LDL Reduction Calculator: Statins, Ezetimibe, PCSK9 & Combination Therapy
Compare statin doses and selected combination therapies in one compact view.
Educational use only. This calculator is not intended for clinical care and does not replace professional medical advice, diagnosis, or treatment. Do not use its estimates alone to make medical decisions or change medication; consult a qualified healthcare professional.
2026 LDL-C goals Quick reference
2026 LDL-C goals at a glance
ACC/AHA guideline ↗Start with the patient’s risk category. These common pathways are a reference, not an automatic risk assessment.
| Patient characteristics | LDL-C goal |
|---|---|
| Primary prevention · borderline or intermediate 10-year PREVENT-ASCVD risk (3% to <10%) | <100 mg/dL<2.6 mmol/L |
| Primary prevention · high 10-year PREVENT-ASCVD risk (≥10%) | <70 mg/dL<1.8 mmol/L |
| Clinical ASCVD · not classified as very high risk | <70 mg/dL<1.8 mmol/L |
| Clinical ASCVD · very high risk (multiple major events, or one event with multiple high-risk conditions) | <55 mg/dL<1.4 mmol/L |
| Diabetes · age 40–75, without ASCVD; additional risk factors can warrant a lower goal | <100 mg/dLHigher-risk pathway: <70 |
Primary-prevention risk pathways apply to eligible adults age 30–79 with LDL-C 70–189 mg/dL. LDL-C ≥190 mg/dL, familial hypercholesterolemia, coronary calcium, kidney disease, and other conditions have dedicated pathways. Clinical ASCVD also calls for ≥50% LDL reduction. Meeting a numerical goal alone does not establish that all treatment criteria are met.
Select an injectable to choose its dose. Selecting another replaces it; uncheck to remove. Estimates come from different trials, not direct comparisons. See assumptions and sources.
Illustrative estimate
160.0 mg/dL
Projected LDL-C
0.0%Total reduction
0.0mg/dL lower
Select a therapy to explore a scenario.
Actual response varies. Confirm with repeat labs. Do not start, stop, or change medication based on this estimate.
Compare all seven statins by dose
| Statin | Dose → reduction | Evidence |
|---|---|---|
| Atorvastatin | 10 mg → 37% · 20 mg → 43% · 40 mg → 49% · 80 mg → 55% | Meta-analysis |
| Rosuvastatin | 5 mg → 38% · 10 mg → 43% · 20 mg → 48% · 40 mg → 53% | Meta-analysis |
| Simvastatin | 10 mg → 27% · 20 mg → 32% · 40 mg → 37% | Meta-analysis |
| Pravastatin | 10 mg → 20% · 20 mg → 24% · 40 mg → 29% · 80 mg → 33% | Meta-analysis |
| Lovastatin | 20 mg → 29% · 40 mg → 37% · 80 mg → 45% | Meta-analysis |
| Fluvastatin | 20 mg → 21% · 40 mg → 27% · 80 mg → 33% | Meta-analysis |
| Pitavastatin | 1 mg → 31% · 2 mg → 39% · 4 mg → 44% | Drug label |
Fluvastatin 80 mg/day refers to XL 80 mg once daily or immediate-release 40 mg twice daily. Simvastatin 80 mg is excluded. Estimates are not equivalent-dose prescribing advice; formulation, interactions, kidney function, pregnancy, and tolerability matter.
How the LDL reduction calculator works
This LDL cholesterol calculator combines a starting LDL-C value with study-based estimates for a selected statin dose, ezetimibe, bempedoic acid, and one PCSK9 therapy. It displays the estimated final LDL, percentage reduction, and absolute change in mg/dL or mmol/L. The result illustrates the arithmetic of LDL lowering; it does not predict an individual response or recommend treatment.
Percentage reductions are sequential, not additive
Each therapy acts on the LDL remaining after the previous step: final LDL = starting LDL × (1 − first reduction) × (1 − next reduction), with reductions written as decimals. A hypothetical 50% reduction followed by 20% gives a combined 60% reduction, not 70%. Starting at 160 mg/dL, that means 80 mg/dL after the first step and 64 mg/dL after the second. The order explains the calculation, not a prescribing sequence.
