The Difference Between Lipitor and Livalo

Written by Shivam Patel, PharmD, BSPS, RPh | Posted June 16, 2021

High cholesterol affects about 38% of all adult Americans. Too much cholesterol in your body can increase the risk of stroke and heart disease, two of the top causes of death in the United States. Unlike some diseases, having high cholesterol doesn’t present any cardinal signs or symptoms; it's vital you routinely get blood work done to ensure levels are below 200 mg/dL. Fortunately, if you do have high cholesterol, there are practical ways to lower it. Diet, exercise, and cholesterol-lowering medication, such as Lipitor (atorvastatin) and Livalo (pitavastatin), are proven to help. Although Lipitor and Livalo both work to help lower cholesterol in your body there are some differences. 

Lipitor vs. Livalo Approved Indications

  • Lipitor plus a healthy diet is approved to treat elevated cholesterol levels including triglycerides and also lower the risk of stroke and heart attack in certain patients such as diabetics.

  • Livalo plus a healthy diet is approved to treat elevated cholesterol levels in adults and certain pediatric patients 8 years and older with a family history of elevated cholesterol.

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Lipitor vs. Livalo Available Dosage

  • Lipitor comes in a dose of 10 mg to 80 mg taken by mouth daily

  • Livalo comes in a dose of 1 mg - 4 mg taken by mouth daily

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Lipitor vs. Livalo Efficacy 

In a head-to-head study, Livalo demonstrated comparable efficacy to Lipitor, which means they both are considered effective at lowering cholesterol levels. One is not superior to the other. 

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Livalo vs. Lipitor Side Effects

Please see the table below for a comparison of Livalo and Lipitor side effects.

Common Livalo Side Effects Common Lipitor Side Effects
  • Muscle Pain
  • Back Pain
  • Diarrhea
  • Constipation
  • Hands and Feet Pain
  • Muscle and Joint Pain
  • Tiredness
  • Diarrhea
  • Upset Stomach
  • Confusion/Memory loss
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Can Livalo cause weight gain?

Weight gain was not a reported common side effect in clinical trials. However, because the medication affects your liver, you should let your provider know if you have experienced rapid weight gain while on Livalo.

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Do statins age you faster?

Statins can induce myopathy in some patients: You may start to feel muscle fatigue and pain, which can feel like “aging.” If this is a concern for you, consider speaking with your provider. Some statins, like Lipitor, have reported side effects of memory loss and confusion, which could also feel like you are “aging.” Your provider may decide these risks still do not outweigh the benefits of lowering high cholesterol and reducing the risk of stroke and heart attack.

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Which is the best statin? Lipitor, Livalo, or Crestor?

Statins are a group of medications that work to lower cholesterol by blocking an enzyme in your body called HMG-CoA-Reductase, which in turn helps decrease the production of cholesterol in the liver. Livalo and Lipitor are both approved for use in the U.S. to help lower cholesterol, so they are both effective. It is up to your health care provider to work with you to determine the best medication and dosage that will optimally work in lowering your cholesterol. 

According to American College of Cardiology guidelines, Lipitor and Crestor can primarily be used for high-intensity cholesterol lowering (greater or equal to 50% lowering of LDL-C) and Livalo, Lipitor, and Crestor can be used for moderate intensity cholesterol lowering (30-49% lowering of LDL-C). LDL-C stands for “low-density lipoprotein cholesterol,” which is calculated from a lipid panel your provider will order for you when blood work is done. That value is used by your provider to determine your risk of heart disease and to tailor your medication regimen.

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Is Zypitamag the same as Livalo?

Zyptitamag has the same active ingredient, pitavastatin, as Livalo. However, the salt that is attached to each chemical structure is magnesium for Zyptitamag and calcium for Livalo. The U.S. FDA considers Zypitamag a therapeutic alternative to Livalo because they have the same therapeutic ingredient despite consisting of a different salt. Per the results of a bioequivalence study, when fasted, Livalo 4mg tablets and Zypitamag 4mg tablets can be considered bioequivalent.

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Which cholesterol drug is safest?

All FDA-approved medications available in the U.S. have been proven to be safe and effective with rigorous clinical trials and post drug approval monitoring for continued safety. This includes Lipitor, Livalo, Crestor, and all other statins currently available in the U.S. So you don't really need to worry about which cholesterol drug is the safest; your provider will work your medical history to identify which option will work best for your specific need of cholesterol lowering.

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Compare Cholesterol Medication Prices

Drug  Strength Quantity U.S. Pharmacy Retail Price  U.S. Discount Card Price Lowest International Pharmacy Price Greatest Percentage Savings
Lipitor  20mg 90 tablets $1,808.10 $1,469.29 $93.60 95%
Atorvastatin 20mg 90 tablets $73.80 $11.46 $23.40 84%
Livalo 2mg 90 tablets $1,145.70 $954.12 $71.90 94%
Pitavastatin 2mg 90 tablets N/A N/A $43.20 N/A

This price data is current as of June 2021. U.S. pharmacy retail price reflects a national average of out-of-pocket cost based on those listed on The lowest international pharmacy prices were based on those listed on U.S. pharmacy discount price reflects lowest pharmacy price in the White Plains, NY area.

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