Everything You Should Know About Lipitor

If you're using Lipitor to manage your cholesterol, you're in good company. Over 29 million people worldwide have been prescribed Lipitor, making it the top cholesterol-lowering drug globally [source: Lipitor]. And with high cholesterol affecting so many, Lipitor remains the highest-grossing drug worldwide, earning over $10 billion annually [source: Loftus]. If you're not using Lipitor, you might wonder what sets it apart. After all, there are other cholesterol-lowering drugs out there, and Lipitor isn't exactly cheap. What makes it so special?

If you're curious about Lipitor's success, you're not alone — even its creators weren’t sure their new drug would stand out. Developed by Parke-Davis (a subsidiary of pharmaceutical giant Warner-Lambert), Lipitor was a latecomer to the cholesterol market. Its journey faced early challenges, including a formula that initially contained 50 percent non-effective material (material that offered no health benefits) and mediocre results in animal trials [source: Winslow]. In those first tests, Lipitor didn’t perform any better than other drugs already available. Although Parke-Davis managed to refine the formula by removing the waste material, there were still doubts about whether the drug should proceed with further testing. Was it truly worth it?

As you may have guessed, it turned out to be worth it. While the animal studies were less than promising, Lipitor quickly demonstrated remarkable effectiveness in humans. In a study involving 24 participants, just 10 milligrams of Lipitor reduced LDL (bad cholesterol) by 38 percent, and at 80 milligrams, LDL levels dropped by 58 percent [source: Winslow]. These results were significantly better than any other medication in the same class, even at higher doses.

Despite these impressive results, Warner-Lambert was still uncertain whether the drug could make a major impact on the cholesterol market. The company teamed up with Pfizer for marketing support, and due to Lipitor's success, Pfizer acquired Warner-Lambert in 2000. Known for its bold marketing strategies, particularly its direct-to-doctor campaigns [source: Simons], Pfizer's involvement raised the question: Was Lipitor's success driven by a powerful advertising blitz, or was it truly the drug's effectiveness? We’ll explore Lipitor’s action in the body on the next page.

Lipitor's Effect in the Body

Lipitor belongs to a category of cholesterol-reducing drugs known as statins. Statins were first developed in Japan during the early 1970s after research revealed that an enzyme called hydroxyl-methylglutaryl-coenzyme A (HMG-CoA), found in the liver, was responsible for producing up to 80 percent of the body's cholesterol. While people can control about 20 percent of their cholesterol through diet, there was no medication available that directly targeted this cholesterol-producing process.

The first statin, mevastatin, was created in Japan in 1971, followed by other statins over time. Lipitor is the brand name for atorvastatin. Statins work by inhibiting HMG-CoA, which not only reduces the production of cholesterol but also prompts the liver to pull excess cholesterol from the bloodstream. This process helps to lower your overall cholesterol levels.

What sets Lipitor apart from other statins is its ability to reduce more cholesterol at lower doses. The typical starting dose for Lipitor is 10 milligrams per day, and it can be prescribed at doses of up to 80 milligrams daily, while other statins are usually prescribed in doses of 20 to 40 milligrams daily. When statins were first prescribed, many doctors had concerns about the long-term effects of high doses, so Lipitor’s early success can be partly attributed to psychological factors: doctors felt reassured that if 80 milligrams was safe, 10 milligrams must be extremely safe [source: Simons]. The scientists who developed Lipitor attribute its potency at low doses to the drug’s longer half-life, meaning it stays active in the body for a longer period [source:

Currently, Lipitor does not have a generic version. If you want the patented formula that has been shown to reduce bad cholesterol by up to 60 percent, you’ll have to pay more [source: Lipitor]. Pfizer’s ongoing marketing strategy emphasizes that no other statin works the same way in your body as Lipitor does, suggesting it’s not worth switching to a cheaper generic alternative. Studies show that atorvastatin is more potent than its generic counterparts and may offer additional benefits, including a reduced risk of heart disease [source: Berenson].

Who should be using Lipitor? Find out on the next page.

Indications for Lipitor

Lipitor is a medication designed to lower bad cholesterol, known as low-density lipoprotein (LDL). This drug is intended to be used alongside a healthy diet and regular exercise. Simply taking Lipitor while indulging in an unhealthy diet won’t effectively lower your cholesterol. However, for some people, diet and exercise alone may not be sufficient to manage cholesterol, as the body produces much of it on its own.

