Your cholesterol has not come down as far as we want on your current tablet. What we are changing and why.

Your cholesterol needs a bit more work

What this result means

Your cholesterol has come down, but not as far as we are aiming for. That is common and it is not a failure. Different people respond to the same dose by different amounts.

Your text message tells you which change we are making. It will be one of these.

The changes we might make

A higher dose of your statin

The usual first step. Atorvastatin comes in 20mg, 40mg and 80mg. Moving up a step lowers cholesterol further and side effects do not rise anything like as steeply as the dose does. Take it exactly as before, one tablet once a day, just the new strength. Your pharmacy will supply the new tablet, so check the box: the old strength should be stopped.

Adding a second tablet, Ezetimibe

Ezetimibe 10mg, one tablet a day, at any time. It works in a completely different way to a statin: it reduces how much cholesterol you absorb from food, rather than how much your liver makes. The two together do more than either alone. Side effects are uncommon. Keep taking your statin as well, unless we have told you otherwise.

Checking how the tablets are going first

Sometimes the answer is not a new tablet. If you have been missing doses, or stopped because of an ache, tell us honestly. It changes what we do next, and it is far more useful to us than a guess. Nobody will be annoyed.

What you need to do

Collect the new prescription from your usual pharmacy.
Take it every day. Missed days are the commonest reason cholesterol stays high.
Book a blood test about 3 months from now, or 8 weeks if we said so in your text.
Keep up the things that work alongside the tablets: not smoking, moving more, less saturated fat.

Side effects and when to contact us

Contact the practice if you get:

new muscle pain, tenderness or weakness that does not settle, especially on both sides;
dark or cola-coloured urine, which means stop the tablet and contact us the same day;
yellowing of the skin or eyes, which means contact us urgently;
a new medicine started by anyone else, so we can check it does not interact.

Chest pain at rest, or sudden face, arm or speech changes: call 999.

More information

NHS.UKStatins: how they work and side effectschmg.co.uk/nhs-statins - opens their website NHS.UKEzetimibe: how to take it and what to expectchmg.co.uk/nhs-ezetimibe - opens their website

Emergency? Chest pain at rest, or sudden face, arm or speech changes: call 999. Otherwise contact the practice.