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A diagnosis of high cholesterol can be intimidating, but there is a lot you can do to control this condition. In addition to modifying your diet and upping your exercise, the addition of a HMG-CoA Reductase Inhibitor — a class of drugs commonly called “statins” — can safely and effectively lower your cholesterol. (HMG-CoA Reductase helps our liver produce cholesterol; when the chemical is inhibited, the amount of cholesterol is correspondingly reduced.) For people with heart disease, statins can lower the risk of a cardiac event and subsequent death. If you and your doctor have determined that you need a statin, how can you pick the right statin for your needs?
There are six statins on the market: atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin, and simvastatin. They differ in their ability to reduce cholesterol, and they also differ in their rates of reducing heart attacks. Their costs are also quite different — and since most people take statins for a long time, the costs add up over the years. With all of these variables, choosing the right statin for you can be complex.
All statins are capable of lowering LDL (“bad”) cholesterol and triglycerides, and raising HDL (“good”) cholesterol. The statins do differ in how effectively they can do this, and it is highly dose-dependent. Says Drug Digest:
If the needed LDL-C reduction is up to 35-36%, any of the statins should be acceptable choices for therapy. For a desired reduction of LDL-C greater than 42%, simvastatin (Zocor), atorvastatin (Lipitor), or rosuvastatin (Crestor) would be needed.
Indeed, the best-known statins are Crestor, Lipitor, and Zocor (quite probably because they have the greatest effect on cholesterol levels). The latter two are also endorsed by Consumer Reports. Taking evidence for effectiveness, safety, and cost into account, the publication rated both of these statins as “Consumer Reports Best Buy Drugs.” They recommend:
• Generic simvastatin (20mg or 40 mg) — if you need 30% or greater LDL reduction and/or have heart disease or diabetes, or if you have had a heart attack or have acute coronary syndrome and your LDL level is not highly elevated.
• Atorvastatin (Lipitor) (40mg or 80mg) — if you have had a heart attack or have acute coronary syndrome and your LDL is highly elevated; use for two years and then reconfirm need or switch to generic simvastatin.
Charts on Drug Digest have some great comparisons. For instance, they show that Lipitor (10-80 mg.) can reduce total cholesterol by 25-45%, while Zocor (5-80 mg.) can reduce the same numbers by 19-36%, and Crestor (5-40 mg.) can reduce it by 33-46%. As for lowering HDL, Lipitor can offer reduction of 5-9%, Zocor lessens HDL by 8-16%, and Crestor lowers these numbers by 8-14%. As you can see, choosing the proper statin has a lot to do with which numbers (Total Cholesterol, HDL, LDL, or triglycerides) you are trying to effect.
A final consideration is that last year there was reporting on an observational study done by Pfizer that suggested that there were certain benefits to using Lipitor over Crestor. However, one must keep in mind that Pfizer conducted the study, and they are the manufacturer of Lipitor, and they are defending this drug against Merck’s Zocor product, which is now available in a generic formula. Here is the information as presented by The Wall Street Journal:
An analysis, published in the latest Clinical Therapeutics Journal, mined a large database of health-care records and found that patients taking Lipitor had a 12% lower risk of a cardiovascular event than those on simvastatin, the generic name for Zocor. The patients on Lipitor had a 15% lower risk of having a heart attack.
So-called observational studies like this one that look at data after the fact aren’t as powerful as prospective clinical trials. Jack Tu, a cardiologist who specializes in outcomes research at Canada’s Institute for Clinical Evaluative Sciences, says the latest Pfizer study didn’t take into account factors that could predispose a patient to heart problems, such as smoking and cholesterol levels. “Just on this alone, you wouldn’t recommend that everyone should switch onto Lipitor,” he says.
Still, Pfizer hopes that doctors will take notice. “We’ve done two rather large observational studies and patients have a lower risk of cardiovascular events on Lipitor [compared with] simvastatin,” says Susan Shiff, Pfizer’s team leader for cardiovascular outcomes. “Doctors need to factor this into discussions with patients.”
You should definitely discuss with your physician which statin is right for you. In general, the best plan is to take the LOWEST dose of a statin that gets you to your target level for cholesterol. Overly large doses can be harmful to your liver and to your muscles. If you experience muscle aches and pains when taking a statin, contact your doctor immediately.
