Statins are frequently prescribed drugs in cardiology practice. One of the most important causes of nonadherence is mainly because of muscle-related symptoms. The main adverse reactions due to statins include myalgia, myopathy, and new onset diabetes mellitus. Lipophylic statins are more prone to produce myopathy compared to hydrophilic ones. Statins increase the incidence of new onset DM in patients already having risk factors for DM. Therefore statins to be continued rather than discontinuing, if patients are diagnosed with new onset diabetes mellitus. The benefits of statin therapy outweigh the risk. Statin intolerance can be effectively managed either by reducing the dosage, switching to other statin or alternate day statin regimen with rosuvastatin. Non-statin therapies like PCSK-9 inhibitors evolocumab and alirocumab are also optional in high-risk patients who are intolerant to statins or in whom statins are contraindicated. Inclisiran is a promising drug, however long-term safety data is needed. Nutraceuticals have cholesterol lowering activity however there is insufficient evidence with respect to long-term safety and effectivenes.