SlideShare a Scribd company logo
If you've made important lifestyle changes and your
total cholesterol — and particularly your LDL
cholesterol — remains high, your doctor may
recommend medication.
Main groups of medications are:
 Statins
 Bile-acid-binding resins
 Cholesterol absorption inhibitors
 Combination cholesterol absorption inhibitor and
statin
 Statins — among the most commonly prescribed
medications for lowering cholesterol — block a
substance your liver needs to make cholesterol.
This causes your liver to remove cholesterol from
your blood.
 Statins may also help your body reabsorb
cholesterol from built-up deposits on your artery
walls, potentially reversing coronary artery
disease.
 Choices include atorvastatin (Lipitor), fluvastatin
(Lescol), lovastatin (Altoprev, Mevacor),
pravastatin (Pravachol), rosuvastatin (Crestor)
and simvastatin (Zocor).
 Your liver uses cholesterol to make bile
acids, a substance needed for digestion.
 The medications cholestyramine (Prevalite),
colesevelam (Welchol) and colestipol
(Colestid) lower cholesterol indirectly by
binding to bile acids.
 This prompts your liver to use excess
cholesterol to make more bile acids, which
reduces the level of cholesterol in your
blood.
 Your small intestine absorbs the cholesterol
from your diet and releases it into your
bloodstream.
 The drug ezetimibe (Zetia) helps reduce
blood cholesterol by limiting the absorption
of dietary cholesterol. Zetia can be used in
combination with any of the statin drugs.
 The combination drug ezetimibe-simvastatin
(Vytorin) decreases both absorption of
dietary cholesterol in your small intestine
and production of cholesterol in your liver.
 It's unknown whether Vytorin is more
effective in reducing heart disease risk than
taking simvastatin by itself.
Medication therapy for cholesterol

More Related Content

Similar to Medication therapy for cholesterol

Hypolipidemic drugs.ppt
Hypolipidemic drugs.pptHypolipidemic drugs.ppt
Hypolipidemic drugs.ppt
Urmila Aswar
 
Understanding Cholesterol.pptx
Understanding Cholesterol.pptxUnderstanding Cholesterol.pptx
Understanding Cholesterol.pptx
RyeCruz3
 
Class hypolipidemics
Class hypolipidemicsClass hypolipidemics
Class hypolipidemicsRaghu Prasada
 
Class hypolipidemics
Class hypolipidemics Class hypolipidemics
Class hypolipidemics
Raghu Prasada
 
hyperlipidemic drugs..pptx
hyperlipidemic drugs..pptxhyperlipidemic drugs..pptx
hyperlipidemic drugs..pptx
Dr Sachin P. Padole
 
New microsoft word document (2)
New microsoft word document (2)New microsoft word document (2)
New microsoft word document (2)
ayooy1992
 
Cardiovascular pcii
Cardiovascular pciiCardiovascular pcii
Cardiovascular pcii
Julio Cruz
 
Anti hyperlipidemic-drugs-presentation
Anti hyperlipidemic-drugs-presentationAnti hyperlipidemic-drugs-presentation
Anti hyperlipidemic-drugs-presentation
Shawn Mad
 
Cholesterol Advantages & Disadvantages
Cholesterol Advantages & Disadvantages Cholesterol Advantages & Disadvantages
Cholesterol Advantages & Disadvantages
Fasama H. Kollie
 
cholesterol.pptx
cholesterol.pptxcholesterol.pptx
cholesterol.pptx
wosen6
 
TOTAL CHOLESTEROL (lipid profile test).pptx
TOTAL CHOLESTEROL (lipid profile test).pptxTOTAL CHOLESTEROL (lipid profile test).pptx
TOTAL CHOLESTEROL (lipid profile test).pptx
dharshini369nike
 
Hypercholesterolemia
HypercholesterolemiaHypercholesterolemia
Hypercholesterolemia
Ahmed Fathy
 
How to manage high cholesterol - Mubashar A Choudry MD
How to manage high cholesterol - Mubashar A Choudry MDHow to manage high cholesterol - Mubashar A Choudry MD
How to manage high cholesterol - Mubashar A Choudry MD
Mubashar A Choudry MD
 
potassium chloride (emergency drugs).pptx
potassium chloride (emergency drugs).pptxpotassium chloride (emergency drugs).pptx
potassium chloride (emergency drugs).pptx
NourhanElSayed24
 