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I was taking 10 mg Lipitor for about 5 years. Now my doctor has switched me to 10 mg Crestor. With both medicine, my lipid profile is almost good and same. I am only worried about the new research indicating that using statin rapidly increasing chances of getting diabetes. Any comments /suggestions
Several years ago my Dr. put me on Lipitor.I developed a sever lower back pain that made it very dificult getting into my car.My wife by chance mentioned to her girlfriend about my pain. She asked if I was on Lipitor. She suggested it may be the problem.I stopped taken Lipitor on my own and after a week my pain was gone.Told my Dr. and he put me on Crestor.Have not had a problem since.That was several years ago.
I'm on 40 mg crestor with no problems with 100 mg of coQ-10 in 3 divided doses. you can get a coupon for $50 off a month at http://www.crestor.com/c/crestor-patients/crestor-savings/index.aspx?sc=3
costco in canada 10mg crestor brand name.. 30 tabs 48.44 Check at Sams or Costco, you do not need a card for prescriptions.
I recently switch from Simvastatin to Crestor, and now I'm having some ED problems. Has anyone had this problem with this pill? I mean, the erection is good but it won't last that long like it used to. Should I blame Crestor for it?
I have aways heard that stopping suddenly taking statins is not good. Why is this never mentioned anymore?
9 months ago I switched from Lipitor 40mg to Simvastatin 80 mg. I now have a lot of muscil sorness I never had in the past. In July this year I tore my Bicepts and Rotator in my right arm with a weight that was much lower then I had used in the past. Could the cahnge in medicine be the cause of the damagge. I am still not back to work and probably won't go until Jan 2012.
Recently ive seen two commercials pulled from T.V.for co-q-10 witch said needed if statin's are taken.Do your own reserch.The only one you can trust is your self.When monitory gain is the motive,wake up before, I have nothing to gain,so why lie,what dose celestriol catch on to,common sence is your best defence
my doctor prescribed me today 10 mg. Simvastatin and continue 4,000 mg/day OTC fish oil..is this enough for: Cholesterol (total)236, Triglycerides 279, HDL 37, VLDL 56 and LDL 143..Thanks..
In about four year'most people notice muscle atrophy,statin'e are co-q-10 depletors and are needed,for heart function.There on t.v.now,do research.The medical feild is a business.do your own reserch,it was never chelestrol, read
crestor and lipitor MAY have triggered a cardiac arrythmia in my case. Zocor has not.
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I am on Lititor 20mg and Crestor 80mg. Is this too much meds ?
My doc changed me from Lipitor to Zocor (cost issue) and then to Crestor. After a few months, I developed slight skin peeling, which creates lesions. They appear almost everywhere, except, thank heavens, not my face. Any ideas? Has anyone else developed skin conditions? tks.
Excellent advice, Dan. And you're absoulutely correct, - it all depends on your insurance company! In a country that gives $500 billion tax cuts to the richest 2% of the population, we can't seem to pony up those pharm rep cards for those with too much plaque in their veins!
Fullcanadian
@Michael Edwards It's so sad that u r in the U.S.A here in Canada if u can't pay for it the Doctor well give it to u for free and there many places in Canada where u don't have to pay for any meds at all for the rest of your life and you can have a good job and you still don't have to pay for your meds.
@Merril (41) Merril, you get the card from your doctor if he has one. I think these cards come from the pharm rep that comes to see the doctor. When I was on Crestor the card that my doctor gave me limited the cost to $25 per month (30 day supply). The catch is that it is only good for 12 refills. I just pulled my Crestor card out of my wallet (haven't thrown it out yet) and the insurance it runs through is "OPUS Health". I am now on Simcor (Zorcor and Niacin) and the card he gave me for that limits the cost to $5 per month...yeah $5. Same 12 month deal. These cards are really secondary insurance cards so how cheap it is depends on how good your primary carrier is. Since your primary won't pay for Crestor your cost probably will be greater (if they accept the card at all). Hope this helps.
Ck out what MJ said: "You need to have your doctor submit an authorization/exception request and you should not have been denied a 30 day temporary fill during the transition while getting the necessary authorizations from your doctor. .... Contact the Centers for Medicare Advocacy (860) 456-7790."
Who is your insurance company? Why did they accept 10% and refuse 5%? Appeal your decision and see what happens. Google consumer advocacy group for drug coverage. Write your representatives. Fight health insurance Companies - They pulled out $12 billion just in profits. Your Dr should be able to overule your healthcare provider.
40-38 ? how many mamal's drink milk dairy for calcium into adulthood. Im telling you some thing.think read "ceolation"
TO 38, if you must take, you must take at least 200 mg.co-q-10.im no dr.Ask your dr.very important lipitor is a co-q 10 depletor, do it,take care
How do you get a card from the company to be able to get Crestor for $65 instead of $144. My insurance just informed me today that they won't pay for my Crestor.
