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Is atorvastatin exactly the same as lipitor: Lipitor (Atorvastatin) – Side Effects, Interactions, Uses, Dosage, Warnings

Lipitor vs. Generic Lipitor (Atorvastatin): A Comparison

  1. Are generic atorvastatin and Lipitor really equivalent?
  2. Atorvastatin dose
  3. Atorvastatin use
  4. Atorvastatin and moderations 
  5. Atorvastatin side effects

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

According to the U.S. Food and Drug Administration (FDA), generic drugs and brand-name drugs should be equivalent in approved dosage, safety, strength, route of administration, quality, and performance characteristics. Essentially, they should be the same medication except in name (FDA, 2018). 

Generic medications are typically only sold once the patents and exclusivities protecting the brand-name version end. Once the patent expires, drug companies must meet strict standards to demonstrate that the generic version effectively provides the same clinical benefits.

Initially sold by Pfizer under the brand name Lipitor, the FDA approved atorvastatin in 1996; once the brand name patent expired in November 2011, a generic version swiftly entered the market.

The widely used statin, also known as an HMG-CoA reductase inhibitor, is FDA-approved to reduce elevated total cholesterol, low-density lipoprotein (LDL), and triglycerides, as well as to increase high-density lipoprotein (HDL) levels. It also helps reduce the risk of heart disease and stroke (FDA, 2017).

Aside from atorvastatin, there are several other FDA-approved statin drugs used to lower LDL cholesterol: fluvastatin (brand name Lescol), rosuvastatin (brand name Crestor), lovastatin (brand name Mevacor), pitavastatin (brand name Livalo), pravastatin (brand name Pravachol), and simvastatin (brand name Zocor). 

A 2017 study of 266 people taking proprietary atorvastatin (Lipitor) or generic atorvastatin (atorvastatin calcium) looked at this question. They found no statistically significant difference between the drugs in lowering total cholesterol, low-density lipoprotein cholesterol, or triglyceride levels. The researchers concluded that switching people from branded medications to less expensive generic versions is clinically sound and a sensible approach to lowering health care costs (Loch, 2017).

Another study looked at people aged 65 years and older hospitalized for acute coronary syndrome (ACS) and prescribed Lipitor or generic atorvastatin once they went home. The results suggested no significant difference in clinical outcomes within one year of starting the drug. The researchers stated that their findings should reassure people about the effectiveness of generic atorvastatin products when used in routine clinical practice for the ACS population (Jackevicius, 2016).

Generic atorvastatin and brand name Lipitor are both available as an oral tablet taken once per day.

Similarly, they share the same standard daily dose for adults. Dosing usually begins at 10 mg to 20 mg, then progresses to higher doses like 10 mg, 20 mg, 40 mg, or 80 mg daily. The pediatric dose (children 10-17 years of age) of atorvastatin starts at 10 mg orally per day, then proceeds to a daily maintenance dose of 10 mg to 20 mg (FDA, 2017). 

Your healthcare provider will work with you to determine the most appropriate dose depending on your therapeutic goals and response to the drug.

One of the most common uses for atorvastatin is to treat hyperlipidemia, which occurs when you have high cholesterol and triglycerides levels in the blood. The body uses cholesterol to create substances like hormones, bile acids, and vitamin D, and triglycerides provide the body with energy. Too much cholesterol causes a buildup of plaques in artery walls, restricting blood flow and increasing the risk of heart attacks and strokes (HHS, 2005).

The problem with hyperlipidemia is that it doesn’t cause any noticeable symptoms, so it can be tricky to diagnose. Healthcare providers rely on routine blood tests and patient history to identify a possible link to the condition (Hill, 2020). During your appointment, your healthcare professional may ask about the following to determine your heart disease risk (Hill, 2020): 

  • Family history of cardiovascular disease, high cholesterol, high triglyceride levels
  • Diet and exercise habits
  • Tobacco, alcohol, and drug use
  • History of coronary artery disease
  • Your risk factors for coronary heart disease, like high blood pressure
  • Symptoms of peripheral arterial disease or angina (chest pain)

Atorvastatin is used to treat high cholesterol and triglycerides along with dietary modifications, like choosing a low-fat diet and eating high-fiber foods. Other uses for atorvastatin include (FDA, 2017):

  • For people with cardiovascular risk factors, atorvastatin can decrease the risk of heart attacks and strokes. Cardiovascular risk factors include age, smoking, high blood pressure, diabetes, low HDL (“good” cholesterol), or a family history of early heart disease.
  • Atorvastatin can reduce the likelihood of heart surgery, as well as lower the risk of heart attacks and strokes in people with heart disease.
  • Adults with homozygous familial hypercholesterolemia and primary dysbetalipoproteinemia, disorders that cause abnormal cholesterol levels, can have lower cholesterol levels with atorvastatin.
  • In pediatric patients (aged 10-17 years) with heterozygous familial hypercholesterolemia (a genetic condition where the body cannot remove cholesterol normally), it can decrease cholesterol levels.