Global Medical Cures™ | Cholesterol Medicines
Global Medical Cures™ | Cholesterol MedicinesGlobal Medical Cures™ | Cholesterol Medicines
Global Medical Cures™ | Cholesterol Medicines
Global Medical Cures™
 
Lipvas (Generic Atorvastatin Calcium Tablets)
Lipvas (Generic Atorvastatin Calcium Tablets)Lipvas (Generic Atorvastatin Calcium Tablets)
Lipvas (Generic Atorvastatin Calcium Tablets)
The Swiss Pharmacy
 
Rostar Tablets (Generic Rosuvastatin Calcium Tablets)
Rostar Tablets (Generic Rosuvastatin Calcium Tablets) Rostar Tablets (Generic Rosuvastatin Calcium Tablets)
Rostar Tablets (Generic Rosuvastatin Calcium Tablets)
Clearsky Pharmacy
 
Hyperlipidemia, pharmacology
Hyperlipidemia, pharmacologyHyperlipidemia, pharmacology
Hyperlipidemia, pharmacology
Mohd Siraj
 
Antihyperlipidemics2
Antihyperlipidemics2Antihyperlipidemics2
Antihyperlipidemics2
Dr Shah Murad
 

Similar to Medication therapy for cholesterol (20)

Hypolipidemic drugs.ppt
Hypolipidemic drugs.pptHypolipidemic drugs.ppt
Hypolipidemic drugs.ppt
 
Understanding Cholesterol.pptx
Understanding Cholesterol.pptxUnderstanding Cholesterol.pptx
Understanding Cholesterol.pptx
 
Class hypolipidemics
Class hypolipidemicsClass hypolipidemics
Class hypolipidemics
 
Class hypolipidemics
Class hypolipidemics Class hypolipidemics
Class hypolipidemics
 
hyperlipidemic drugs..pptx
hyperlipidemic drugs..pptxhyperlipidemic drugs..pptx
hyperlipidemic drugs..pptx
 
High Cholesterol power point show
High Cholesterol power point showHigh Cholesterol power point show
High Cholesterol power point show
 
New microsoft word document (2)
New microsoft word document (2)New microsoft word document (2)
New microsoft word document (2)
 
Cardiovascular pcii
Cardiovascular pciiCardiovascular pcii
Cardiovascular pcii
 
Anti hyperlipidemic-drugs-presentation
Anti hyperlipidemic-drugs-presentationAnti hyperlipidemic-drugs-presentation
Anti hyperlipidemic-drugs-presentation
 
Cholesterol Advantages & Disadvantages
Cholesterol Advantages & Disadvantages Cholesterol Advantages & Disadvantages
Cholesterol Advantages & Disadvantages
 
cholesterol.pptx
cholesterol.pptxcholesterol.pptx
cholesterol.pptx
 
TOTAL CHOLESTEROL (lipid profile test).pptx
TOTAL CHOLESTEROL (lipid profile test).pptxTOTAL CHOLESTEROL (lipid profile test).pptx
TOTAL CHOLESTEROL (lipid profile test).pptx
 
Hypercholesterolemia
HypercholesterolemiaHypercholesterolemia
Hypercholesterolemia
 
How to manage high cholesterol - Mubashar A Choudry MD
How to manage high cholesterol - Mubashar A Choudry MDHow to manage high cholesterol - Mubashar A Choudry MD
How to manage high cholesterol - Mubashar A Choudry MD
 
potassium chloride (emergency drugs).pptx
potassium chloride (emergency drugs).pptxpotassium chloride (emergency drugs).pptx
potassium chloride (emergency drugs).pptx
 
Global Medical Cures™ | Cholesterol Medicines
Global Medical Cures™ | Cholesterol MedicinesGlobal Medical Cures™ | Cholesterol Medicines
Global Medical Cures™ | Cholesterol Medicines
 
