Lipitor vs. Repatha
See how Lipitor and Repatha compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Lipitor is a daily statin pill that lowers LDL cholesterol and has decades of safety data, while Repatha is an injectable antibody for people who need deeper LDL reduction or cannot tolerate statins.
Repatha typically lowers LDL cholesterol more than Lipitor and is usually added on top of statin therapy rather than used in place of it.
Lipitor costs far less than Repatha, which has no generic or biosimilar competition and requires an injection every two to four weeks.
Lipitor vs. Repatha Drug Summary
Lipitor
Lipitor (atorvastatin) is an HMG-CoA reductase inhibitor, or statin, that lowers LDL cholesterol and triglycerides while reducing the risk of heart attack and stroke. It is taken as a once-daily oral tablet and has been prescribed since 1996.
Repatha
Repatha (evolocumab) is a PCSK9 inhibitor, a human monoclonal antibody that lowers LDL cholesterol beyond what statins achieve alone. It is given as a subcutaneous injection every two weeks or once monthly, often alongside a statin like Lipitor.
Lipitor vs. Repatha Side Effects
Lipitor
Repatha
Lipitor vs. Repatha Dosage
Lipitor
Repatha
| 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 | 140 mg every 2 weeks | At the start |
| Maximum dose | 420 mg every 2 weeks | If needed |
| Dose changes | 2 increases | 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 |
Repatha
| STAGE | DOSE | WHEN |
| Starting dose | 140 mg every 2 weeks | At the start |
| Maximum dose | 420 mg every 2 weeks | If needed |
| Dose changes | 2 increases | As tolerated |
Lipitor vs. Repatha Indications
Lipitor
Lipitor is approved to lower LDL cholesterol and triglycerides in adults and children over 10 with dyslipidemia. It also reduces the risk of heart attack, stroke, and certain heart procedures in people with multiple cardiovascular risk factors, type 2 diabetes, or familial hypercholesterolemia.
Lowering LDL and triglycerides in adults and kids 10+
Reducing heart attack and stroke risk with CV risk factors
Reducing heart attack and stroke risk in type 2 diabetes
Treating heterozygous familial hypercholesterolemia in teens
Repatha
Repatha is approved to reduce the risk of heart attack, stroke, and certain heart procedures in adults with established cardiovascular disease. It is also used to lower LDL cholesterol in people with familial hypercholesterolemia, usually added on to a statin or other LDL-lowering therapy.
Reducing heart attack and stroke risk in known heart disease
Lowering LDL in heterozygous familial hypercholesterolemia
Lowering LDL in homozygous familial hypercholesterolemia
Approved for children 10+ with familial hypercholesterolemia
Lipitor vs. Repatha Pros and Cons
Lipitor
Lipitor has decades of safety data, a low cost as a generic, and works well for most people with high cholesterol. Its main risks are muscle-related side effects and drug interactions, and it may not lower LDL enough for people with severe familial hypercholesterolemia.
Pros
Oral tablet, no injections needed
Decades of real-world safety data since 1996
Available generically at low cost
Roughly $450 to $530 per month, well below Repatha
Cons
Risk of muscle pain and rare rhabdomyolysis at higher doses
May require liver enzyme monitoring in some patients
Interacts with many other medications, raising myopathy risk
Usually produces smaller LDL drops than PCSK9 inhibitors
Repatha
Repatha produces much larger LDL reductions than statins alone and has trial evidence for lowering heart attack and stroke risk. It costs significantly more, requires injections, and currently has no generic or biosimilar alternative.
Pros
Produces much larger LDL reductions than statins alone
Backed by FOURIER trial showing fewer heart attacks and strokes
Only one or two doses per month, no daily pill
Option for people who cannot tolerate statins
Cons
Requires an injection every two to four weeks
Injection site reactions and possible latex sensitivity
No biosimilar competition yet, keeping cost high
Roughly $580 to $730 per month, more than atorvastatin
Common Symptoms and Related Diseases You Can Explore
Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.