Pravachol vs. Vytorin

See how Pravachol and Vytorin compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Pravachol is a single-ingredient statin, while Vytorin combines a statin with a cholesterol-absorption blocker for extra LDL reduction.

  • Generic pravastatin typically costs far less per month than brand-name Vytorin, which has no generic combination version in the US.

  • Vytorin is the only one of the two approved for homozygous familial hypercholesterolemia and homozygous sitosterolemia.

Pravachol vs. Vytorin Drug Summary

Pravachol

Pravachol (pravastatin) is a statin that lowers LDL cholesterol and triglycerides while raising HDL cholesterol. It is taken as one tablet by mouth once a day, with or without food. The brand name has been discontinued in the US, so it is now available only as generic pravastatin.

Vytorin

Vytorin combines ezetimibe, which blocks cholesterol absorption in the intestine, with simvastatin, a statin that blocks cholesterol production in the liver. It treats high cholesterol and certain inherited cholesterol disorders, taken as one tablet by mouth once a day. It comes in four strengths pairing a fixed 10 mg of ezetimibe with 10 mg to 80 mg of simvastatin.

Pravachol vs. Vytorin Side Effects

Pravachol

Most common
Musculoskeletal pain (up to 24.9%)
Upper respiratory infection (up to 21.2%)
Nausea/vomiting (up to 10.5%)
Diarrhea (up to 6%)

Vytorin

Most common
Headache (up to 5.8%)
Increased ALT (up to 3.7%)
Myalgia (up to 3.6%)
Diarrhea (up to 2.8%)

Pravachol vs. Vytorin Dosage

Pravachol

Dosage
Dosage Table
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

Vytorin

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 10 mg/10 mg once daily At the start
Maximum dose 10 mg/10 mg once daily Same as starting
Dose changes None Fixed dose

Pravachol vs. Vytorin Indications

Pravachol

Pravachol is FDA-approved to lower LDL cholesterol, total cholesterol, and triglycerides, and to raise HDL cholesterol in adults with high cholesterol. It also reduces the risk of heart attack, stroke, and cardiovascular death in adults with risk factors for heart disease, and lowers the risk of death in adults with existing coronary heart disease. It is approved for children 8 and older with heterozygous familial hypercholesterolemia.

  • Lower LDL cholesterol, total cholesterol, and triglycerides

  • Raise HDL cholesterol

  • Reduce risk of heart attack and stroke in adults with risk factors

  • Reduce risk of death in adults with existing coronary heart disease

  • Treat children 8 and older with heterozygous familial hypercholesterolemia

Vytorin

Vytorin is FDA-approved to lower LDL cholesterol, total cholesterol, triglycerides, and Apo B, and to raise HDL cholesterol in adults with high cholesterol. It also treats homozygous familial hypercholesterolemia and homozygous sitosterolemia, two rare inherited cholesterol disorders. In patients with a recent heart attack or unstable angina, it has been shown to reduce cardiovascular events beyond a statin alone.

  • Lower LDL cholesterol, total cholesterol, triglycerides, and Apo B

  • Raise HDL cholesterol

  • Treat homozygous familial hypercholesterolemia

  • Treat homozygous sitosterolemia

  • Reduce cardiovascular events after a recent heart attack or unstable angina

Pravachol vs. Vytorin Pros and Cons

Pravachol

Pravachol has decades of real-world safety data and is now available only as an inexpensive generic. It is considered a lower-to-moderate intensity statin, so it may lower LDL less than higher-intensity options or combination therapies.

Pros

  • Only available as generic pravastatin, typically $10 to $30 a month without insurance

  • Fewer drug interactions than many statins since it isn't broken down by CYP3A4

  • More than 30 years of real-world safety data as one of the earliest statins approved

  • Simple dosing with just one dose increase if the starting dose isn't enough

Cons

  • Considered a lower-to-moderate intensity statin, so it lowers LDL less than high-intensity options

  • Only one cholesterol-lowering mechanism, unlike combination therapies

  • Not approved for homozygous familial hypercholesterolemia or sitosterolemia

  • Muscle aches and elevated liver enzymes can still occur, especially at the 80 mg dose

Vytorin

Vytorin pairs a statin with a second cholesterol-absorption-blocking drug, giving it a different mechanism than pravastatin alone. It carries a much higher list price and more drug interaction concerns tied to the simvastatin component.

Pros

  • Combines two cholesterol-lowering mechanisms in one tablet for deeper LDL reduction

  • Only option here approved for homozygous familial hypercholesterolemia and sitosterolemia

  • IMPROVE-IT trial showed fewer cardiovascular events than a statin alone after a heart attack or unstable angina

  • Four dose strengths allow fine-tuning of the simvastatin component

Cons

  • List price runs roughly $600 to $650 a month without insurance, well above generic pravastatin

  • Simvastatin component is broken down by CYP3A4, adding more drug interaction risks

  • 80 mg dose carries a higher muscle-injury risk and is generally avoided for new starts

  • Not recommended for patients with active liver disease

Common Symptoms and Related Diseases You Can Explore

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