha
• OTC cholesterol meds
• Natural alternatives
• How to switch
• Choosing the right treatment

In this article

• Atorvastatin alternatives
• Other statins
• Colestid
• Zetia
• Tricor
• Repatha
• OTC cholesterol meds
• Natural alternatives
• How to switch
• Choosing the right treatment

Atorvastatin is a commonly prescribed generic drug that lowers cholesterol levels and helps prevent heart attacks in at-risk patients. It belongs to a family of medications called HMG-CoA reductase inhibitors, more commonly referred to as “statins.” Though highly effective at reducing “bad” cholesterol (low-density lipoprotein or LDL cholesterol), atorvastatin may not work for everyone. It can also cause troublesome side effects, including muscle damage or pain. When atorvastatin therapy is challenging, clinicians have a variety of alternative cholesterol-lowering medications that can be added to or substituted for atorvastatin. 

What can I take instead of atorvastatin?

If atorvastatin doesn’t work well or is causing unbearable side effects, healthcare providers are generally reluctant to stop using statins because of their proven efficacy. They will first try different statins. Some statins are stronger than atorvastatin at lowering cholesterol. Some are milder and cause fewer side effects. Once they’ve tried other statins, they may reduce the statin dose and add another type of drug or, when all else fails, switch to another drug. 

Non-statin treatment options include cholesterol absorption blockers, bile acid sequestrants, fibrates, and PCSK9 inhibitors. Finally, another drug, Nexletol (bempedoic acid), is specifically approved by the FDA as a stand-alone treatment for people who can’t take statins.

Prescription drug prices often change. These are the most accurate medication prices available at the time of publication in ZIP code 23666 as of December 1, 2025. The listed price, without insurance, refers to the price of brand-name drugs (unless otherwise specified). The listed SingleCare price references the price of generic drugs if available. Click the link under “Savings options” to see the latest drug prices.

Top 5 atorvastatin alternatives

1. Other statins (Crestor (rosuvastatin), Zocor (simvastatin), pravastatin, or lovastatin)

For some patients, atorvastatin may not be an effective option for managing their high cholesterol, so a more potent statin may be appropriate. Crestor or its generic version, rosuvastatin, is one of the most potent statins at reducing bad cholesterol (low-density lipoprotein or LDL) and triglycerides (fats) in the blood. However, side effects can be more problematic with rosuvastatin. On the other hand, a healthcare provider may prescribe pravastatin if side effects or drug interactions are a problem. The downside is that it’s less effective than atorvastatin at lowering cholesterol. Lovastatin is also a milder statin.

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2. Colestid (colestipol) 

Colestipol hydrochloride is an oral antilipemic agent that works differently from statins. It is a non-absorbable bile acid sequestrant that increases the body’s excretion of bile acid. Colestipol is not absorbed into the bloodstream, so it is less likely to cause side effects and can be used by people who can’t take statins. The downside is that it is not as effective as statins at lowering cholesterol, has no effect on “good” cholesterol (high-density lipoprotein or HDL cholesterol), and can actually raise triglycerides. It is not suitable for people who already have high triglycerides. Other bile acid sequestrants include cholestyramine and colesevelam.

3. Zetia (ezetimibe)

Ezetimibe is a cholesterol absorption inhibitor drug. Taken as a tablet, ezetimibe works by blocking the body’s absorption of cholesterol from food. Doctors prescribe it alone or with other cholesterol-lowering drugs to treat hypercholesterolemia. The primary advantage of ezetimibe is that it raises HDL, the “good” cholesterol, while also having lowering effects on triglycerides and LDL cholesterol. However, when used alone, ezetimibe is not as effective as a statin. Ezetimibe should be avoided in pregnant women, children, or patients with liver disease.