Lipvas (Generic Atorvastatin Calcium Tablets)
Lipvas (Generic Atorvastatin Calcium Tablets)Lipvas (Generic Atorvastatin Calcium Tablets)
Lipvas (Generic Atorvastatin Calcium Tablets)
 
Rostar Tablets (Generic Rosuvastatin Calcium Tablets)
Rostar Tablets (Generic Rosuvastatin Calcium Tablets) Rostar Tablets (Generic Rosuvastatin Calcium Tablets)
Rostar Tablets (Generic Rosuvastatin Calcium Tablets)
 
Hyperlipidemia, pharmacology
Hyperlipidemia, pharmacologyHyperlipidemia, pharmacology
Hyperlipidemia, pharmacology
 
Antihyperlipidemics2
Antihyperlipidemics2Antihyperlipidemics2
Antihyperlipidemics2
 

More from janmacmann

Medication therapy for cholesterol
Medication therapy for cholesterolMedication therapy for cholesterol
Medication therapy for cholesterol
janmacmann
 
Lifestyle changes to
Lifestyle changes toLifestyle changes to
Lifestyle changes to
janmacmann
 
Lifestyle changes to
Lifestyle changes toLifestyle changes to
Lifestyle changes to
janmacmann
 
About triglycerides
About triglyceridesAbout triglycerides
About triglycerides
janmacmann
 
Basics of cholesterol
Basics of cholesterolBasics of cholesterol
Basics of cholesterol
janmacmann
 
Module 3 blood sugar
Module 3 blood sugarModule 3 blood sugar
Module 3 blood sugarjanmacmann
 
Module 3 enzymes and electrolytes
Module 3 enzymes and electrolytesModule 3 enzymes and electrolytes
Module 3 enzymes and electrolytesjanmacmann
 
Module 3 kidney and liver function
Module 3 kidney and liver functionModule 3 kidney and liver function
Module 3 kidney and liver functionjanmacmann
 
Welcome to oiler well online!
Welcome to oiler well online!Welcome to oiler well online!
Welcome to oiler well online!
janmacmann
 
Now what module 2
Now what module 2Now what module 2
Now what module 2
janmacmann
 
Complete blood count
Complete blood countComplete blood count
Complete blood count
janmacmann
 
What is bmi
What is bmiWhat is bmi
What is bmi
janmacmann
 
Psa
PsaPsa
Thyroid testing
Thyroid testingThyroid testing
Thyroid testing
janmacmann
 
Complete blood count
Complete blood countComplete blood count
Complete blood count
janmacmann
 
What is bmi
What is bmiWhat is bmi
What is bmi
janmacmann
 
What is blood pressure
What is blood pressureWhat is blood pressure
What is blood pressure
janmacmann
 
Waist circumference
Waist circumferenceWaist circumference
Waist circumference
janmacmann
 
Now what, 10 steps
Now what, 10 stepsNow what, 10 steps
Now what, 10 steps
janmacmann
 

More from janmacmann (20)

Medication therapy for cholesterol
Medication therapy for cholesterolMedication therapy for cholesterol
Medication therapy for cholesterol
 
Lifestyle changes to
Lifestyle changes toLifestyle changes to
Lifestyle changes to
 
Lifestyle changes to
Lifestyle changes toLifestyle changes to
Lifestyle changes to
 
About triglycerides
About triglyceridesAbout triglycerides
About triglycerides
 
Basics of cholesterol
Basics of cholesterolBasics of cholesterol
Basics of cholesterol
 
Module 3 blood sugar
Module 3 blood sugarModule 3 blood sugar
Module 3 blood sugar
 
Module 3 enzymes and electrolytes
Module 3 enzymes and electrolytesModule 3 enzymes and electrolytes
Module 3 enzymes and electrolytes
 
Module 3 kidney and liver function
Module 3 kidney and liver functionModule 3 kidney and liver function
Module 3 kidney and liver function
 
Welcome to oiler well online!
Welcome to oiler well online!Welcome to oiler well online!
Welcome to oiler well online!
 
