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Millions of patients in the U.S. use cholesterol lowering drugs like Lipitor (made by Pfizer) or Zocor (made by Merck) in an effort to lower heart disease risk. Last year, the patent protection for Zocor expired and the generic form of it called simvastatin was put on the market. Since generic simvastatin became available, health insurers have been pressuring doctors and patients to switch from brand name cholesterol lowering drugs like Lipitor to this similar and much cheaper generic form of Zocor.
Price is the main reason people are switching to the generic simvastatin. Currently it costs about $2 per day for Lipitor, but with the generic brand it is closer to 35 cents or less. Switching over could save billions of dollars in health care costs.
Both Lipitor and Zocor are from a drug class called statins. Statins work by inhibiting the enzyme that produces cholesterol. Other cholesterol-lowering drugs from this class include Crestor (rosuvastatin), Pravachol (pravastatin), Lescol (fluvastatin), and Mevacor (lovastatin).
Compared to Lipitor, Zocor (simvastatin) is less potent. Therefore, if you were taking 10 mg of Lipitor, you would have to take 20 mg of the generic Zocor. Currently, the highest dose you can get of Zocor is 80 mg (equal to 40 mg of Lipitor). This means that if you are presently taking more than 40 mg of Lipitor you will not be able to get a strong enough dose. For most people this shouldn’t be a problem.
By law, the generic version of Zocor is required to contain the same active ingredients as the brand name. They also have to the same dosage, potency, quality, function, and approval from the FDA.
Both Lipitor and Zocor share similar side effects because they are from the same statin drug class. Not all of the side effects are known; some patients experience headache, muscle pain and weakness, muscle tissue breakdown (rhabdomyolysis), memory loss, postoperative delirium, and others. (For more side effects check out: Five Biggest Risk Factors in Taking Lipitor or Other Statins)
What do you think? Have you experienced any differences since switching to the generic form of Zocor? Please share your experiences!
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More and more evidence is pointing towards statin drugs causing muscle pain and even debilitating muscle problems.
There are generally three types of muscle trauma that people experience from statin medications, says Dr. William Shiel, a specialist in muscle and joint conditions. The first is muscle aching, which typically goes away within a couple weeks after stopping statin treatment. The second experience is muscle pain and mild muscle inflammation with or without a feeling of weakness. A blood test may reveal elevated levels of CPK enzymes which typically mean that the skeletal muscle is injured or under stress. This can take up to a few months to heal. The third condition (rhabdomyolysis) is most serious involving severe muscle inflammation, weakness, and the breakdown of muscle. Patients experience muscle damage and pain throughout their entire body. Elevated CPK enzymes can also accumulate and damage the kidney.
Jill Slade, assistant professor of radiology and osteopathic manipulative medicine at MSU, believes that the muscle damage caused by statin drugs is underestimated. Her current study is following 50 patients on statin medications to track their muscle integrity through magnetic resonance imaging. “While statins have tremendously helped millions of Americans lower their cholesterol and improve their cardiac health, we need to be confident we are not causing other problems in the body,” Slade said. “Statins work by preventing cholesterol from forming. While this is a good thing inside structures such as liver cells, it can be problematic in places such as muscle cells.”
A recent study at the University of Alabama supports this. It shows that statins may prevent skeletal muscle from repairing and regenerating normally due to the anti-proliferative effects of the drug. The researchers also agree that the current 7 percent of patients reporting skeletal muscle problems may not be accurate. Dr. Anna Thalacker-Mercer said, “It is possible that older adults may not be able to distinguish between muscle pain related to a statin effect or an effect of aging and therefore adverse effects of statins in older adults may be under-reported.”
Dr. Shiel stated that it is important for patients and doctors to be extra aware of this potential side effect because it is easier to treat the sooner it is found. “When discovered late, it can lead to serious injury—not only to the muscles but also potentially to the kidneys and heart.” In 2001 the FDA pulled one statin drug, Baycol, off the market because it was shown to be the cause of 31 deaths from muscle tissue breakdown (rhabdomyolysis). From Dr. Shiel’s experience, “Of all causes [of muscle pain] statin drugs are what I see as the most common culprits.”
What do you think? Have you experienced any muscle pain after taking statin drugs like Lipitor? Please leave a comment about any side effects or experiences you have had with this drug!
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A new study reported in the New England Journal of Medicine shows that taking statin drugs like Crestor or Lipitor may prevent heart disease even if you don’t have high cholesterol levels.
The study looked to test whether statins could prevent heart disease in patients with normal cholesterol levels but high C-reactive protein (CRP) levels. C-reactive protein is a biomarker used to measure the levels of inflammation, which is thought to play a role in half of all cardiac events. Inflammation has a compound effect on the amount of LDL cholesterol absorbed by artery walls and can lead to further plaque buildup (See our article on The Role of Inflammation in Heart Attacks).
The clinical trial included 17,802 men and women from different parts the world with cholesterol levels less than 130 mg/dL and CRP levels above 2.0 mg/L. Participants were given 20 mg of rosuvastatin (Crestor) or a placebo.
After 2 years, the 5 year study was ended because the endpoints had been met. The results showed that statins lowered the risk of cardiac events by 44 percent. The statins were shown to lower LDL cholesterol by 50% and CRP levels by 37%. The total number of deaths was 20% less in participants taking statins compared to the placebo group.
