Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

Which cholesterol-lowering medication is considered safe for use during pregnancy?

1. Fenofibrate

2. Atorvastatin

3. Colesevelam

4. Evolocumab

The correct answer is: Colesevelam

Colesevelam is considered safe for use during pregnancy because it is a bile acid sequestrant that works in the intestines to lower cholesterol levels. Its mechanism does not involve systemic absorption, which minimizes the risk of affecting the fetus. Bile acid resins like colesevelam are generally regarded as safer alternatives during pregnancy since there is more established safety data regarding their use in this population. While other cholesterol-lowering medications may be effective in managing cholesterol levels, they may pose risks due to their systemic effects or lack of sufficient safety studies in pregnant individuals. For example, atorvastatin and evolocumab are both statins that inhibit cholesterol synthesis; however, statins are contraindicated during pregnancy due to potential teratogenic effects. Fenofibrate, while it may be prescribed in certain situations, is also not recommended during pregnancy due to limited safety data.