Lipitor vs. Pravachol
See how Lipitor and Pravachol compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Lipitor is a higher-intensity statin that lowers LDL cholesterol more per milligram than Pravachol, which is a lower-to-moderate-intensity option.
Pravachol is not broken down by the liver's CYP3A4 enzyme, so it interacts with fewer other medications than Lipitor, a plus for patients on multiple drugs.
Both are taken once daily as a tablet, but generic pravastatin typically costs far less out of pocket each month than brand-name Lipitor.
Lipitor vs. Pravachol Drug Summary
Lipitor
Lipitor (atorvastatin) is a statin that blocks a liver enzyme involved in making cholesterol, lowering LDL and triglycerides while modestly raising HDL. It comes as a once-daily oral tablet, dosed from 10 mg to 80 mg depending on how much LDL lowering a patient needs.
Pravachol
Pravachol (pravastatin) is also a statin that blocks the same liver enzyme to lower LDL and triglycerides, though it produces smaller reductions per milligram than Lipitor. It comes as a once-daily oral tablet, usually starting at 40 mg and increasing to 80 mg if needed.
Lipitor vs. Pravachol Side Effects
Lipitor
Pravachol
Lipitor vs. Pravachol Dosage
Lipitor
Pravachol
| 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 |
| STAGE | DOSE | WHEN |
| Starting dose | 40 mg once daily | At the start |
| Maximum dose | 80 mg once daily | If needed |
| Dose changes | 1 increase | As tolerated |
Lipitor
| 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 |
Pravachol
| STAGE | DOSE | WHEN |
| Starting dose | 40 mg once daily | At the start |
| Maximum dose | 80 mg once daily | If needed |
| Dose changes | 1 increase | As tolerated |
Lipitor vs. Pravachol Indications
Lipitor
Lipitor is prescribed to lower LDL cholesterol and triglycerides in adults and children 10 and older, and to reduce the risk of heart attack, stroke, and certain heart procedures in people with cardiovascular risk factors. It's also approved for adults with type 2 diabetes who have added risk factors, and for both forms of familial hypercholesterolemia.
Lowering LDL cholesterol and triglycerides in adults and children 10+
Reducing heart attack, stroke, and heart surgery risk in adults with risk factors
Reducing heart attack and stroke risk in adults with type 2 diabetes
Treating heterozygous familial hypercholesterolemia in adolescents
Pravachol
Pravachol is prescribed to lower LDL cholesterol and triglycerides in adults with primary hyperlipidemia, and to reduce the risk of heart attack, stroke, and revascularization procedures in adults with or without existing heart disease. It's also approved to treat heterozygous familial hypercholesterolemia in children ages 8 to 18.
Lowering LDL cholesterol and triglycerides in adults with hyperlipidemia
Reducing heart attack, stroke, and revascularization risk in adults
Reducing elevated triglyceride levels in adults with hypertriglyceridemia
Treating heterozygous familial hypercholesterolemia in children 8 to 18
Lipitor vs. Pravachol Pros and Cons
Lipitor
Lipitor is a high-intensity statin, meaning it lowers LDL cholesterol more per milligram than Pravachol at comparable doses. It carries the same core statin risks as other drugs in its class, but its wider list of FDA-approved uses gives doctors more flexibility for higher-risk patients.
Pros
Higher-intensity LDL lowering, often reaching bigger reductions at equivalent doses
Broadest FDA-approved indication list among common statins, including homozygous FH
Long real-world track record as the most-prescribed statin in history
Cons
Metabolized through CYP3A4, so more prone to interactions with certain antibiotics and antifungals
Brand-name list price runs far higher than generic pravastatin, though Lipitor's own generic is cheap
Higher-intensity dosing can carry a somewhat greater relative risk of muscle-related side effects
Pravachol
Pravachol is a lower-to-moderate-intensity statin, so it lowers LDL cholesterol less per milligram than Lipitor. Because it isn't broken down by the liver's CYP3A4 enzyme, it interacts with fewer other medications, which can matter for patients taking multiple drugs.
Pros
Not metabolized by CYP3A4, so it interacts with fewer common medications
Backed by long-term outcome trials such as WOSCOPS, CARE, and LIPID
Generic pravastatin has a much lower cash list price than brand-name Lipitor
Cons
Lower-intensity LDL lowering per milligram, may not reach goal for patients needing large reductions
Narrower FDA-approved indication list, not approved for homozygous familial hypercholesterolemia
Maximum approved dose of 80 mg may be insufficient for some very high-risk patients
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