Maintaining a healthy cholesterol level is crucial for heart health. Unlike risk factors such as age or family history, cholesterol is a controllable risk factor for heart disease. High cholesterol can cause arteries to clog, leading to heart attacks. Lipitor can reduce bad cholesterol by 39 to 60 percent, depending on the dose [source: Lipitor].

Lipitor also has a secondary effect of boosting high-density lipoproteins (HDL), the 'good' cholesterol. Studies show that it can raise HDL levels by 5 to 9 percent [source: Lipitor]. Low levels of HDL increase the risk of heart disease because HDL helps carry excess cholesterol to the liver, effectively removing it from the bloodstream and lowering overall cholesterol.

Because Lipitor helps reduce the risk of heart disease, the U.S. Food and Drug Administration (FDA) has approved it as a treatment for lowering the risk of heart attacks, certain heart surgeries, and chest pain. It’s also recognized for its ability to reduce the risk of strokes, which are essentially heart attacks of the brain. In fact, Lipitor is not only effective in preventing the first stroke, but also in lowering the risk of a second one. A 2006 study published in the New England Journal of Medicine found that patients who took Lipitor after a first stroke had a 16 percent lower risk of having another stroke compared to those who took a placebo [source: Rosalind Franklin University of Medicine and Science].

On the following page, we’ll discuss some common side effects associated with Lipitor.

Side Effects of Lipitor

Common side effects of Lipitor include headaches, constipation, diarrhea, gas, stomach discomfort, skin rashes, and muscle pain.

In some instances, muscle pain can signal a more severe reaction: a small group of patients developed rhabdomyolysis, a condition where muscle tissue breaks down and releases proteins that can cause kidney failure. This risk increases if you’re taking other medications alongside Lipitor. As with any prescription drug, it's essential to inform your doctor about other medications you're using.

Liver issues are another serious potential side effect. If you already have liver problems, you should not use Lipitor, and your doctor might carry out blood tests while you’re on the medication to monitor your liver function. Symptoms of severe side effects may include extreme muscle weakness, nausea, vomiting, dark urine, unusual tiredness, yellowing of the eyes or skin, and abdominal pain.

Lipitor is not recommended for pregnant or breastfeeding women. However, a 2008 study casts doubt on whether Lipitor is beneficial for women. The study, published in the Journal of Empirical Legal Studies, argued that there is insufficient evidence to prove Lipitor reduces the risk of heart attack in women [source: Wiley-Blackwell]. The study also claimed that Pfizer marketed the drug as effective for both genders without disclosing the lack of supporting evidence for women [source: Wiley-Blackwell].

The question of whether women should take Lipitor gains significance when considering the possibility that the drug might lead to memory loss in women. In 2008, Dr. Orli Etingin, vice chairman of medicine at New York Presbyterian Hospital, remarked, "This drug makes women stupid" [sources: Cahoon, Beck]. This comment, which was widely covered by media outlets, led many doctors to defend Lipitor. They argued that any claims of memory loss associated with the drug were merely anecdotal and that its advantages far outweigh the potential risks. Given the need for more research on statins and cognitive effects, it's important to consult your doctor about the latest findings if you have concerns.

You can reduce the likelihood of experiencing some of Lipitor's more serious side effects by avoiding a certain substance. Discover what it is on the following page.

Lipitor and Grapefruit

If you're accustomed to kicking off your day with a refreshing glass of grapefruit juice, you'll need to adjust that habit once you start taking Lipitor. Despite sounding like a healthy choice, it could have potentially dangerous consequences. Lipitor is one of several medications that can have harmful effects when combined with grapefruit juice.

When grapefruit juice is consumed, it's processed by specific enzymes in the liver—the same enzymes responsible for breaking down Lipitor in your body. Essentially, if these enzymes are preoccupied with metabolizing the grapefruit juice, they can't break down the medication properly, leading to an excessive amount of it in your system. This can result in severe side effects like rhabdomyolysis, where muscle pain leads to kidney issues.

In 2006, researchers from UNC-Chapel Hill discovered that chemicals called furanocoumarins in grapefruit juice might be inhibiting those enzymes, which means we could see furanocoumarin-free grapefruit juice in the future [source: University of North Carolina School of Medicine]. Until then, it's crucial to check the warning labels on your prescriptions carefully, as grapefruit juice interacts negatively with about 50 different medications [source: University of Rochester Medical Center]. Now might be the time to explore new juice options, as grapefruit juice is the only fruit juice known to cause adverse drug interactions.

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