Lipid Disorder Education Program

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Comparing the Statins

I. Differences Between Drugs

 

Lovastatin (Mevacor)

Pravastatin (Pravachol)

Simvastatin (Zocor)

Fluvastatin (Lescol)

Atorvastatin (Lipitor)

Standard Starting Dose (mg)

20

20

20

20

10

Maximum Dose (mg)

80

40

80

80

80

LDL Reduction at Maximum Dose (mg)

40%

34%

47%

34%

60%

Price* (Relative to lovastatin)

1.0

0.9

1.6

0.5

0.8

*Starting dose (Subject to almost daily fluctuations!)

II. Similarities between drugs

  1. Adverse effect profile
  2. Potential to interact with other medications (fibrates, niacin and cyclosporine)
  3. Effect on triglycerides and HDL cholesterol levels.

III. Take-Home Message

  1. Atorvastatin is the most effective LDL lowering agent. (Cerivastatin on a per mg basis)
  2. Fluvastatin is the least potent LDL cholesterol lowering agent.
  3. Fluvastatin is currently the least expensive statin.

IV. The Bottom Line (as of November, 1998)

  1. For severe LDL cholesterol elevations, particularly in patients with cardiovascular disease: Consider atorvastatin
  2. For mild LDL cholesterol elevations, particularly where drug costs are an issue: Consider fluvastatin or cerivastatin.

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