Lipitor vs Zocor: Which is Better?

Key Takeaways

Both atorvastatin and simvastatin are effective at lowering LDL (the “bad” cholesterol). A study found that atorvastatin (Lipitor) is slightly more effective because it is a stronger, long-acting statin.
Studies found the most effective statin drug is rosuvastatin, followed by atorvastatin, pitavastatin, simvastatin, lovastatin, pravastatin, and fluvastatin.
Both simvastatin and atorvastatin are associated with a slightly higher risk of side effects like muscle weakness and muscle pain.

Is Lipitor or Zocor better for high cholesterol?

Zocor (simvastatin) and Lipitor (atorvastatin) are both effective in lowering cholesterol. However, one study that compared these two drugs and other statins found that Lipitor is slightly more effective than Zocor because it is a stronger, long-acting statin.

What’s the difference between Lipitor and Zocor?

Lipitor and Zocor are both statin drugs or HMG-CoA reductase inhibitors used to treat high cholesterol. Both work by inhibiting the activity of an enzyme called HMG-CoA (hydroxymethylglutaryl-CoA) reductase, which is necessary for cholesterol production. They are both brand name drugs with generics available. Here are the key differences between Lipitor vs Zocor.

Generic Drug

Lipitor is made by Pfizer and contains the generic drug atorvastatin calcium as the active ingredient.

Zocor is made by Merck and contains the generic drug simvastatin as the active ingredient.

Dosage and Administration

Both Lipitor and Zocor come as a film-coated tablet to take by mouth once daily, with or without food.

The recommended starting dose of Lipitor (generic atorvastatin) is between 10 mg (milligrams) or 20 mg daily. The maintenance dose of Lipitor ranges between 10 mg and 80 mg once daily.

The recommended dosage range of Zocor (generic simvastatin tablet) is 20 mg to 40 mg once daily, but it can be as low as 5 mg daily. The typical starting dose of Zocor is 10 to 20 mg once daily. The maximum dose is 40 mg once daily for most people. The Zocor dosage of 80 mg once daily is restricted to those who have been taking Zocor 80 mg for an extended period (12 months or longer) without any symptoms of muscle toxicity.

Age range

Both Lipitor and Zocor are approved for use in adults. Children between the ages of 10 and 17 years with heterozygous familial hypercholesterolemia (a genetic condition causing cholesterol levels to be dangerously high) may be prescribed Lipitor or Zocor to be used in combination with healthy diets.

Type of statin

Atorvastatin (Lipitor) is a more potent (stronger) statin than simvastatin (Zocor).

Atorvastatin (Lipitor) is a long-acting statin, meaning it stays in the body for more time. Consequently, you can take atorvastatin (Lipitor) at any time of the day that is convenient. Atorvastatin is classified as a high-intensity statin.

Simvastatin (Zocor) is a short-acting statin and stays in the body for less time. It should, therefore, be taken in the evening for maximum effectiveness because the liver makes more cholesterol at night. Simvastatin is a moderate-intensity statin, except for simvastatin 80 mg, which is classified as a high-intensity agent,

Both atorvastatin (Lipitor) and simvastatin (Zocor) are lipophilic statins and are associated with a slightly higher risk of side effects like muscle weakness and muscle pain. If you experience these side effects on simvastatin or atorvastatin, it may be worth asking your healthcare professional about taking other statin drugs that are hydrophilic, such as pravastatin, fluvastatin, and rosuvastatin.

Effectiveness

Both simvastatin and atorvastatin are effective in lowering cholesterol. No strong head-to-head clinical trials have been done comparing simvastatin and atorvastatin (Zocor vs Lipitor). However, one comparative study that looked at these two drugs and other statins found that the most effective statin drug is rosuvastatin, followed by atorvastatin, pitavastatin, simvastatin, pravastatin, fluvastatin, and lovastatin. Therefore, it would appear that atorvastatin (Lipitor) is slightly more effective than simvastatin (Zocor).

Side effects

Lipitor can cause side effects such as heartburn, gas, upset stomach, diarrhea, joint pain, muscle aches, memory problems, and confusion.

