Any Advantages Or Is Livalo Just One More Statin?

When I heard that Livalo was being promoted as the newest statin to market I first wondered why anyone would bother to bring a newer drug to a field of excellent drugs many of which have been around long enough to be available as inexpensive generics.  The primary sales pitch of the Kowa-Lilly reps seems to be that this is “mg. for mg. the most potent statin” available.  By this they mean that per mg. of dosing it lowers LDL cholesterol more than any other statin.  Anyone who understands pharmacology at all immediately recognizes this as meaningless statement.  Every drug has its appropriate dose, and comparing the number of milligrams of one drug to the number of mg. of another drug is just silly.  In essentially every class of drugs each medication has its own appropriate dose and comparing the dose in mg of one drug to another, and saying that the drug with the lower mg dose is more potent is just ridiculous.

Livalo has a number of things going against it and at this point I cannot think of a single reason I would prescribe it unless someone can show it to have unique benefits as compared to more established statins.  Here are my concerns and reasoning:

  • No Better at Lowering LDL: Livalo is promoted by its manufacturer to be equally effective at lowering LDL cholesterol at its medium and highest doses to atorvastatin (Lipitor) and Simvastatin (Zocor).  Average LDL reductions as follows:
    • Livalo 2 mg = 38 – 39% reduction
    • Atorvastatin 10 mg = 38% reduction
    • Simvastatin 20 mg = 35% reduction
    • Livalo 4 mg = 44-45% reduction
    • Atorvastatin 20 mg = 44% reduction
    • Simvastatin 40 mg = 43% reduction
    • Atovastatin 40 and 80 mg dosing not compared to Livalo.
  • No Data for Cardiovascular Outcomes:  Livalo has no data for primary efficacy at reducing cardiovascular morbidity or mortality.  This type of data is well established for simvastatin and atorvastatin.  This is a big deal.  Why use a drug with no reason to expect superior efficacy that lacks data to even be confident it has any efficacy at the real desired outcome.
  •  High Price for Many Years:  Livalo has just been released to market.  It is priced at at 115.99/ 30 tablets.  This compares to simvastatin 20  at $5.90/ 30 tablets  at Costco (no Livalo price online at Costco, likely because there is so little market demand).  Generic Lipitor (atorvastatin) will become available as a generic late this year, and is currently available at Costco at $165.70/ 30 tablets.  All told the generic statins are appropriate for the vast majority of patients.
  • Safety Data Pending:  Why use a drug with no apparent advantages immediately after it comes to market.  All of us remember the fiascos of many newly released drugs when they became available to the mass market and serious problems came to light.  (Think Ketek and Vioxx)

Livalo seems to have a side effects profile very similar to the currently available statins.  If there is a lower incidence of myalgias and myositis there may turn out to be a niche role for Livalo, but at this time I’ll wait to see a lot larger experience than the studies presented so far.

Summary on Livalo:  A simply Ho-Hum new drug that I plan to forget the name of as soon as I finish this post.  Stick with either a good generic like simvastatin.  If you need a branded drug use one with more post-market experience and the promise of being available as a generic very soon like Lipitor.  Overall the Simvastatin vs Lipitor debate leans towards simvastatin until Lipitor becomes generic.  Then I anticipate atorvastatin to be the stain of choice for most patients.  For the patient who has mild to moderate myalgias on either of these two drugs, consider a very low dose of pravastatin or even red yeast rice.

61 Responses to Any Advantages Or Is Livalo Just One More Statin?

  1. after trying every other statins & all my muscles felt like they were tearing. My numbers are over 250..I eat good & exercise 67 & still work. Been on livalo & zetia for 2 mos, & will go for blood work 7/15/17.. so far my nose runs almost all the time, I am fatigued & depressed. My appetite has increased but maybe that I not a good thing.. if it brings my numbers down it may be worth if no other negative things show up in tests..i have high blood pressure & apnea & recent plague in my trying to get my risk of stroke & numbers down..

  2. I also took Livalo but had to get off of it because of the price. Why can’t the pharmaceutical company come down on the price. This really infuriates me. I have tried other statins but nothing woks like the Livalo. I keep a very clean, process food free diet and exercise as much as possible. Really Kowa-Lilly give us a break!

  3. I’m not sure if fluvastatin (Lescol XL) is still available, but among its peers, it seems to have a better tolerability profile.

    It never had the big advertising push, but the big guns in dyslipidemia always had a soft spot for it vs. simvastatin and atorvastatin for its sometimes “gentler” nature.

  4. I, also have taken nearly all of the major statins including red yeast rice and they all produced side effects that made their use untenable. They all worked to reduce my combined average 290+ to under 200 but the skin pain (like shingles), stomach upset, and extreme joint/muscle pain was unbearable and I stopped using any thing. A recent calcium scan showed plaque development in my arteries so the Dr. prescribed Livalo. I’m on my 12th day(2mg dose)and so far no side effects and am awaiting the first blood test.

  5. I’ve been on Livalo for three months now – just had my bloodwork done last week, cholesterol went from 245 to 176 with NO SIDE EFFECTS….I began taking Baycol in the 90’s…joint pain was horrible, they recalled it, tried Lipitor and Crestor, same thing , horrid joint pain. Livalo is great with the exception my insurance won’t pay for it….but it’s well worth the money.

  6. don’t let them fool you it’s just another statin with the same side effects. joint pain, point pain, joint pain.

  7. I started taking Livalo 6 months ago — Zocor made my feet ache which only discouraged me from walking. I tested to make sure it was the Zocor — the aches started immediately and took 3 days to wear off after stopping the Zocor. My insurance required me to try other statins first, which had the same effect. I was then allowed to use Livalo. The copay is high, but Livalo has a coupon to bring cost to $18/mo. I have not had a follow up blood test yet.

  8. Been taking Livalo for more than 4 years with great results. No muscle aches or soreness. My insurance doesn’t cover it now but I am willing to cut costs in other areas to keep my success with this prescription in tack. I have also added Red Yeast Rice twice per week just to make by prescription last a bit longer.

  9. Been taking Livalo for over a year and no problems. Good numbers. Insurance no longer covers it, so I’ll have to try something else. I’ve used most of the others and didn’t have as good a result as Livalo.

  10. I have tried at least 5 different statins not sure all the names but they all made me ache to the point I could not hardly function so I quit taking them and tried Red yeast rice and a better diet and my cholesterol level went up, so my doctor put me on Livalo so far,about a month I haven’t had the achiness but have had some minor stomach trouble. But my problem is my insurance refuses to pay for Livalo. I go for a cholesterol test at the end of January.

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