Ezetimibe vs Lipitor

Introduction

Ezetimibe and Lipitor are commonly prescribed to patients with high cholesterol levels. They both belong to the different classes of drugs. Their main function is to lower cholesterol levels with a different mechanism of action.

Lipitor works by inhibiting the enzyme involved in cholesterol production, while Ezetimibe is a cholesterol absorption inhibitor, which majorly prevents the absorption of cholesterol in the intestines. Both drugs have similar efficacy, but the difference lies in how they lower cholesterol levels. This gives healthcare providers different options to treat the same condition in different ways based on the specific needs of the patient and medical history.

About Ezetimibe and Lipitor

What is Ezetimibe?

Ezetimibe is a drug that is used to reduce the high levels of cholesterol in the body effectively. They lessen the amount of cholesterol reaching the bloodstream by blocking the absorption of cholesterol from the intestines. Ezetimibe belongs to a class of drugs known as cholesterol absorption inhibitors.

There is no research on whether Ezetimibe helps reduce the risk of cardiovascular disorders. However, it has proven efficient in lowering LDL cholesterol and total cholesterol levels in the blood. Physicians usually do not recommend Ezetimibe alone. It is given as a part of the comprehensive treatment plan, which constitutes dietary and lifestyle changes. Ezetimibe is also prescribed in combination with other medications that also help lower blood cholesterol levels.

What Condition is Ezetimibe Approved to Treat?

Ezetimibe is approved by the FDA under the name Zetia. This drug alone is usually not enough to manage cholesterol levels. It is always recommended in combination with other drugs. Ezetimibe helps with the following conditions:

High cholesterol levels
Primary hypercholesterolemia
Mixed dyslipidemia
Elevated levels of LDL and total cholesterol

How Does Ezetimibe Work for High Cholesterol Levels?

The primary site for dietary cholesterol absorption is the small intestine. The intestinal cells contain a cholesterol transport protein called PC1L1 (Niemann-Pick C1-Like 1) situated on the brush border of the intestinal cells. Ezetimibe acts as an inhibitor and blocks this protein. Resultantly, cholesterol is not able to enter and be absorbed by the intestinal cells.

As a result, less cholesterol enters the blood, so the liver needs to take more cholesterol from the blood to produce bile, which is necessary for digestion. This help reduces the total cholesterol, LDL cholesterol, and non-HDL cholesterol levels in the blood. However, the amounts of triglycerides and fat-soluble vitamins remain unaffected.

Optimal cholesterol control can be achieved by using Ezetimibe along with other medications and some diet and lifestyle changes.

What is Lipitor?

It is a prescription drug that helps prevent cardiovascular disorders and also lowers abnormally high lipid levels. It belongs to the class of drugs named statins. Lipitor is a brand name for the drug atorvastatin that is used in combination with a healthy diet and lifestyle to bring cholesterol to desired levels. Lipitor works to reduce the levels of low-density lipoprotein and triglyceride while raising the levels of high-density lipoprotein in the blood.

Lipitor is also known as a moderate-to-high-intensity statin because it actually lowers cholesterol much better than different statins of the same kind. Besides helping with high cholesterol levels, it also has some side effects like muscle pain and liver issues. Therefore, a healthy diet and exercise are a must with this medication.

What Condition Is Lipitor Approved to Treat?

Lipitor was approved by the FDA in 1996. It is helpful for a wide range of conditions, majorly involving the heart. Lipitor is also effective for people having heart complications with type 2 diabetes. It can be used by children above 10 years.

The following are the conditions that Lipitor helps with:

Heart diseases
Stroke
Prevent the risk of developing heart disease
Hyperlipidemia
Hypertriglyceridemia
Hyperlipoproteinemia Type IIa (Elevated LDL)
Hyperlipoproteinemia Type IIb (Elevated LDL + VLDL)
Hyperlipoproteinemia Type III (Elevated beta-VLDL + IDL)
Hyperlipoproteinemia Type IV (Elevated VLDL)
Homozygous Familial Hypercholesterolemia
Heterozygous Familial Hypercholesterolemia

How Does Lipitor Work for High Cholesterol Levels?

Our liver is involved in the production of cholesterol. To accelerate this production, there is an enzyme called HMC-CoA reductase. This enzyme helps the liver in cholesterol production. If it's not there, cholesterol production will cease.

Statins, in general, are the inhibitors of the enzyme HMC-CoA reductase. Lipitor works the same way and thus reduces the conversion of HMG-CoA to mevalonate. As a result, no cholesterol is produced in the liver, which ultimately lowers its level in the blood.

Apart from that, Lipitor also works by increasing the LDL receptors present on the surface of hepatic cells. This reduction in the levels of LDL cholesterol in blood proves effective in lowering the risk of various cardiovascular disorders: strokes and heart attacks being the major ones.

Lipitor lowers IDL-C (intermediate density lipoprotein) in patients with dysbetalipoproteinemia. While it efficiently lowers the levels of total cholesterol (TC) in patients with nonfamilial hypercholesterolemia, heterozygous familial hypercholesterolemia, and mixed dyslipidemia.

Effectiveness

How Effective Are Ezetimibe and Lipitor for Treating High Cholesterol Levels?

Both Ezetimibe and Lipitor are highly effective drugs against high cholesterol levels. However, the time it takes to start producing effects varies significantly as they both have different mechanisms of action.