4. Tricor (fenofibrate)

Fenofibrate is a fibric acid derivative. Like statins, fibric acid derivatives affect the liver and increase the metabolism of triglycerides. This lowers triglyceride levels in the blood, decreasing LDL cholesterol levels and increasing HDL cholesterol levels. Fibrates are powerful cholesterol-lowering drugs, but they can have bad side effects. Fibrates are contraindicated in patients with hepatic disease or unexplained liver function abnormalities. Other fibrates include gemfibrozil and fenofibric acid.

5. Repatha

PCSK9 inhibitors, such as Repatha (evolocumab), Praluent (alirocumab), and Leqvio (inclisiran), can be used alone or in combination with other cholesterol-lowering medications to treat hyperlipidemia. Doses are injected once every two to four weeks. PCSK9 inhibitors are highly effective drugs with generally mild side effects. Even better, these drugs have no known drug interactions. The downside is that they are expensive. Health insurance providers typically impose stringent restrictions on insurance coverage, including step therapy and prior authorization. If insurance coverage or cost is a challenge, try showing your SingleCare discount card at your local pharmacy to see if the expense becomes more manageable.

Over-the-counter cholesterol medications

There are no over-the-counter medications that can lower cholesterol, but a range of OTC supplements might help. None are as effective as statin medications at treating high levels of cholesterol. Therefore, before starting any supplements, consult your doctor or pharmacist to ensure they are safe. 

Niacin, a B3 vitamin, has been used for a long time to lower cholesterol levels. Niacin has been shown to lower total cholesterol, LDL cholesterol, and triglycerides, while also raising HDL cholesterol. Dietary sources of niacin include meats like chicken, turkey, and tuna, as well as plants such as beans, green vegetables, and whole wheat. While niacin is effective and one of the most proven supplements for lowering cholesterol, it is not an effective substitute for statin therapy.

Other supplements have shown some positive effects on serum cholesterol levels. Flaxseed, red yeast rice, berberine, and garlic are among those. Clinical data suggest that turmeric can lower LDL levels and may provide some protection against cardiovascular disease. Omega-3 fatty acids can reduce high triglyceride levels and raise good HDL cholesterol (high-density lipoprotein) levels. 

Natural alternatives to atorvastatin

Lifestyle changes are the most effective and natural way to lower cholesterol, beginning with a balanced diet and regular exercise. Though not as effective as statins, do not underestimate the cholesterol-lowering power of a heart-healthy diet and regular physical activity! Other lifestyle changes that significantly affect cholesterol levels include weight loss, smoking cessation, and limiting alcohol consumption.

Your healthcare professional can work with you to develop a low-fat diet, combined with regular physical activity, as well as other lifestyle modifications. It is important to include your doctor as part of your non-prescription cholesterol-lowering therapies to help determine if they are safe and adequate.

How to switch to an atorvastatin alternative

There are a variety of reasons you may feel atorvastatin is not the right choice for you. If you have already begun atorvastatin therapy, do not stop the therapy until you speak to your prescriber and agree upon a new plan. If you are experiencing muscle pain that you fear may be caused by your atorvastatin therapy, bring this to your doctor’s attention immediately. They will help you determine which statin alternative is best for you. If you become pregnant or are planning to, this should be shared with your healthcare provider to ensure they pick the safest option for you.

Your pharmacist can help you determine which cholesterol-lowering agents are covered by your insurance plan. Many of these agents are generic and relatively affordable. SingleCare offers free savings coupons on most prescription antilipemic drug choices.

Choosing the right path for high cholesterol treatment

If atorvastatin does not successfully control LDL cholesterol levels or causes intolerable side effects, healthcare professionals and patients have a variety of options:

• Other types of statins 
• Adding a different type of cholesterol-lowering medication to statin therapy
• Substituting one or more non-statins for statin therapy
• Adding over-the-counter supplements to cholesterol medications
• Making significant lifestyle changes, including dietary changes, exercise, and weight loss

As with most long-term or chronic health conditions, cholesterol or cardiovascular issues involve a complex and long-term management strategy. Always consult a healthcare professional for medical advice when considering the best path for cholesterol treatment.