Lipitor vs. Zetia: What's the difference?
- Lipitor (atorvastatin) and Zetia (ezetimibe) are used to lower cholesterol levels in the blood.
- Lipitor and Zetia belong to different drug classes. Lipitor is an HMG-CoA reductase inhibitor (a “statin” drug) and Zetia is a cholesterol-lowering drug.
- Side effects of Lipitor and Zetia that are similar include diarrhea and joint pain.
- Side effects of Lipitor that are different from Zetia include constipation, fatigue, gas, heartburn, headache, common cold, pain in the extremities, and urinary tract infection (UTI).
- Side effects of Zetia that are different from Lipitor include abdominal pain, back pain, muscle aches, and sinusitis.
What is Lipitor? What is Zetia?
Lipitor (atorvastatin) is a “statin” drug (an HMG-CoA reductase inhibitor) used to lower cholesterol levels in the blood. Lipitor reduces total cholesterol along with LDL (“bad”) cholesterol, which is chiefly responsible for coronary artery disease development. Reducing LDL cholesterol slows the progression and can reverse coronary artery disease. Lipitor also raises HDL ("good") cholesterol that protects against coronary artery disease and reduces the concentration of triglycerides in the blood, which are also associated with coronary artery disease. Lipitor prevents angina, stroke, heart attack, hospitalization for congestive heart failure, and revascularization procedures in individuals with coronary artery disease.
Zetia (ezetimibe) is used to treat elevated blood cholesterol. The most commonly used class of drugs for lowering cholesterol levels, statins, acts by preventing the production of cholesterol by the liver. Zetia has a different mechanism of action and lowers blood cholesterol by reducing the absorption of cholesterol from the intestine. It does not affect the absorption of triglycerides or fat-soluble vitamins.
What are the side effects of Lipitor and Zetia?
Lipitor is generally well tolerated. Minor side effects include:
Other commonly reported side effects include:
Lipitor may cause liver and muscle damage. Serious liver damage caused by statins is rare. Liver tests should be performed at the beginning of treatment then as needed thereafter.
Inflammation of the muscles caused by statins can lead to serious breakdown of muscle cells called rhabdomyolysis. Rhabdomyolysis causes the release of muscle protein (myoglobin) into the blood, and myoglobin can cause kidney failure and even death. When used alone, statins cause rhabdomyolysis in less than one percent of patients. To prevent the development of serious rhabdomyolysis, patients taking atorvastatin should contact their health-care professional immediately if they develop unexplained muscle pain, weakness, or muscle tenderness.
Statins have been associated with increases in HbA1c and fasting serum glucose levels as seen in diabetes.
Post-marketing reports for atorvastatin of adverse events include:
Symptoms may start one day to years after starting treatment and resolve within a median of three weeks after stopping the statin.
The most common side effects of ezetimibe are:
Other important side effects include:
Latest Cholesterol News
Daily Health News
What is the dosage of Lipitor vs. Zetia?
- Lipitor is prescribed once daily.
- The usual starting dose for adults is 10-20 mg per day, and the maximum dose is 80 mg per day. Adults who need more than a 45% reduction in LDL cholesterol may be started at 40 mg daily.
- Pediatric patients should receive 10 mg once daily up to a maximum dose of 20 mg daily.
- Lipitor may be taken with or without food and at any time of day.
- The recommended dose of ezetimibe is 10 mg daily. Ezetimibe can be taken with or without food and at the same time as statin drugs.
What drugs interact with Lipitor and Zetia?
Decreased elimination of Lipitor could increase levels of Lipitor in the body and increase the risk of muscle toxicity from Lipitor. Therefore, Lipitor should not be combined with drugs that decrease its elimination. Examples of such drugs includes:
- erythromycin (E-Mycin),
- ketoconazole (Nizoral),
- itraconazole (Sporanox),
- clarithromycin (Biaxin),
- telithromycin (Ketek),
- cyclosporine (Sandimmune),
- nefazodone (Serzone), and
- HIV protease inhibitors such as indinavir (Crixivan) and ritonavir (Norvir).
Large quantities of grape fruit juice (>1.2 liters daily) also will increase blood levels of Lipitor and should not be taken.
The following drugs also may increase the risk of muscle toxicity when combined with Lipitor.
- amiodarone (Cordarone)
- verapamil (Calan Verelan, Isoptin)
- cyclosporine (Sandimmune)
- niacin (Niacor, Niaspan, Slo-Niacin)
- gemfibrozil (Lopid)
- fenofibrate (Tricor)
Lipitor increases the effect of warfarin (Coumadin) and the concentration in blood of digoxin (Lanoxin). Patients taking Lipitor and warfarin or digoxin should be monitored carefully. Cholestyramine (Questran) decreases the absorption of Lipitor. Lipitor should be given at least two hours before and at least four hours after cholestyramine.
Rifampin increases breakdown of Lipitor. To reduce the likelihood of this interaction both drugs should be given at the same time. Lipitor should not be given after rifampin.