Hyperlipidemia is a progressive, life-long disease. When left untreated, people can develop cardiovascular disease, leading to heart attacks, strokes, and even death. Luckily, most people can manage hyperlipidemia with medication, diet, and lifestyle modifications.

According to the American Heart Association, diet is one method in your arsenal for lowering your cholesterol. Cut back on the trans and saturated fats found in red meat and fried foods, and focus on a heart-healthy approach to eating that emphasizes fruits, vegetables, and whole grains (AHA, 2017).

Exercise is another essential part of the solution and can help increase the effectiveness of the medication. The AHA recommends 150 minutes, or 2.5 hours, per week of moderate-intensity physical activity such as walking, running, swimming, or cycling (AHA, 2017).

It seems like common sense that diet and exercise can improve health, but there is actual data to support these recommendations. Researchers found that people who adopted lifestyle modifications, like eating a healthy diet, engaging in physical activity, not smoking, and no obesity, had a much lower risk of coronary artery disease events than those who didn’t practice these wellness habits. The risk was 50% lower in people with healthy lifestyle changes (Khera, 2016).

Lifestyle modifications can go a long way to improving your overall health and your risk for heart disease. However, some people don’t see enough change in their cholesterol numbers and need prescription drugs, like atorvastatin, to help.

Before starting a new medication, it’s important to educate yourself on potential side effects and drug interactions. Atorvastatin has been linked to various adverse reactions. Although they are often mild, you should consult your healthcare provider for medical advice if any of these symptoms become more severe or do not go away.

Common side effects of Lipitor in placebo-controlled trials include (FDA, 2017):

  • Cold symptoms
  • Joint pain
  • Diarrhea
  • Pain in arms or legs
  • Urinary tract infections 
  • Heartburn
  • Nausea
  • Muscle pain, aches, or spasms (myalgia)
  • Gas
  • Headache
  • Forgetfulness or memory loss
  • Confusion
  • Trouble sleeping (insomnia)

Less often, atorvastatin may cause more serious side effects. Call your healthcare provider or seek immediate medical attention if you experience any of the following (UpToDate, n.d.).

  • Muscle disease (myopathy) or rhabdomyolysis
  • Liver problems
  • Chest pain
  • Fever
  • Extreme tiredness
  • Swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
  • Severe skin rash (including erythema multiforme and Stevens-Johnson syndrome)
  • Anaphylaxis (severe allergic reaction with swelling and difficulty breathing)
  • Unusual bleeding or bruising

Atorvastatin can cause elevations in liver blood test levels, specifically in serum transaminases. Your provider may run baseline blood tests before starting atorvastatin (McIver, 2020). People with active liver disease should not take atorvastatin.

Seek medical advice right away if you have any symptoms of liver damage or failing liver function, like fatigue and weakness, loss of appetite, stomach pain, yellowing of your skin or the whites of your eyes, or dark urine. Another severe but rare side effect is rhabdomyolysis—muscle breakdown that can lead to kidney disease and even death. If you have muscle aches (which are not uncommon by themselves) and also have a fever, extreme tiredness, or dark-colored urine, this might be a sign of rhabdomyolysis. Get medical attention immediately.

Lastly, do not use atorvastatin if you are pregnant, trying to become pregnant, or breastfeeding because of the risk of adverse effects.

In summary, statins like atorvastatin are very effective at treating high cholesterol and lowering your risk of heart disease, especially when used along with lifestyle changes. Talk to your healthcare provider about the risk and benefits to see if atorvastatin is right for you. 