Possible adverse effects of Zocor include stomach pain, nausea, constipation, headache, forgetfulness, confusion, and red, itchy skin.

Risks

There are reports in medical journals of rhabdomyolysis (muscle breakdown), liver damage, and high blood sugar with both atorvastatin (Lipitor) and simvastatin (Zocor) use. High doses of Lipitor (80 mg daily) have also been linked to an increased risk of a repeat hemorrhagic stroke in people with a recent hemorrhagic stroke.

Contraindications

Both simvastatin (Zocor) and atorvastatin (Lipitor) should be used with caution in people with a history of allergic reactions to statin medications, liver disease or liver problems, and kidney disease or kidney problems. Statins medications may cause birth defects and fetal harm if they are taken during pregnancy.

Interactions

Both simvastatin (Zocor) and atorvastatin (Lipitor), as well as lovastatin (Mevacor), are metabolized (broken down) by the CYP450 3A4 enzyme in the body. The blood levels of these statin drugs can be increased or decreased in the presence of certain other medications that can inhibit the activity of the CYP450 3A4 enzyme to avoid high levels of statin in the body, which can worsen toxicity and side effects. Conversely, medications that can induce or emphasize the action of CYP450 3A4 can cause an excessive breakdown of statin, leading to treatment failure.

In addition, eating certain foods like grapefruit or drinking grapefruit juice while on these statin drugs can increase their plasma concentration and increase the risk of side effects, including muscle pain. If food or drug interactions are a concern, your doctor may prescribe a different statin that is metabolized differently, such as pravastatin, pitavastatin, fluvastatin, or rosuvastatin.

Frequently Asked Questions?

Why is atorvastatin preferred over simvastatin?

Atorvastatin may be preferred over simvastatin because it is a stronger statin. Atorvastatin is also a long-acting statin and can be taken in the morning or night. Simvastatin is short-acting and works best if taken in the evening.

What is the most serious side effect of Zocor?

The most serious side effect of Zocor and other statins is rhabdomyolysis or muscle breakdown, which can lead to acute renal failure. This is a rare adverse event, and most people tolerate statins well.

What are the best statins with the least side effects?

Among the 7 statins that are FDA-approved in the United States, simvastatin (Zocor) and pravastatin (Pravachol) seem to be the statins with the least amount of side effects and be better tolerated than the other statins.

What is the best statin for high cholesterol?

Studies have shown that rosuvastatin (Crestor) and atorvastatin (Lipitor) are the strongest statins for high cholesterol.

What is cholesterol?

Cholesterol is a fatty or waxy substance that the body needs to build healthy cells. We get some cholesterol from food (dietary cholesterol), but most of it is made in the liver. Rarely, high cholesterol levels can be due to inherited conditions such as homozygous familial hypercholesterolemia or heterozygous familial hypercholesterolemia.

While it is not inherently bad, too much cholesterol is harmful. Along with high blood sugar and high blood pressure, high cholesterol is a major risk factor for heart disease and cardiovascular events like heart attack and stroke.

To lower your risk of cardiovascular problems, you should ideally have a total cholesterol level below 200 mg/dL, LDL levels below 100 mg/dL, triglyceride levels below 150 mg/dL, and high-density lipoprotein (HDL or good cholesterol) levels above 60 mg/dL.

The American Heart Association recommends that all adults above the age of 20 years should have their cholesterol blood levels checked every 4-6 years, more frequently if they are at an increased risk of cardiovascular disease.

What are statin drugs?

Statins are a group of FDA-approved drugs that help lower cholesterol, specifically low-density lipoprotein (LDL) cholesterol levels. LDL, also called bad cholesterol, can form fatty deposits in the walls of the blood vessels, increasing the risk of coronary heart disease, heart attack, and stroke.

How do statins lower blood cholesterol?

Statin treatment helps to lower blood cholesterol by blocking an enzyme called HMG CoA reductase that the liver needs to make cholesterol. That’s why a statin is also called an HMG CoA reductase inhibitor. These drugs also increase the body’s ability to remove cholesterol that is already circulating in the blood. Evidence suggests statins also reduce inflammation in the artery walls.

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