Now what module 2
Now what module 2Now what module 2
Now what module 2
 
Complete blood count
Complete blood countComplete blood count
Complete blood count
 
What is bmi
What is bmiWhat is bmi
What is bmi
 
Psa
PsaPsa
Psa
 
Thyroid testing
Thyroid testingThyroid testing
Thyroid testing
 
Complete blood count
Complete blood countComplete blood count
Complete blood count
 
What is bmi
What is bmiWhat is bmi
What is bmi
 
What is blood pressure
What is blood pressureWhat is blood pressure
What is blood pressure
 
Waist circumference
Waist circumferenceWaist circumference
Waist circumference
 
Now what, 10 steps
Now what, 10 stepsNow what, 10 steps
Now what, 10 steps
 
What is bmi
What is bmiWhat is bmi
What is bmi
 

Recently uploaded

ESC Beyond Borders _From EU to You_ InfoPack general.pdf
ESC Beyond Borders _From EU to You_ InfoPack general.pdfESC Beyond Borders _From EU to You_ InfoPack general.pdf
ESC Beyond Borders _From EU to You_ InfoPack general.pdf
Fundacja Rozwoju Społeczeństwa Przedsiębiorczego
 
How to Split Bills in the Odoo 17 POS Module
How to Split Bills in the Odoo 17 POS ModuleHow to Split Bills in the Odoo 17 POS Module
How to Split Bills in the Odoo 17 POS Module
Celine George
 
Introduction to Quality Improvement Essentials
Introduction to Quality Improvement EssentialsIntroduction to Quality Improvement Essentials
Introduction to Quality Improvement Essentials
Excellence Foundation for South Sudan
 
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
siemaillard
 
Basic phrases for greeting and assisting costumers
Basic phrases for greeting and assisting costumersBasic phrases for greeting and assisting costumers
Basic phrases for greeting and assisting costumers
PedroFerreira53928
 
Operation Blue Star - Saka Neela Tara
Operation Blue Star   -  Saka Neela TaraOperation Blue Star   -  Saka Neela Tara
Operation Blue Star - Saka Neela Tara
Balvir Singh
 
Synthetic Fiber Construction in lab .pptx
Synthetic Fiber Construction in lab .pptxSynthetic Fiber Construction in lab .pptx
Synthetic Fiber Construction in lab .pptx
Pavel ( NSTU)
 
Palestine last event orientationfvgnh .pptx
Palestine last event orientationfvgnh .pptxPalestine last event orientationfvgnh .pptx
Palestine last event orientationfvgnh .pptx
RaedMohamed3
 
The Art Pastor's Guide to Sabbath | Steve Thomason
The Art Pastor's Guide to Sabbath | Steve ThomasonThe Art Pastor's Guide to Sabbath | Steve Thomason
The Art Pastor's Guide to Sabbath | Steve Thomason
Steve Thomason
 
Unit 8 - Information and Communication Technology (Paper I).pdf
Unit 8 - Information and Communication Technology (Paper I).pdfUnit 8 - Information and Communication Technology (Paper I).pdf
Unit 8 - Information and Communication Technology (Paper I).pdf
Thiyagu K
 
How to Create Map Views in the Odoo 17 ERP
How to Create Map Views in the Odoo 17 ERPHow to Create Map Views in the Odoo 17 ERP
How to Create Map Views in the Odoo 17 ERP
Celine George
 
Mule 4.6 & Java 17 Upgrade | MuleSoft Mysore Meetup #46
Mule 4.6 & Java 17 Upgrade | MuleSoft Mysore Meetup #46Mule 4.6 & Java 17 Upgrade | MuleSoft Mysore Meetup #46
Mule 4.6 & Java 17 Upgrade | MuleSoft Mysore Meetup #46
MysoreMuleSoftMeetup
 
TESDA TM1 REVIEWER FOR NATIONAL ASSESSMENT WRITTEN AND ORAL QUESTIONS WITH A...
TESDA TM1 REVIEWER  FOR NATIONAL ASSESSMENT WRITTEN AND ORAL QUESTIONS WITH A...TESDA TM1 REVIEWER  FOR NATIONAL ASSESSMENT WRITTEN AND ORAL QUESTIONS WITH A...
TESDA TM1 REVIEWER FOR NATIONAL ASSESSMENT WRITTEN AND ORAL QUESTIONS WITH A...
EugeneSaldivar
 
