Compound Physician required

Statins

First-line ApoB lowering. The most studied class in modern cardiology.

Approved Verified 27 August 2026

What it does

Among the most-studied drugs in human history, with consistent net benefit when ApoB is elevated. Myalgia rates in blinded trials are close to placebo. The default escalation when ApoB stays high after lifestyle effort.

Inhibits HMG-CoA reductase, the rate-limiting enzyme in cholesterol synthesis. Reduced hepatic synthesis upregulates LDL receptors, which clear circulating ApoB particles.

  • ApoB
  • LDL-C

What the evidence shows

Overall evidence strength: High certainty

Who it's for, who should skip

Elevated ApoB despite diet and lifestyle effort. Delaying treatment to 'try lifestyle harder' is one of the more expensive decisions in this category.

Running it

Form
oral
Dose
daily
Titration
target individualized to overall risk profile

Measuring it

Retest ApoB — 4–12 weeks after starting or changing the dose, then every 6–12 months — ApoB follows the lipid-panel schedule..

  • LDL-C baseline
  • LDL-C annual
  • ApoB baseline
  • ApoB annual

Safety

  • myalgia (uncommon in blinded trials but real for some) uncommon
  • modest increase in new-onset diabetes in predisposed individuals

Stacking & alternatives

Access & cost

Prescription or clinician order — typically via primary care or cardiology.

Last reviewed 27 August 2026. Regulatory status verified 27 August 2026.