How much does each therapy lower LDL-C in this model?
| Therapy | Calculator input | Evidence |
|---|---|---|
| Statins | Specific drug and daily dose; historical estimates differ from guideline intensity categories. | Law meta-analysis; pitavastatin label |
| Ezetimibe | 18% without a statin; 25% with one | Prescribing information |
| Bempedoic acid | 21% without a statin; 18% with one | CLEAR Outcomes; CLEAR Harmony |
| Evolocumab | 59% for either supported schedule | FOURIER |
| Alirocumab | 44%, 62%, or 54%, depending on the selected regimen | ODYSSEY CHOICE I; ODYSSEY LONG TERM |
| Inclisiran | 50%, rounded from trial estimates | ORION-10/11 |
These inputs come from different populations, follow-up periods, and treatment backgrounds. They mix within-group and placebo-adjusted effects and are not head-to-head comparisons. The alirocumab values do not establish comparative effectiveness between doses. Combining these percentages is a mathematical approximation, not a separately validated trial result.
Choosing the starting LDL and interpreting the result
Use an untreated LDL to explore a new combination. If your LDL was measured while already taking medication, use add-on mode and select only newly added therapies. Existing treatment stays fixed; the calculator cannot reconstruct an untreated level or model a statin switch. Selecting an existing medicine again would count its effect twice.
Percentage reduction describes the proportion removed; absolute reduction is the difference between the starting and final LDL. To convert mg/dL to mmol/L, divide by 38.67. The calculator handles both units. Its optional goal comparison does not assign a cardiovascular risk category or determine whether a treatment is appropriate.
Individual response, adherence, medical conditions, and interactions can change the actual result. The tool does not calculate heart attack or stroke risk and is not a comprehensive interaction checker. Follow-up measurements and professional assessment determine the actual response. Health inputs are not saved or sent by this calculator; page-view analytics remain separate.
Full references
Agent names link to supporting trials (or the dose-response meta-analysis or label for statins). The ezetimibe label and CLEAR trials document the background-dependent inputs; outcome trials are also included for context. Accessed September 16, 2026.
- Law MR, Wald NJ, Rudnicka AR. Quantifying effect of statins on low density lipoprotein cholesterol, ischaemic heart disease, and stroke: systematic review and meta-analysis. BMJ. 2003;326:1423. doi:10.1136/bmj.326.7404.1423. Table 2.
- Kowa Pharmaceuticals America. LIVALO (pitavastatin) prescribing information. DailyMed. Table 7: adult dose-response study. Accessed September 16, 2026.
- Blumenthal RS, et al. 2026 ACC/AHA multisociety Guideline on the Management of Dyslipidemia. Circulation. 2026;153:e1154–e1276. doi:10.1161/CIR.0000000000001423.
- American College of Cardiology. ACC, AHA Release New Clinical Guideline For Managing Dyslipidemia. March 13, 2026.
- American College of Cardiology. Getting to Goals: Applying the 2026 Dyslipidemia Guideline in High-Risk Patients. September 1, 2026.
- Sabatine MS, et al. Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease. N Engl J Med. 2017;376:1713–1722. doi:10.1056/NEJMoa1615664.
- Robinson JG, et al. Efficacy and Safety of Alirocumab in Reducing Lipids and Cardiovascular Events. N Engl J Med. 2015;372:1489–1499. doi:10.1056/NEJMoa1501031.
- Cannon CP, et al. Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes. N Engl J Med. 2015;372:2387–2397. doi:10.1056/NEJMoa1410489.
- Ray KK, et al. Two Phase 3 Trials of Inclisiran in Patients with Elevated LDL Cholesterol. N Engl J Med. 2020;382:1507–1519. doi:10.1056/NEJMoa1912387.
- Nissen SE, et al. Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients. N Engl J Med. 2023;388:1353–1364. doi:10.1056/NEJMoa2215024.
- Regeneron Pharmaceuticals. PRALUENT (alirocumab) prescribing information. Section 14: ODYSSEY CHOICE I, NCT01926782. Accessed September 16, 2026.
- Novartis Pharmaceuticals. LEQVIO (inclisiran) prescribing information. Dosage and administration. Accessed September 16, 2026.
- Ezetimibe tablets prescribing information. DailyMed. Section 14, Tables 6–7: monotherapy and addition to ongoing statin. Accessed September 16, 2026.
- Ray KK, et al. Safety and Efficacy of Bempedoic Acid to Reduce LDL Cholesterol. N Engl J Med. 2019;380:1022–1032. doi:10.1056/NEJMoa1803917.
- Esperion Therapeutics. NEXLETOL (bempedoic acid) prescribing information. January 2026. Section 7: drug interactions.
LDL cholesterol: what the number means · All preventive cardiology guides
Continue exploring
Start with a guide to what each measurement tells you.
LDL Cholesterol →What the number means and how LDL is lowered.
ApoB Test →Understand particle number and its relationship to LDL cholesterol.
Lipoprotein(a) →Explore this inherited lipid measurement.
Preventive Cardiology →