The Challenger.pdf DNHS Official Publication
The Challenger.pdf DNHS Official PublicationThe Challenger.pdf DNHS Official Publication
The Challenger.pdf DNHS Official Publication
Delapenabediema
 
Overview on Edible Vaccine: Pros & Cons with Mechanism
Overview on Edible Vaccine: Pros & Cons with MechanismOverview on Edible Vaccine: Pros & Cons with Mechanism
Overview on Edible Vaccine: Pros & Cons with Mechanism
DeeptiGupta154
 
Digital Tools and AI for Teaching Learning and Research
Digital Tools and AI for Teaching Learning and ResearchDigital Tools and AI for Teaching Learning and Research
Digital Tools and AI for Teaching Learning and Research
Vikramjit Singh
 
2024.06.01 Introducing a competency framework for languag learning materials ...
2024.06.01 Introducing a competency framework for languag learning materials ...2024.06.01 Introducing a competency framework for languag learning materials ...
2024.06.01 Introducing a competency framework for languag learning materials ...
Sandy Millin
 
Chapter 3 - Islamic Banking Products and Services.pptx
Chapter 3 - Islamic Banking Products and Services.pptxChapter 3 - Islamic Banking Products and Services.pptx
Chapter 3 - Islamic Banking Products and Services.pptx
Mohd Adib Abd Muin, Senior Lecturer at Universiti Utara Malaysia
 
The Roman Empire A Historical Colossus.pdf
The Roman Empire A Historical Colossus.pdfThe Roman Empire A Historical Colossus.pdf
The Roman Empire A Historical Colossus.pdf
kaushalkr1407
 
Thesis Statement for students diagnonsed withADHD.ppt
Thesis Statement for students diagnonsed withADHD.pptThesis Statement for students diagnonsed withADHD.ppt
Thesis Statement for students diagnonsed withADHD.ppt
EverAndrsGuerraGuerr
 

Recently uploaded (20)

ESC Beyond Borders _From EU to You_ InfoPack general.pdf
ESC Beyond Borders _From EU to You_ InfoPack general.pdfESC Beyond Borders _From EU to You_ InfoPack general.pdf
ESC Beyond Borders _From EU to You_ InfoPack general.pdf
 
How to Split Bills in the Odoo 17 POS Module
How to Split Bills in the Odoo 17 POS ModuleHow to Split Bills in the Odoo 17 POS Module
How to Split Bills in the Odoo 17 POS Module
 
Introduction to Quality Improvement Essentials
Introduction to Quality Improvement EssentialsIntroduction to Quality Improvement Essentials
Introduction to Quality Improvement Essentials
 
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
 
Basic phrases for greeting and assisting costumers
Basic phrases for greeting and assisting costumersBasic phrases for greeting and assisting costumers
Basic phrases for greeting and assisting costumers
 
Operation Blue Star - Saka Neela Tara
Operation Blue Star   -  Saka Neela TaraOperation Blue Star   -  Saka Neela Tara
Operation Blue Star - Saka Neela Tara
 
Synthetic Fiber Construction in lab .pptx
Synthetic Fiber Construction in lab .pptxSynthetic Fiber Construction in lab .pptx
Synthetic Fiber Construction in lab .pptx
 
Palestine last event orientationfvgnh .pptx
Palestine last event orientationfvgnh .pptxPalestine last event orientationfvgnh .pptx
Palestine last event orientationfvgnh .pptx
 
The Art Pastor's Guide to Sabbath | Steve Thomason
The Art Pastor's Guide to Sabbath | Steve ThomasonThe Art Pastor's Guide to Sabbath | Steve Thomason
The Art Pastor's Guide to Sabbath | Steve Thomason
 
Unit 8 - Information and Communication Technology (Paper I).pdf
Unit 8 - Information and Communication Technology (Paper I).pdfUnit 8 - Information and Communication Technology (Paper I).pdf
Unit 8 - Information and Communication Technology (Paper I).pdf
 
How to Create Map Views in the Odoo 17 ERP
How to Create Map Views in the Odoo 17 ERPHow to Create Map Views in the Odoo 17 ERP
How to Create Map Views in the Odoo 17 ERP
 
