Lipitor vs. Praluent

See how Lipitor and Praluent compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Lipitor is a daily statin pill available as a low-cost generic since 2011, while Praluent is an injectable PCSK9 inhibitor with no generic option.

  • Praluent is typically added to statin therapy when LDL remains too high, or used to lower cardiovascular risk after a heart attack or in established heart disease.

  • Lipitor carries a small risk of muscle and liver-related side effects, while Praluent's most common side effects are injection site reactions and flu-like symptoms.

Lipitor vs. Praluent Drug Summary

Lipitor

Lipitor (atorvastatin) is a statin that lowers LDL cholesterol and triglycerides by blocking an enzyme the liver uses to make cholesterol. It's taken as a once-daily tablet, with doses ranging from 10 mg to 80 mg. It's approved for adults and children with high cholesterol, including inherited forms, and to reduce heart attack and stroke risk in people with cardiovascular risk factors.

Praluent

Praluent (alirocumab) is a PCSK9 inhibitor, an injectable monoclonal antibody that lowers LDL cholesterol by helping the liver clear more of it from the blood. It's self-injected under the skin every 2 or 4 weeks, usually alongside a statin. It's approved for adults with high cholesterol, familial hypercholesterolemia, and for reducing cardiovascular events in people with existing heart disease.

Lipitor vs. Praluent Side Effects

Lipitor

Most common
nasopharyngitis (up to 8.3%)
arthralgia (up to 6.9%)
diarrhea (up to 6.8%)
pain in extremity (up to 6.0%)

Praluent

Most common
nasopharyngitis (up to 11.3%)
injection site reactions (up to 7.2%)
influenza (up to 5.7%)
urinary tract infection (up to 4.8%)

Lipitor vs. Praluent Dosage

Lipitor

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 10 mg once daily At the start
Maximum dose 80 mg once daily If needed
Dose changes 3 increases As tolerated

Praluent

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 75 mg every 2 weeks At the start
Maximum dose 300 mg every 4 weeks If needed
Dose changes 2 increases As tolerated

Lipitor vs. Praluent Indications

Lipitor

Lipitor is FDA-approved to lower LDL cholesterol and triglycerides in adults and children 10 and older with dyslipidemia. It also reduces the risk of heart attack, stroke, and certain heart procedures in people with cardiovascular risk factors, including those with type 2 diabetes. It additionally treats both heterozygous and homozygous familial hypercholesterolemia.

  • Lowers LDL cholesterol and triglycerides in adults and children 10+

  • Reduces heart attack and stroke risk with cardiovascular risk factors

  • Reduces heart attack and stroke risk with type 2 diabetes

  • Treats heterozygous familial hypercholesterolemia in adolescents

Praluent

Praluent is FDA-approved to lower LDL cholesterol in adults with primary hyperlipidemia, usually added to a statin already at its highest tolerated dose. It also treats heterozygous familial hypercholesterolemia in adults and children 8 and older. In people with established heart disease, it reduces the risk of heart attack, stroke, and hospitalization for unstable angina.

  • Lowers LDL cholesterol as add-on to statin therapy

  • Treats heterozygous familial hypercholesterolemia in adults and kids 8+

  • Reduces heart attack and stroke risk in cardiovascular disease

  • Reduces hospitalization risk for unstable angina

Lipitor vs. Praluent Pros and Cons

Lipitor

Lipitor has decades of safety data and is available as an inexpensive generic tablet taken once daily. It carries a real, if small, risk of muscle and liver side effects that can require occasional monitoring.

Pros

  • Oral tablet, no injections needed

  • Available as a low-cost generic (atorvastatin) since 2011

  • Approved for homozygous familial hypercholesterolemia, unlike Praluent

  • Decades of long-term safety data since its 1996 approval

Cons

  • Small risk of muscle pain, myopathy, or rhabdomyolysis

  • Can raise liver enzymes; contraindicated in active liver disease

  • Interacts with several other medications through liver enzymes

  • May not lower LDL enough on its own for some high-risk patients

Praluent

Praluent offers a non-statin option for lowering LDL cholesterol, given by injection every two or four weeks instead of a daily pill. It has strong outcomes data in people with existing heart disease, but it comes with no generic alternative and a different side effect profile than statins.

Pros

  • Lowers LDL further when statins alone aren't enough

  • Only self-injected PCSK9 inhibitor with 2-week or monthly dosing

  • Reduces major cardiovascular events after acute coronary syndrome

  • Fewer drug-drug interactions since it isn't processed by liver enzymes

Cons

  • Requires injections instead of a daily pill

  • Injection site reactions are common

  • No generic or biosimilar version available in the US

  • Not approved for homozygous familial hypercholesterolemia or under age 8

Common Symptoms and Related Diseases You Can Explore

Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.