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When we think of generic drugs, it’s easy to think of them as designer knock-off handbags: they do enough to pass for the original—unless you look too close. But that’s a fallacy when it comes to prescription medications. Instead, it’s more accurate to think of a designer handbag with the tag ripped out. You can’t charge for the well-known brand name anymore, but it’s still the same quality, the same design, the same, well, everything that truly matters.
Many of us need to get familiar with these generic medications, even though they’re not household names. Between 2003 and 2012, the percentage of Americans over the age of 40 taking cholesterol-lowering medication increased from 20% to 28%, according to the U.S. Centers for Disease Control and Prevention (CDC). Of those people, a considerable 93% were on a statin, such as Lipitor (CDC, 2015). So if you’re considering generic Lipitor, here’s what you need to know about how it compares to the brand-name.
What are statins, and how do they work?
Statins, also known as HMG-CoA reductase inhibitors, are a class of medications that aim to reduce elevated cholesterol levels in people with a high risk of developing cardiovascular disease (also called heart disease), a group of conditions that can cause heart attack, chest pain, and stroke. High cholesterol is one of the six primary risk factors for developing CVD (Texas Heart Institute, 2020). Statin medications lower the low-density lipoprotein (LDL) cholesterol by blocking HMG-CoA reductase, an enzyme that controls the rate at which cholesterol is made by the body. This class of medications includes:
- atorvastatin (Lipitor)
- fluvastatin (Lescol, Lescol XL)
- lovastatin (Altoprev, Mevacor)
- pitavastatin (Livalo)
- pravastatin (Pravachol)
- rosuvastatin (Crestor)
- simvastatin (Zocor)
But there are two types of statins: those marketed as single-ingredient products, like those listed above, and those that are combined with other medications to help further reduce cholesterol levels. These combined medications include (FDA, 2014):
- Advicor (lovastatin/niacin extended-release)
- Simcor (simvastatin/niacin extended-release)
- Vytorin (simvastatin/ezetimibe)
What’s the difference between brand name and generic Crestor?
What is generic Lipitor?
Some prescription medications are sold under both a brand name and their chemical name, also known as the generic version. When a company develops a drug, they get a patent on the active chemical component—but these patents can expire. As soon as a patent expires, a generic form of the medication can be approved by the U.S. Food and Drug Administration (FDA) for sale. That’s what happened with Lipitor. Generic Lipitor is governed by the same rules the FDA has for all generic drugs: it has to have the same active ingredient as Lipitor (in this case atorvastatin calcium), as well as the same strength, dosage form, and route of administration (in this case, a pill taken by mouth). Whoever makes the generic version of a drug has to prove to the FDA prior to approval that it’s the same as the brand-name drug (FDA, 2018).
Simply put, brand-name Lipitor and generic atorvastatin are the same medication, and, because of that, each is just as safe and effective as the other. Lipitor is made by Pfizer and generic Lipitor, which was first available in November 2011, is made by many different companies.
The efficacy of generic drugs has also been tested in studies. There was no difference in health or outcomes between patients on Lipitor and those taking generic atorvastatin in one study that looked at people who had been hospitalized for heart attacks (Jackevicius, 2016). A 2017 study compared Lipitor to generic drugs with the same formulation in patients with hyperlipidemia and found the same to be true. Generic atorvastatin was just as effective as Lipitor at lowering triglycerides, total cholesterol, and LDL cholesterol (Loch, 2017).
It should be noted, though, that generic drugs come with the same potential side effects as their brand-name counterparts. For generic Lipitor, that includes rhabdomyolysis/muscle problems, liver damage, increased blood sugar, digestive upset, joint pain or muscle pain, tiredness, neurological effects, and memory loss.
Reasons for switching from Lipitor to generic Lipitor
People generally switch between these statin drugs for two reasons: the price difference or their health insurance coverage. Generic drugs are generally cheaper than prescription drugs. Health insurance may cover part of your prescription cost, but the copay on a generic form of a drug is still generally lower than that of brand-name drugs.
There is also a chance that one drug or the other isn’t covered by your specific health insurance plan. Review the prescription medication information from your health insurance provider if you have specific questions about what is covered. If you are interested in switching drugs for the treatment of your high cholesterol, it’s best to discuss your options with your healthcare provider.
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Things to consider when switching
The biggest factors your healthcare provider may consider when discussing a switch from a brand-name statin drug to its generic version is how well that chemical compound is working for you and whether you’re experiencing side effects. It’s possible that your prescribing physician may want to switch you from Lipitor to another generic statin drug, rather than atorvastatin. Your healthcare provider may perform a blood test to evaluate your cholesterol levels and decide if you should switch to generic Lipitor or should try a different statin drug.
It’s also important to keep in mind that since it’s the same chemical compound, generic Lipitor will have the same potential drug interactions as the brand-name version. Just like with Lipitor, drinking alcohol with generic atorvastatin is generally safe if done moderately, though people with liver conditions such as liver disease should avoid alcohol when taking statins. If you have any questions about your individual health and making the switch from brand-name to generic Lipitor, seek medical advice from a healthcare professional.
- Centers for Disease Control and Prevention (CDC). (2015, November 06). Products – Data Briefs – Number 177 – December 2014. Retrieved July 29, 2020 from https://www.cdc.gov/nchs/products/databriefs/db177.htm
- Food and Drug Administration (FDA). (2014, December 16). Statins. Retrieved July 31, 2020 from https://www.fda.gov/drugs/information-drug-class/statins
- Food and Drug Administration (FDA). (2018, June 01). Generic Drug Facts. Retrieved Aug. 9, 2020 from https://www.fda.gov/drugs/generic-drugs/generic-drug-facts
- Jackevicius, C. A., Tu, J. V., Krumholz, H. M., Austin, P. C., Ross, J. S., Stukel, T. A., et al. (2016). Comparative Effectiveness of Generic Atorvastatin and Lipitor ® in Patients Hospitalized with an Acute Coronary Syndrome. Journal of the American Heart Association, 5(4). doi:10.1161/jaha.116.003350. Retrieved from https://www.ahajournals.org/doi/10.1161/JAHA.116.003350
- Loch, A., Bewersdorf, J. P., Kofink, D., Ismail, D., Abidin, I. Z., & Veriah, R. S. (2017). Generic atorvastatin is as effective as the brand-name drug (LIPITOR®) in lowering cholesterol levels: A cross-sectional retrospective cohort study. BMC Research Notes, 10(1), 291. doi:10.1186/s13104-017-2617-6. Retrieved from https://bmcresnotes.biomedcentral.com/articles/10.1186/s13104-017-2617-6
- Texas Heart Institute. (2020, February 03). Heart Information Center: Heart Disease Risk Factors. Retrieved Aug. 10, 2020 from https://www.texasheart.org/heart-health/heart-information-center/topics/heart-disease-risk-factors/
Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.