Mule 4.6 & Java 17 Upgrade | MuleSoft Mysore Meetup #46
Mule 4.6 & Java 17 Upgrade | MuleSoft Mysore Meetup #46Mule 4.6 & Java 17 Upgrade | MuleSoft Mysore Meetup #46
Mule 4.6 & Java 17 Upgrade | MuleSoft Mysore Meetup #46
 
TESDA TM1 REVIEWER FOR NATIONAL ASSESSMENT WRITTEN AND ORAL QUESTIONS WITH A...
TESDA TM1 REVIEWER  FOR NATIONAL ASSESSMENT WRITTEN AND ORAL QUESTIONS WITH A...TESDA TM1 REVIEWER  FOR NATIONAL ASSESSMENT WRITTEN AND ORAL QUESTIONS WITH A...
TESDA TM1 REVIEWER FOR NATIONAL ASSESSMENT WRITTEN AND ORAL QUESTIONS WITH A...
 
The Challenger.pdf DNHS Official Publication
The Challenger.pdf DNHS Official PublicationThe Challenger.pdf DNHS Official Publication
The Challenger.pdf DNHS Official Publication
 
Overview on Edible Vaccine: Pros & Cons with Mechanism
Overview on Edible Vaccine: Pros & Cons with MechanismOverview on Edible Vaccine: Pros & Cons with Mechanism
Overview on Edible Vaccine: Pros & Cons with Mechanism
 
Digital Tools and AI for Teaching Learning and Research
Digital Tools and AI for Teaching Learning and ResearchDigital Tools and AI for Teaching Learning and Research
Digital Tools and AI for Teaching Learning and Research
 
2024.06.01 Introducing a competency framework for languag learning materials ...
2024.06.01 Introducing a competency framework for languag learning materials ...2024.06.01 Introducing a competency framework for languag learning materials ...
2024.06.01 Introducing a competency framework for languag learning materials ...
 
Chapter 3 - Islamic Banking Products and Services.pptx
Chapter 3 - Islamic Banking Products and Services.pptxChapter 3 - Islamic Banking Products and Services.pptx
Chapter 3 - Islamic Banking Products and Services.pptx
 
The Roman Empire A Historical Colossus.pdf
The Roman Empire A Historical Colossus.pdfThe Roman Empire A Historical Colossus.pdf
The Roman Empire A Historical Colossus.pdf
 
Thesis Statement for students diagnonsed withADHD.ppt
Thesis Statement for students diagnonsed withADHD.pptThesis Statement for students diagnonsed withADHD.ppt
Thesis Statement for students diagnonsed withADHD.ppt
 

Medication therapy for cholesterol

  • 1.
  • 2.
  • 3. If you've made important lifestyle changes and your total cholesterol — and particularly your LDL cholesterol — remains high, your doctor may recommend medication. Main groups of medications are:  Statins  Bile-acid-binding resins  Cholesterol absorption inhibitors  Combination cholesterol absorption inhibitor and statin
  • 4.  Statins — among the most commonly prescribed medications for lowering cholesterol — block a substance your liver needs to make cholesterol. This causes your liver to remove cholesterol from your blood.  Statins may also help your body reabsorb cholesterol from built-up deposits on your artery walls, potentially reversing coronary artery disease.  Choices include atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Altoprev, Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor) and simvastatin (Zocor).
  • 5.  Your liver uses cholesterol to make bile acids, a substance needed for digestion.  The medications cholestyramine (Prevalite), colesevelam (Welchol) and colestipol (Colestid) lower cholesterol indirectly by binding to bile acids.  This prompts your liver to use excess cholesterol to make more bile acids, which reduces the level of cholesterol in your blood.
  • 6.  Your small intestine absorbs the cholesterol from your diet and releases it into your bloodstream.  The drug ezetimibe (Zetia) helps reduce blood cholesterol by limiting the absorption of dietary cholesterol. Zetia can be used in combination with any of the statin drugs.
  • 7.  The combination drug ezetimibe-simvastatin (Vytorin) decreases both absorption of dietary cholesterol in your small intestine and production of cholesterol in your liver.  It's unknown whether Vytorin is more effective in reducing heart disease risk than taking simvastatin by itself.