If you’re taking a statin but your LDL cholesterol is still too high, a new once-daily pill may offer another way to bring it down.
Lipfendra, also known as enlicitide, is a newly approved cholesterol medication that can be taken along with statins. It may also be an option for people who can’t tolerate statins.
“Statins have been used for decades and are proven to lower the risk of heart attack and stroke, so we don’t think of this as Lipfendra versus statins,” says Danielle Grillo, APRN, with Hartford HealthCare Medical Group.“The goal is to find the treatment, or combination of treatments, that gets your cholesterol to the right level for your risk.”
Here’s what to know.
1. Lipfendra is a new kind of cholesterol pill
Lipfendra belongs to a group of cholesterol medications called PCSK9 inhibitors.
“Patients may already have heard about injectable PCSK9 medications,” says Grillo. “What’s new is that we can now target the same pathway with a once-daily pill instead of an injection, which may be more appealing for some patients.”
PCSK9 inhibitors work by helping your liver remove more LDL cholesterol from your blood. This makes them helpful for people whose LDL remains above their recommended goal, even with other treatments.
“New treatments can be difficult to understand, and that’s why your medical team is here to help,” says Grillo. “Having medications that work in different ways gives us more options to help patients reach their cholesterol goals and manage their heart and stroke risk.”
> Related: Worried Your Statin Is Causing Side Effects? Read This First
2. Lipfendra can significantly lower LDL cholesterol
Clinical trials found that Lipfendra significantly reduced LDL cholesterol in adults with high cholesterol, including those with an inherited condition called familial hypercholesterolemia. Most participants were already taking statins.
“That kind of drop gets our attention,” says Grillo. “If someone’s LDL is still well above their goal, being able to lower it substantially more could make a meaningful difference.”
But these results measure changes in cholesterol levels. Research is now underway to see if Lipfendra can prevent heart attacks or strokes.
“If your statin is working well and your LDL is where it should be, there may be no reason to switch,” says Grillo. “Lipfendra can also be used with a statin.”
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3. Lipfendra may help when your current treatment isn’t enough
There isn’t one LDL goal that’s right for everyone.
“Two people can have the same LDL number and need very different treatment,” says Grillo. “We look at your cholesterol in the context of your overall heart and stroke risk. If you’ve already had a heart attack or stroke, for example, we want your LDL much lower than we would for someone at lower risk.”
Lipfendra is particularly helpful for some people with heterozygous familial hypercholesterolemia (HeFH), an inherited form of high cholesterol, when their LDL remains too high despite treatment.
It can also be a good fit if you’ve had trouble taking statins.
“If a statin causes problems, we may first try a different statin or dose,” says Grillo. “But if that still isn’t enough, there are other medications we can use. The goal is to find a treatment you can tolerate that also lowers your LDL enough to reduce your risk.”
> Related: 6 Reasons Your Cholesterol Is High That Aren’t Your Diet
4. A new option still has to fit your everyday life
You’ll take Lipfendra in the morning on an empty stomach with water, black coffee or plain tea. Then you’ll need to wait at least 30 minutes before eating or drinking anything else.
“A pill may sound easier than an injection, but the routine still needs to work for you,” says Grillo. “When you’re choosing a medication you may take long term, those practical details are worth considering.”
Like any medication, Lipfendra can also cause side effects.
“Diarrhea and dizziness can happen with Lipfendra, but don’t stop taking it on your own,” she adds. “Tell your care team what you’re experiencing so we can decide whether an adjustment or different treatment makes more sense.”
Plan ahead: Think about whether taking a pill before breakfast every morning would realistically fit your routine.
> Related: What Your Cholesterol Numbers Mean
Should you ask your doctor about Lipfendra?
If your current cholesterol medication is working well, you might not need to change anything.
But if your LDL is still too high, you’re having trouble with statin side effects or you need more cholesterol lowering because of your heart risk, Lipfendra may be worth discussing with your provider.
“The biggest takeaway is that we have more options,” says Grillo. “That gives us more ways to personalize treatment and find what works best for each patient.”