My husband has been on Crestor (5 mg) for about 6 months. He doesn't seem to have any problems with it so I hesitate to change to Lipitor or Zocor. Crestor will not go generic for several years. IT IS VERY EXPENSIVE. The price for 30 pills is $144.00 but with a card from the company it is offered for $65.00. I feel that this is still very xpensive for seniors. We have no Medicare advantage.
I have been on Crestor 20 mg for years and have not had any problems. My Mom is on Lipitor and Im noticing shes getting weaker, cant walk very long and has to sit down. I hear Lipitor causes muscle aches. Im going to ask her doctor about changing it to Crestor etc..
Humana charges $41 for a 30-day supply of Crestor (10MG) and $6 for Lovastatin or Pravastatin Sodium or Simvastatin. I formerly was prescribed Lipitor which caused muscle weakness. Suggestions?
I have been on Lipitor, Crestor and Zocor, of course not at the same time. Out of the three Crestor seems to presently works the best. With smaller doses and larger reduction in Bad Cholesterol, I have had challenges with insurance companies with all three. But now using Crestor and paying a much larger copay. I do not like to pay so much for any medication but at least its covered in part. Somewhere approximately a third of the cost is copay. I have had no side effects of any kind with Crestor and considering the options. God Bless America.
Has anyone had headaches or sleep problems while on Crestor? Does this resolve over time?
Michael L. - I guess there are some that professed "change" and "health care reform" and that hasn't happened. If you think hard about this insurance companies control your life and money - health, home, auto, life and probably a few more.
rhetoric
MJ - I don't feel the public understands the issue of healthcare insurance reform. And they won't until the lamestream media outlines the abuse. With a med pay ratio of .80 cents and an expanded customer base in 3 years, they will suck even more money out of this economy. Unfortunately, the Roberts court has opened the gates to fund an unlimited amount of anti-reform retoric. We are totally boned unless the public wakes up.
Cheryl - You indicated you're a heart patient. If you've had a heart attack, 40mg might be justified. However, as MJ suggested, I wouldn't delay seeing an internist if your doc won't listen. 20mg is the standard max dosage unless your cardiologist feels you need aggressive treatment because of your history. If you're losing weight & have no appetite, u really need to find a cause.
Michael L. you are so right, but the problem is people are sitting back and taking all this abuse from insurance companies and Big Pharma. We need more advocates to educate the people.
When my husband's cardiologist started him on Crestor he started with 10 mg. I would be very careful if you are not feeling well after starting that medication or any medication. Talk to your doctor and if the Cardiologist won't listen, talk to an internist.
I am a heart patient. My doctor recently does me with Crestor at 40 mg. daily. I just read that 10 mgs is a high dose. Am have been sick with no appetite for several weeks since starting this drug. Am I being over prescribed Crestor?
So the insurance companies know best? So much for the GOP argument re the government getting in between you and your doctor. We have to pay for their advertising, admin, marketing, profits and payments to bondholders. Remind me again why single payer is not even considered in our healthcare insurance reform debate? Because Baucus took almost 2 mil from Health & Pharma insurance cos. UnitedHealthcare did the same thing to me. Required me to switch off of Lipitor (which I'd taken since the early 1990's to Zocor (cheaper). So long as we keep health insurance companies around, we will get care on the same level as Costa Rica ($9K per capita). Health Care insurance companies took $12 billion in profits (JUST PROFITS) out of your healthcare payments because they have the power to decide who you see, your deductible, your copay's and your pharmaceutical coverage. When will the public wake up? This is where some wingnut will scream "Socialism." What a load of crap!
In taking ANY statin, the following supplements have good substantiation: the "Ubiquinol" (only) version of CoQ10 (100mgs), L-Carnitine, L-Carnosine, Alpha-Lipoic-Acid, Acetyl- L-Cysteine, D-Ribose: Cramps will likely abate, and risk of C-HeartFailure is mini-mized.
you said to split the crestor 10mg in half. How do you split a pill with no line? Thank youmartha
You could do 2 things. Purchase the crestor in generic form in Canada it's about $33 per month or have your dr. write a prescription for 10 mg and split the pill.
I take Crestor 5mg,mynumbers are good.the problem is the cost of this drug. Is there an other drug I can take that will be less, not Lipitor I got muscle pains when using Lipitor thank you
Let me confirm what one person already said regarding Niaspan. I am also taking 80mg of Lipitor--a fantastic statin, but it did nothing for my HDL which was at 40. After taking Niaspan (750 mg) my HDl jumped to 54--a 14 point rise. I do have a little muscle pain, but it is not so bad that I would put my life at risk by ending the Lipitor-niaspan combination. I walk a vigorous 3 miles a day, 6 days a week. I had a bypass 10 years ago, and at age 77 I'm in excellent health. I weigh 164 and rarely eat more than 1000 calories a day. I know a lot of pot belly guys in their 60's that look older than I do, and can't keep up with me when we walk.
