Home Conditions High cholesterol

High cholesterol — guide.

Hypercholesterolemia = elevated levels of total cholesterol or LDL (bad). A major risk factor for atherosclerosis, heart attack, and stroke. Management — lifestyle + statins for those at high risk.

Also called: hypercholesterolemia elevated LDL dyslipidemia
6 recommended OTC medicines
8,931 pharmacies available

In short: High cholesterol (hypercholesterolemia) means raised levels of total or LDL cholesterol and is a major risk factor for atherosclerosis, heart attack and stroke. Beyond lifestyle changes, pharmacies stock over-the-counter supplements such as omega-3, phytosterols, psyllium, berberine, red yeast rice or coenzyme Q10, whose prices you can compare on HartaFarmacii across Dr. Max, Tei, Catena and HelpNet, with figures updated daily. This information is for guidance only and does not replace a medical consultation; see a doctor if your blood tests show very high LDL cholesterol levels.

Data verified on from public sources (OpenStreetMap, chain websites, ANM/MS) — updated daily.

OTC — adjuncts

What you can take alongside treatment

Informational only — HartaFarmacii is not an approved medical site. Talk to your doctor or pharmacist before taking any medicine. Don't self-medicate. Emergencies: 112.

When to seek urgent medical help

Any of these signs calls for prompt medical evaluation:

  • Very high levels (LDL >190, TG >500)
  • Family history of familial hypercholesterolemia
  • Previous cardiovascular events
  • Chest pain, shortness of breath
  • Xanthomas (fat deposits on tendons/skin)

What high cholesterol is

Cholesterol is an essential fatty substance the body uses to build cell membranes, hormones, and vitamin D. It becomes a problem when it circulates in excess in the form of LDL (the „bad” cholesterol), which is deposited in the artery walls and forms atheroma plaques. This atherosclerosis process narrows the arteries and underlies myocardial infarction, stroke, and peripheral arterial disease. High cholesterol produces no symptoms — which is why it is called a „silent killer” and is discovered through blood tests. HDL (the „good” cholesterol) has a protective role. The treatment decision is not made solely on the LDL value, but according to the person's overall cardiovascular risk.

Targets (according to CV risk)

  • Low risk: LDL <116 mg/dl.
  • Moderate risk: LDL <100 mg/dl.
  • High risk: LDL <70 mg/dl.
  • Very high risk (after MI, diabetes with organ damage): LDL <55 mg/dl.

Treatment

Lifestyle (first step):

  • Reduce saturated fats (<7% of calories) and trans fats.
  • Increase soluble fiber (oats, legumes) — lowers cholesterol by 5-10%.
  • Omega-3 from oily fish 2-3 times/week.
  • Mono- and polyunsaturated fats (olive oil, nuts, avocado).
  • Plant phytosterols (2-3g/day) — lower LDL by 10%.
  • Regular exercise.
  • Weight loss if appropriate.

Statins (Rx) — atorvastatin, rosuvastatin, simvastatin. Lower LDL by 30-55%, with proven CV benefit.

Alternatives/add-ons — ezetimibe, PCSK9 inhibitors, bempedoic acid, fibrates (for triglycerides).

OTC and supplements

Strong evidence:

  • Phytosterols 2-3g/day — lower LDL by 10-15%.
  • Oat beta-glucans 3g/day.
  • Omega-3 EPA 4g/day (therapeutic dose, Rx in Romania).
  • Psyllium 10g/day.

Moderate evidence:

  • Berberine 500 mg three times a day — lowers LDL.
  • Red yeast rice (monacolin K — similar to lovastatin).
  • Garlic extract.
  • Policosanol.

Caution: supplements do not replace a statin in patients at high CV risk.

Medical disclaimer: the information in this guide is for informational purposes only and does not replace the advice of a doctor or pharmacist. For diagnosis and treatment, consult a healthcare professional.

Medicines compared

Medicines used for high cholesterol

This list is for guidance only, generated automatically from the DCI/category match. It is not a medical recommendation — consult your doctor before starting any treatment.

This list is not a medical recommendation. Consult your doctor or pharmacist.

Night-time, weekends, public holidays

24/7 pharmacies for high cholesterol

Patients with high cholesterol sometimes need medicines outside normal opening hours — either because of an acute flare-up, or because chronic treatment has to continue and a stock shortage has come up. Below you have direct access to the list of pharmacies open 24/7, with address, phone number and verified opening hours.

For chronic (prescription) treatment, check stock at your preferred pharmacy in good time — especially for medicines price-capped through CANAMED, where stock can run out between deliveries. Call before you set off.

Search the pharmacy

Medicine categories for high cholesterol

Step by step

How to find a pharmacy fast for high cholesterol

Open the interactive map and allow location access — you will see pharmacies sorted by distance, each with its opening hours and a one-tap route in Google Maps. For night-time or weekend emergencies, switch on the 24/7 filter and keep only the on-duty ones. For high cholesterol some medicines need a prescription — make sure you have a valid one (electronic or paper) before you leave, to avoid wasted trips.

For chronic treatment, save your preferred pharmacy as a favourite in the app and check prices in the price comparator — differences between chains can reach 20-40% for OTC products, while for prescription medicines capped through CANAMED the maximum price is fixed, though there may be promotions. If treatment for high cholesterol involves a prescription covering several months, plan your collection a few days before you run out.

Left untreated

Possible complications

See also

Related symptoms and conditions

Symptom

Fatigue

Fatigue is a persistent lack of energy, beyond what is normal after exertion. Causes range from lack of sleep to anemia, hypothyroidism, diabetes, depression, and chronic illnesses.

 Condition

Arterial hypertension

Arterial hypertension (HTN) = BP above 140/90 mmHg on repeated measurements. It affects 30-40% of adults and is the leading cause of stroke, heart attack, heart failure, and kidney failure.

 Condition

Type 2 diabetes mellitus

Type 2 diabetes accounts for 90% of cases. A combination of insulin resistance and relative deficiency. Associated with obesity, sedentary lifestyle, genetics. Onset usually after age 40, but increasing in young people.

Frequently asked questions

What else would you like to know?

Do I have to take a statin if I have high cholesterol?
It depends on your overall cardiovascular risk (not just on LDL). The doctor calculates the SCORE/ASCVD score and decides. At high risk, a statin is indicated even at moderate LDL.
Are supplements enough?
At low risk — they can be enough alongside lifestyle changes. At high risk or with diabetes — no, statins are the standard.
Do statins cause muscle pain?
Yes, mild myalgia occurs in ~10-15% of cases. Rarely — rhabdomyolysis (an emergency). Coenzyme Q10 100-200 mg/day may help.
Does total cholesterol or LDL matter?
LDL, non-HDL, and apolipoprotein B. Total cholesterol as screening. HDL is usually protective (but we do not medicate to raise it).

See also

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