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Pharmacy and Medications

Lipitor vs. zocor

03/03/2005

Question:

Is there any reason why I could take zocor and not lipitor for cholestrol? I recently started taking blood pressure med. and asked the dr. if I could switch to a cheaper cholestrol med. for cholestrol.He gave me lipitor and my hands, and calves hurt. My hands to the point of waking me up they felt like they were going to pop. Anyhow, I quit taking both and went to the dr.He said to keep taking the blood pressure, and stop the lipitor and see what happened- I feel much better. Anyhow, I know that I need a cholestrol med. just wondering which one , and why lipitor gave me that reaction. I still want a med that my insurance will pay more on. Insurance and medication prices are eating us ALIVE!!!!I wonder if maybe crestor would be alright?

Answer:

Since, you experienced pain in your hands and calves when you were on Lipitor (atorvastatin), neither Zocor(simvastatin) nor Crestor (rosuvastatin) are likely to be good alternatives. This is because simvastatin and rosuvastatin are in the same class as atorvastatin, and the pain you experienced is likely to occur with any of the drugs in this class.

However, there are other alternatives your doctor can prescribe you that may be easier on your wallet. One is a medication called ezetimibe (ez-et-tim-mibe). In the United States, ezetimibe is sold under the brand name Zetia. Ezetimibe works by reducing the amount of cholesterol absorbed from the diet. It is relatively new and is priced competitively with Atovastatin.

A second choice is called colesevelam (coal-es-sev-uh-lam) hydrochloride. This medicine is sold as WelChol in the United States. It has special directions on how to properly take it so that it will effectively lower your cholesterol. Colesevelam works be reducing the recycling of bile salts. Since bile salts are made in the liver from cholesterol, increasing bile salt excretion can lower cholesterol. Earlier products of this sort interfered with the absorption of many medicines. Welchol seems to be less likely to do this.

Zetia and WelChol are just two of the newer options. They may not be appropriate for you. Many other options exist. Ask your doctor what is the best alternative for you. Remember that any cholesterol lowering medicine will work best when combined with proper diet and exercise.

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Response by:

Robert James Goetz, PharmD, DABAT
Assistant Professor of Pharmacy Practice
College of Medicine
University of Cincinnati