I have been on statins for 12 years, most recently lipitor. i couldn't even walk my dog without serious back pain. threw the lipitor away and now i am jogging (slowly and not too far) for the first itme in 40 years. but doc put me on crestor, so we shall see. I can't stand the mental misery of statins but i must live with them somehow.
I have been on 20 mg of Lipitor daily for 3 years and my numbers have improved dramatically. However, I have muscle pains in my legs and my knees have acted up for no apparent reasons, achy & stiff. Any thoughts or suggestions?? Also, can you take 40 mg every other day vs 20 mg every day ?? Prescription price for 100 pills is same...odd ?1?
Which statin to take? The answer is very simple: Crestor. Rosuvastatin (Crestor) is the only statin that can reverse plaques in the arteries. In the highest dose Lipitor can stop the growth of the plaque and the rest can slow the growth. Notice the difference between "reverse", "stop" and "slow down". Slowing means the plaque is still growing, stop means its still there in the same size as before - and reversing means the plaque morphologically changes, decreasing in its size. Do the thinking, which should be the goal? What I am saying is proven by evidence based medical studies.
1. aerobic exercise at least 1/2 hr. every day 2. increase mono and polyunsaturated fats 3. eliminate transfats totally and saturated fats as much as possible 4. lots of veggies and fruits 5. forget sugar and simple carbs--they're artery killers. 6. Lots of fish and chicken. Fried is fine if you fry in Canola oil. 7. Take about 14,000 mg of fish oil daily--yep--that's what it takes. 8. Simvastatin 80mg/day. I found out I have a calcium score of 1600, no blockage YET. What? you don't know your calcium score?! Get a 256 slice fast CT scan--1/4 th the radiation of a 64 slice machine and much higher resolution. Sure it's expensive, but only way to find out what's going on in there noninvasively and conclusively. Results: My total cholesterol is now 110, LDL is 37, HDL 40, triglycerides 110. Don't play games if you have atherosclerosis. You NEED to attack this aggressively! Get a Preventive Cardiologist who knows what he/she is doing. I wish I had found one when I was 40 rather than 64!
Rose: There is some evidence for increases in hemoglobin a1c (long term measure of blood glucose) with statin use but it looks to be around 0-10%. If you were borderline diabetic it could push you over, however, exercise and dietary changes that should be implemented with statin use should counter this change. See: http://www.ncbi.nlm.nih.gov/pubmed/20147603
Does anyone know if Crestor, Lipitor, or Zocor can cause Diabetes?
This is for Michael Edwards. I just went through something similar for my husband with another medication and another Part D Provider. You need to have your doctor submit an authorization/exception request and you should not have been denied a 30 day temporary fill during the transition while getting the necessary authorizations from your doctor. Also notice how the Part D providers make statements that changes to medications can happen at any time. Contact the Centers for Medicare Advocacy (860) 456-7790. The Part D law for people renewing Part D plans is crazy and makes no sense. Hope this helps
I take 80 mg of Lipitor. It's a great statin, but it didn't do much for my HDL whih stayed at 40. Then my doctor added Niaspan to my regimin, and my HDL shot up to a very comforting 58. Niaspan is a prfescription drug with all of the benefits of regualr niacin, but without the flushing. Niaspan is a great drug for raising HDL. Ask your doctor about it. Trust me on this-- an 18 point rise in HDL--fantastic. My Lipitor does keeps my overall cholesterol at 119 and my LDL at 67. Niaspan and Lipitor work great together for me. combination
I had a no fasting reading of 213 Triglycerides in Oct while on 60 mg's Lipitor (181 total Cholesterol, 56 HDL, & 93 LDL) I can't imagine what my Triglycerides will be on Simvastatin. Anybody know how I can get justify getting back on Lipitor? I don't like being a lab rat for AARP's United Healthcare.
Translator
SINCE WE AGREE THERE ALL STATIN'S,THE QUESTION SHOULD BE IS IT A GUN, A KNIFE ,OR HANGING BEST WAY TO DIE .IN THE END THE RESULT IS ALL THE SAME.THEY ARE ALL CO-Q-10 DEPLETORS,AND YOU ALL KNOW WHAT THAT DOSE
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