  1. American Heart Association (AHA). (2017). Prevention and treatment of high cholesterol (hyperlipidemia). Retrieved on Oct. 8, 2020 from https://www.heart.org/en/health-topics/cholesterol/prevention-and-treatment-of-high-cholesterol-hyperlipidemia
  2. Hill, M. F. & Bordoni, B. (2020). Hyperlipidemia. StatPearls. Retrieved on Oct. 8, 2020 from https://www.ncbi.nlm.nih.gov/books/NBK559182/
  3. Jackevicius, C. A., Tu, J. V., Krumholz, H. M., Austin, P. C., Ross, J. S., Stukel, T. A., et al. (2016). Comparative effectiveness of generic atorvastatin and lipitor® in patients hospitalized with an acute coronary syndrome. Journal of the American Heart Association, 5(4): e003350. doi: 10.1161/JAHA.116.003350. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4859299/
  4. Khera, A.V., Emdin, C.A., Drake, I., Natarjan, P., & Bick, A.G. (2016). Genetic risk, Adherence to a healthy lifestyle, and coronary disease. New England Journal of Medicine, 375: 2349-2358. doi: 10.1056/NEJMoa1605086. Retreived from https://www.nejm.org/doi/full/10.1056/nejmoa1605086
  5. Loch, A., Bewersdorf, J. P., Kofink, D., Ismail, D., Abidin, I. Z., & Veriah, R. S. (2017). Generic atorvastatin is as effective as the brand-name drug (LIPITOR®) in lowering cholesterol levels: a cross-sectional retrospective cohort study. BMC Research Notes, 10(1), 291. doi: 10.1186/s13104-017-2617-6. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5514478/
  6. McIver, L. A. & Siddique, M. S. (2020). Atorvastatin. StatPearls. Retrieved Retrieved on Oct. 8, 2020 from https://www.ncbi.nlm.nih.gov/books/NBK430779/
  7. UpToDate. (n.d.). Atorvastatin: Drug Information. Retrieved on Oct. 8, 2020 from https://www.uptodate.com/contents/atorvastatin-drug-information
  8. U.S. Department of Health and Human Services (HHS). (2005). Your guide to lowering your cholesterol with TLC. Retrieved on Oct. 8, 2020 from https://www.nhlbi.nih.gov/files/docs/public/heart/chol_tlc.pdf
  9. U.S Food and Drug Administration (FDA). (2018). Generic drugs: questions & answers. Retrieved on Oct. 8, 2020 from https://www.fda.gov/drugs/questions-answers/generic-drugs-questions-answers#q2
  10. U.S Food and Drug Administration (FDA). (May 2017). LIPITOR (atorvastatin calcium) tablets, for oral use. Retrieved on Oct. 8, 2020 from https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020702s067s069lbl.pdf

Dr. Chimene Richa is a board-certified Ophthalmologist and Senior Medical Writer/Reviewer at Ro.

Lipitor vs. Generic Lipitor: Should I Switch?

  1. What are statins, and how do they work?
  2. What is generic Lipitor?
  3. Reasons for switching from Lipitor to generic Lipitor

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

When we think of generic drugs, it’s easy to think of them as designer knock-off handbags: they do enough to pass for the original—unless you look too close. But that’s a fallacy when it comes to prescription medications. Instead, it’s more accurate to think of a designer handbag with the tag ripped out. You can’t charge for the well-known brand name anymore, but it’s still the same quality, the same design, the same, well, everything that truly matters.

Many of us need to get familiar with these generic medications, even though they’re not household names. Between 2003 and 2012, the percentage of Americans over the age of 40 taking cholesterol-lowering medication increased from 20% to 28%, according to the U.S. Centers for Disease Control and Prevention (CDC). Of those people, a considerable 93% were on a statin, such as Lipitor (CDC, 2015). So if you’re considering generic Lipitor, here’s what you need to know about how it compares to the brand-name.

Statins, also known as HMG-CoA reductase inhibitors, are a class of medications that aim to reduce elevated cholesterol levels in people with a high risk of developing cardiovascular disease (also called heart disease), a group of conditions that can cause heart attack, chest pain, and stroke. High cholesterol is one of the six primary risk factors for developing CVD (Texas Heart Institute, 2020). Statin medications lower the low-density lipoprotein (LDL) cholesterol by blocking HMG-CoA reductase, an enzyme that controls the rate at which cholesterol is made by the body. This class of medications includes:

  • atorvastatin (Lipitor)
  • fluvastatin (Lescol, Lescol XL)
  • lovastatin (Altoprev, Mevacor)
  • pitavastatin (Livalo)
  • pravastatin (Pravachol)
  • rosuvastatin (Crestor)
  • simvastatin (Zocor)

But there are two types of statins: those marketed as single-ingredient products, like those listed above, and those that are combined with other medications to help further reduce cholesterol levels. These combined medications include (FDA, 2014):

  • Advicor (lovastatin/niacin extended-release)
  • Simcor (simvastatin/niacin extended-release)
  • Vytorin (simvastatin/ezetimibe)

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Some prescription medications are sold under both a brand name and their chemical name, also known as the generic version. When a company develops a drug, they get a patent on the active chemical component—but these patents can expire. As soon as a patent expires, a generic form of the medication can be approved by the U.S. Food and Drug Administration (FDA) for sale. That’s what happened with Lipitor. Generic Lipitor is governed by the same rules the FDA has for all generic drugs: it has to have the same active ingredient as Lipitor (in this case atorvastatin calcium), as well as the same strength, dosage form, and route of administration (in this case, a pill taken by mouth). Whoever makes the generic version of a drug has to prove to the FDA prior to approval that it’s the same as the brand-name drug (FDA, 2018).