Cholestyramine (Questran), colestipol (Colestid) and colesevelam (WelChol), bile acid-binding drugs that may be used to treat elevated levels of cholesterol, bind to ezetimibe and reduce its absorption from the intestine by about 50%. Therefore, ezetimibe should be taken at least two hours before or 4 hours after administration of these drugs. Cyclosporine (Gengraf, Neoral) increases the levels of ezetimibe while ezetimibe increases levels of cyclosporine. Combining both drugs may increase side effects of either drug.
Are Lipitor and Zetia safe to take while pregnant or breastfeeding?
- Lipitor should not be taken during pregnancy because the developing fetus requires cholesterol for development, and Lipitor reduces the production of cholesterol. Lipitor should only be administered to women of childbearing age if they are not likely to become pregnant.
- It is not known if Lipitor is secreted in breast milk. Because of the potential risk of adverse events, breastfeeding mothers should not use Lipitor.
- There are no adequate studies of ezetimibe in pregnant women. Therefore, physicians must weight the benefit of prescribing ezetimibe during pregnancy against potential but unknown risks.
- There are no adequate studies of ezetimibe in women who are breastfeeding. Therefore, physicians must weight the benefit of prescribing ezetimibe to nursing women against potential but unknown risks.
Lipitor (atorvastatin) and Zetia (ezetimibe) are used to lowers cholesterol levels in the blood. Lipitor and Zetia belong to different drug classes. Lipitor is an HMG-CoA reductase inhibitor (a “statin” drug) and Zetia is a cholesterol-lowering drug.
Multimedia: Slideshows, Images & Quizzes
High Cholesterol (Hyperlipidemia) Quiz: Test Your Medical IQ
High cholesterol can be a dangerous condition. Take the Cholesterol Quiz to understand what high cholesterol means in terms of...
Picture of Cholesterol
Cholesterol carried in particles of low density (LDL cholesterol) is referred to as the "bad" cholesterol because elevated levels...
Lower Your Cholesterol, Save Your Heart
Need to lower your cholesterol levels? Use these smart diet tips to quickly and easily lower your blood cholesterol levels....
Cholesterol Drugs: What to Expect With Heart Medication
When diet and exercise aren't enough, should you turn to drugs? Learn cholesterol basics, drug classes, and available drugs along...
Cholesterol Levels: What the Numbers Mean
Do you know the different cholesterol levels and what they mean? Learn the alphabet soup of cholesterol testing: LDL, HDL, good,...
Cholesterol: High Triglyceride Foods to Avoid
High triglycerides increase the risk of heart disease. Lower triglyceride levels and reduce cholesterol by eating foods that...
Related Disease Conditions
High Blood Cholesterol
Second Source article from Government...
Cholesterol (Lowering Your Cholesterol)
High cholesterol and triglyceride levels increase the risk of cardiovascular disease. Getting your cholesterol and triglyceride...
High Cholesterol: Frequently Asked Questions
Cholesterol occurs naturally in the body. High blood cholesterol levels increase a person's risk of developing heart disease,...
Low Cholesterol Diet
Cholesterol is naturally produced by the body, and is a building block for cell membranes and hormones. Low-density lipoprotein...
HDL vs. LDL Cholesterol (Differences, Normal Ranges, Meanings)
HDL (high-density lipoprotein), or the "good" cholesterol, and LDL (low-density lipoprotein), or the "bad"...
Treatment & Diagnosis
- High Cholesterol (Hyperlipidemia) FAQs
- Heart Attack Prevention From a Doctor's Perspective
- Statins - - Doing More Than Lowering Your Cholesterol?
- Cholesterol: Questions To Ask Your Doctor
- Cholesterol: The Truth About Cholesterol
- Cholesterol: HDL cholesterol ratio
- Cholesterol - Mr. D.T.'s Story of Hope
- Cholesterol Guidelines for Adults (2001)
- Cholesterol Guidelines
- Can Menopause Cause High Cholesterol?
- What are Cholesterol-Lowering Statins?
- Do Bile Acid Resins Lower Cholesterol?
- Can Fibrate Drugs Lower Cholesterol?
- What Are The Side Effects of Lipitor on a Fetus?
- What Should Cholesterol Levels Be After Heart Attack?
- How Do I Lower My Cholesterol (Triglycerides)
- Does Lipitor Help Rheumatoid Arthritis?
- Does Hypothyroidism Cause High Cholesterol?
- Does Exercise Lower Cholesterol?
- What Foods Lower Cholesterol?
- Does Stress Cause High Cholesterol?
- Is Lipitor Safe if I Have Fatty Liver?
- Cholesterol Treatment
- Cholesterol, The Basics Of Prevention
Medications & Supplements
- atorvastatin - oral, Lipitor
- ezetimibe - oral, Zetia
- Lipitor (atorvastatin)
- ezetimibe (Zetia)
- atorvastatin (Lipitor) vs. simvastatin (Zocor)
- Lipitor (atorvastatin) vs. Crestor (rosuvastatin)
- Lipitor (atorvastatin) vs. Niacin (nicotinic acid, vitamin B3)
- Lipitor (atorvastatin) vs. Vytorin (simvastatin and ezetimibe)
Prevention & Wellness
Health Solutions From Our Sponsors
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.