Pharmacists can play a key role in preventing many adverse sequelae from improperly treated hypercholes-terolemia through treatment and monitoring strategies. Simvastatin and lovastatin utilization in an outpatient population was evaluated in this retrospective chart review. A dose-response effect for total cholesterol reduction was observed. Only 33% (13/40) of patients achieved consensus National Cholesterol Education Program (NCEP) therapy goals. Of those not meeting NCEP guidelines, 11% (3/27) were on maximum doses. Dosage adjustment occurred for 56% (15/27) but 27% (4/15) had no follow-up level. These results suggest that more aggressive lipid-lowering treatment and monitoring are necessary if guidelines are to be met.