Q. After a heart attack six years ago, I went on Lipitor (atorvastatin) because my doctor said it was proven to reduce the risk of a second heart attack in high-risk people like me. Three years ago, I switched to a generic (simvastatin) to save money. Now that Lipitor is going generic, should I switch back? And can I be assured that the generic version will be as effective as brand-name Lipitor at preventing a second heart attack?
A. The statins are a great class of drugs, and I don’t think there is any reason to switch from one statin to another as long as you are reaching your LDL cholesterol goal and are not having side effects.
I have switched many of my own patients from Lipitor to a generic statin to help them save money, making sure that their LDL was controlled on their new medication. Despite Lipitor going generic, I won’t be switching them back if they are “at goal.” But if their LDL is still elevated on an older generic statin, I’ll try generic Lipitor.
There’s no reason to expect any difference in benefit from generic atorvastatin versus brand-name Lipitor. By law, generic drugs are required to have the same quality, strength, and purity as their brand-name counterparts.
Whichever statin you take, you should have periodic blood tests to check for liver problems. And promptly report any side effects such as muscle pain to your doctor.
— Thomas Lee, M.D.
Editor in Chief, Harvard Heart Letter