The new findings could rework who is eligible for statins, potentially adding 10 million more Americans to the existing 36 million already taking a statin drug. Currently, only people with high LDL cholesterol levels are prescribed statins. This study may help validate CRP levels as an additional test to determine people at a higher risk for heart disease.
Do you think statins should be prescribed to people who don’t have high cholesterol levels? Please share your opinions and experiences with statin drugs!
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It’s typically thought that if you have good cholesterol levels you are safe from a heart attack. Yet, almost half of all cardiac events happen in people with normal cholesterol levels, indicating that something else is at play. Inflammation may be the cause, which is showing to play a significant role in atherosclerosis, the process where fat deposits build up along the inner lining of the artery.
Inflammation, caused by an increase in white blood cells, is the body’s natural immune response to infection, injury, or other harmful stimuli. When there are higher levels of LDL cholesterol in your bloodstream, your body reacts against it with this immune response. As blood flow increases, more LDL cholesterol can be absorbed in the artery walls causing even more inflammation. Thus, inflammation has a snowball effect, compounding the amount of LDL cholesterol absorbed into your cells. The more absorbed cholesterol, the more plaque you have. Eventually the plaque breaks apart and can cause a heart attack or stroke by clotting and blocking blood flow.
Determining your level of inflammation may help to predict your risk of a heart attack or stroke beyond just looking at your cholesterol levels. Inflammation levels can be found by measuring your blood for C-reactive protein (CRP), which is released by your body when inflammation occurs. Research shows that the higher your CRP levels, the higher your chance of experiencing a cardiac event. One study showed that people with higher CRP levels were twice as likely to have a heart attack as those who had lower levels.
Treatment for inflammation turns out to be similar to the treatment of high cholesterol. In addition to lowering cholesterol levels, statins have been shown to reduce CRP levels and inflammation. Still, lifestyle changes are typically recommended as the first line of defense, as statins have potential adverse effects. A healthy diet low in saturated fat, exercise, and quitting smoking and drinking are all things you can do to lower both CRP levels and LDL cholesterol.
Please share your thoughts and experiences! Have you or someone you know experienced side effects from taking Lipitor?
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Although it is typically thought that lifestyle change alone can’t lower LDL cholesterol levels as well as statins, there is mounting evidence that it may. Joseph Keenan, a cardiologist and professor at the University of Minnesota, prescribes Lipitor to his patients and was using it himself until he began to experience muscle spasm side-effects and blood tests which indicated muscle damage. For people like Keenan who can’t tolerate statins, a balanced diet, exercise and supplements may be the answer. Keenan managed to lower his LDL cholesterol by 60% without prescription drugs. After his personal success, Keenan believes that 70% of people who would be prescribed cholesterol drugs could get their cholesterol levels to a healthy balance solely through these lifestyle changes.
A balanced diet of vegetables, fruits, whole grains, fish, and legumes has shown to work well in lowering LDL cholesterol. Whole food diets work best compared to prepared foods that are low in cholesterol, says Christopher Gardner, a Stanford nutrition specialist. This is because the components of whole foods, such as plant sterols, interact differently with your body and are able to lower LDL cholesterol. Plant sterols work by displacing some of the cholesterol from intestinal micelles resulting in less cholesterol being absorbed into the bloodstream. Thus, plant sterols have shown to lower LDL levels by 10%. Plant sterols are present in small quantities in many fruits, vegetables, vegetable oils, nuts, seeds, cereals and legumes.
In addition to diet, exercise has a big effect on cholesterol levels; specifically aerobic exercise and HDL levels. A new research study from the Archives of Internal Medicine says that at least two hours per week of aerobic exercise like walking, biking, or swimming will provide an increase in HDL or “good” cholesterol levels. Workouts need to last at least 30 minutes to gain HDL benefit, and it is recommended to exercise at least five days per week. The study found that the “gains in HDL cholesterol levels translate to a 5% drop in men’s heart disease risk and more than a 7% drop in women’s heart disease risk.”
Already, 16 million patients take some form of the drug statin. As this patient base grows to include millions more people worldwide, another side of high cholesterol research is showing that simply diet, exercise, and supplements can be as effective as statins in lowering LDL cholesterol and potentially more effective in preventing cardiac events.
Have you been diagnosed with high cholesterol? Have you decreased your cholesterol levels? If so, by what means? Have you found that “natural” means like diet and exercise make you feel better overall, due to fewer side effects? Share your experiences!
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MikeMD wrote:
10. December 2008 at 11:01 pm :
Been taking lipitior for one year, after heart attack the day after thanksgiviing in 2007, saw side effects on internet in April or May stopped taking for about three weeks, talked to a man that had been taking lipitor for a while, and said dont believe everything you read. Bad information, started taking again, now around the middle of Nov, 08 started having pain in shoulders, while working strain or pulled inside muscle on left forearm, then a couple days later pain continued up on inside of left arm, then about three days later pain on forearm on right arm in up to shoulder. STUDIED side effects again, LIPITOR IS THE PROBLEM, NO DOUBT IN MY MIND. STOPPED WILL SEE MY DOCTOR ASAP
29. December 2008 at 9:02 pm :
I have unexplained muscle pain. I stopped taking Lipitor.