Simply put, brand-name Lipitor and generic atorvastatin are the same medication, and, because of that, each is just as safe and effective as the other. Lipitor is made by Pfizer and generic Lipitor, which was first available in November 2011, is made by many different companies.

The efficacy of generic drugs has also been tested in studies. There was no difference in health or outcomes between patients on Lipitor and those taking generic atorvastatin in one study that looked at people who had been hospitalized for heart attacks (Jackevicius, 2016). A 2017 study compared Lipitor to generic drugs with the same formulation in patients with hyperlipidemia and found the same to be true. Generic atorvastatin was just as effective as Lipitor at lowering triglycerides, total cholesterol, and LDL cholesterol (Loch, 2017).

It should be noted, though, that generic drugs come with the same potential side effects as their brand-name counterparts. For generic Lipitor, that includes rhabdomyolysis/muscle problems, liver damage, increased blood sugar, digestive upset, joint pain or muscle pain, tiredness, neurological effects, and memory loss.

People generally switch between these statin drugs for two reasons: the price difference or their health insurance coverage. Generic drugs are generally cheaper than prescription drugs. Health insurance may cover part of your prescription cost, but the copay on a generic form of a drug is still generally lower than that of brand-name drugs.

There is also a chance that one drug or the other isn’t covered by your specific health insurance plan. Review the prescription medication information from your health insurance provider if you have specific questions about what is covered. If you are interested in switching drugs for the treatment of your high cholesterol, it’s best to discuss your options with your healthcare provider.

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The biggest factors your healthcare provider may consider when discussing a switch from a brand-name statin drug to its generic version is how well that chemical compound is working for you and whether you’re experiencing side effects. It’s possible that your prescribing physician may want to switch you from Lipitor to another generic statin drug, rather than atorvastatin. Your healthcare provider may perform a blood test to evaluate your cholesterol levels and decide if you should switch to generic Lipitor or should try a different statin drug.

It’s also important to keep in mind that since it’s the same chemical compound, generic Lipitor will have the same potential drug interactions as the brand-name version. Just like with Lipitor, drinking alcohol with generic atorvastatin is generally safe if done moderately, though people with liver conditions such as liver disease should avoid alcohol when taking statins. If you have any questions about your individual health and making the switch from brand-name to generic Lipitor, seek medical advice from a healthcare professional.

  1. Centers for Disease Control and Prevention (CDC). (2015, November 06). Products – Data Briefs – Number 177 – December 2014. Retrieved July 29, 2020 from https://www. cdc.gov/nchs/products/databriefs/db177.htm
  2. Food and Drug Administration (FDA). (2014, December 16). Statins. Retrieved July 31, 2020 from https://www.fda.gov/drugs/information-drug-class/statins
  3. Food and Drug Administration (FDA). (2018, June 01). Generic Drug Facts. Retrieved Aug. 9, 2020 from https://www.fda.gov/drugs/generic-drugs/generic-drug-facts 
  4. Jackevicius, C. A., Tu, J. V., Krumholz, H. M., Austin, P. C., Ross, J. S., Stukel, T. A., et al. (2016). Comparative Effectiveness of Generic Atorvastatin and Lipitor ® in Patients Hospitalized with an Acute Coronary Syndrome. Journal of the American Heart Association, 5(4). doi:10.1161/jaha.116.003350. Retrieved from https://www.ahajournals.org/doi/10.1161/JAHA.116.003350
  5. Loch, A., Bewersdorf, J. P., Kofink, D., Ismail, D., Abidin, I. Z., & Veriah, R. S. (2017). Generic atorvastatin is as effective as the brand-name drug (LIPITOR®) in lowering cholesterol levels: A cross-sectional retrospective cohort study. BMC Research Notes, 10(1), 291. doi:10.1186/s13104-017-2617-6. Retrieved from https://bmcresnotes.biomedcentral.com/articles/10.1186/s13104-017-2617-6
  6. Texas Heart Institute. (2020, February 03). Heart Information Center: Heart Disease Risk Factors. Retrieved Aug. 10, 2020 from https://www.texasheart.org/heart-health/heart-information-center/topics/heart-disease-risk-factors/ 

Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.

Lipitor: what is it – AMO Academy News