Ezetimibe starts reducing the cholesterol level within two weeks. However, it may take up to six weeks for the maximum effects to be achieved. It should also be noted that Ezetimibe doesn't work well without including exercise and a healthy diet in your life.

Lipitor, on the other hand, may take a couple of weeks to start producing desired effects. To achieve stable cholesterol levels, it is necessary to dose Lipitor for a duration of 4 to 6 weeks.

Dosage Information

How is Ezetimibe Administered for High Cholesterol Levels?

Ezetimibe is available in different forms that include:

Tablets (10, 20, 40, and 80 mg)
Capsules

Ezetimibe Dosage Information

The dosage for every individual varies depending on the severity of the conditions, any other medications being taken, and response to treatment. Generally, the following dosage works well for patients with high cholesterol levels:

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How is Lipitor Administered for High Cholesterol Levels?

Lipitor tablets are available that are white, oval-shaped, and film-coated. A low dose is given to the patients initially, and then it is slowly dosed up.

Lipitor Dosage Information

The lipid profile and underlying health conditions of an individual play an important role in determining the right dose. However, a daily dose of Lipitor can be anywhere between 10 to 80 mg.

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Side Effects

While both drugs are effective against high cholesterol levels, they come with some side effects. The condition may worsen if the drugs react with some other medication you are already taking. It is essential to seek medical help if you observe any side effects.

What are the most common side effects of Ezetimibe?

Following are the common side effects observed by patients who intake Ezetimibe:

Diarrhea
Joint pain
Skin rash
Itching
Swelling of face, tongue, lips, or throat
Stomach pain
Fatigue
Dizziness
Fever
Headache
Sore throat
Runny nose

Are there any potential serious side effects of Ezetimibe?

The patient may experience some serious side effects when dosing on Ezetimibe. Some of them may include:

Severe stomach pain
Liver problems
Severe muscle issues
Allergic reactions

What are the most common side effects of Lipitor?

The following are the most common side effect of Lipitor that patients usually experience.

Headache
Sore throat
Diarrhea
Nose bleed
Constipation
Runny nose
Urinary tract infection
Stomach pain
Muscle pain
Joint pain
Difficulty falling asleep

Are there any potential serious side effects of Lipitor?

The patient may experience some serious side effects when dosing on Lipitor.

Lives issues
Acute pancreatitis
Muscle pain and cramps
Erythema multiform
Kidney failure

Contraindications and interactions

Warnings and general precautions for Ezetimibe and Lipitor

Both these medicines should be taken at the dose recommended by the doctor. It should not be taken for a longer time or in doses higher or lower than what was prescribed. Generally, they are well tolerated, but it is necessary to follow precautions to avoid unusual circumstances.

These medicines work well when combined with a healthy diet and exercise. The diet is usually low in sugar, fat, and cholesterol. This makes the medicines efficient.

Also, you should swallow the whole tablet, and it can be consumed with or without food. Never break, chew, or crush the tablet.

Avoid drinking large quantities of alcohol when you are dosing Ezetimibe and Lipitor, as this may have unwanted effects on the liver.

Contraindications and important interactions for Ezetimibe and Lipitor

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Cost Comparison

How much do Ezetimibe and Lipitor cost?

The location and pharmacy greatly affect the cost of both medicines. However, an estimated cost of Ezetimibe and Lipitor in the US is given below.

10 mg – 10 mg of Ezetimibe costs $82 for 30 tablets.
10 mg – 20 mg of Ezetimibe costs $109 for 30 tablets.
10 mg – 40 mg of Ezetimibe costs $80 for 30 tablets.
10 mg – 80 mg of Ezetimibe costs $109 for 30 tablets.

Below is the estimated price for Lipitor oral tablets.

10 mg of Lipitor costs $1,178 for 90 tablets.
20 mg of Lipitor costs $1,677 for 90 tablets.
40 mg of Lipitor costs $1,677 for 90 tablets.
80 mg of Lipitor costs $1,255 for 64 tablets.

Popularity of Ezetimibe and Lipitor

When it comes to managing high cholesterol levels, Ezetimibe and Lipitor are the widely prescribed medications. However, Lipitor is comparatively more popular and holds the status of best-selling medicine. Over 26 million patients in the US used this medicine in 2020, compared to only 1 million patients for Ezetimibe. This is majorly due to the ability of Lipitor to reduce cholesterol levels and prevent cardiovascular diseases.

Ezetimibe is used as an alternative when Lipitor is not well tolerated. This drug works differently than statins as they prevent the absorption of cholesterol in the intestine.

However, there is no one medicine that is the best for all. Efficacy, safety, cost, and individual needs of patients are considered before prescribing any medicine.

Conclusion

Takeaway

In conclusion, Ezetimibe and Lipitor are both effective medications used to control high cholesterol levels. Nonetheless, they both help with other cardiovascular disorders as well. Ezetimibe is typically prescribed in combination with other drugs like statins and diet and lifestyle changes. Individuals who cannot tolerate statins very well are given statins along with Ezetimibe for sufficient cholesterol reduction.

Lipitor, on the other hand, is a widely prescribed medicine having a long history of use. It directly inhibits cholesterol production by the liver and is widely studied.

The most appropriate medication is prescribed considering the individual needs. Therefore, it is best to consult a healthcare professional for further information.