LDL Reduction Calculator: Statins, Ezetimibe, PCSK9 & Combination Therapy
Estimate a new treatment combination from an untreated LDL-C, or model additions and dose changes from a measured on-treatment LDL-C.
Educational use only. This tool and its outputs do not constitute medical advice, diagnosis, or treatment and do not replace clinical judgment. Independently verify the inputs, equations, assumptions, units, and outputs, and confirm that the tool is appropriate for your intended use before relying on a result.
Do not use these 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.
Enter an untreated LDL-C, measured before lipid-lowering medication.
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 estimates how much LDL-C may change with statins, ezetimibe, bempedoic acid, or PCSK9-targeting therapies. Start with an untreated LDL-C and select a complete regimen, or enter a measured on-treatment LDL-C, record the medicines already being taken, and model additions or supported dose changes.
The estimates are based on LDL-lowering effects reported in clinical trials, prescribing information, and published studies. They illustrate expected LDL reduction but do not predict an individual response or recommend treatment.
LDL reductions are calculated sequentially
When multiple medications are selected, their effects are applied to the LDL cholesterol remaining after each step rather than simply added together.
For example, a 50% reduction followed by a 20% reduction produces an estimated 60% total LDL reduction, not 70%. An LDL-C of 160 mg/dL would fall to 80 mg/dL after the first therapy and approximately 64 mg/dL after the second.
LDL-lowering estimates used by the calculator
| Therapy | Estimated LDL-C reduction |
|---|---|
| Statins | Varies by medication and dose |
| Ezetimibe | ~18–25% |
| Bempedoic acid | ~18–21% |
| Evolocumab | ~59% |
| Alirocumab | ~44–62%, depending on regimen |
| Inclisiran | ~50% |
These estimates come from different studies and patient populations and should not be interpreted as head-to-head comparisons. Estimates for combinations are mathematical approximations rather than results from a single clinical trial.
Choosing your starting LDL-C
For an untreated LDL-C, select the complete regimen you want to model. For an on-treatment LDL-C, enter the medicines and doses present when that value was measured, then select only the change you want to explore. Existing medicines provide context and are not applied again.
Supported changes include adding therapy, changing a dose within the same statin, and changing a dose or schedule within the same injectable agent. The calculator does not reconstruct an untreated LDL-C, model stopping medication, or switch between agents.
Interpreting your estimate
The calculator shows your estimated final LDL-C, percentage reduction, absolute reduction, and comparison with a selected LDL-C goal.
Actual LDL response varies between individuals and may be affected by adherence, medical conditions, drug interactions, and other factors. This calculator does not calculate cardiovascular risk, recommend treatment, or replace follow-up lipid testing.
For the equations, evidence behind each estimate, limitations, and full references, see LDL Reduction Calculator: Methodology and Evidence →
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 →