Two medicines, side by side
Atorvastatin vs fluvastatin
Atorvastatin and fluvastatin are both labeled for high cholesterol. Drugs@FDA records approvals of atorvastatin since 1996 and of fluvastatin since 1993. Pharmacies paid $0.0228 per atorvastatin 10 mg tablet and $2.88 per fluvastatin ER 80 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Atorvastatin's other strengths are brand-only: $1.23 per mL (Atorvaliq 20 mg/5 mL suspension). How each works, in its label's words: Atorvastatin, “LIPITOR is a selective, competitive inhibitor of HMG-CoA reductase, the rate-limiting enzyme that converts 3-hydroxy-3-methylglutaryl-coenzyme A to mevalonate, a precursor of sterols, including …”; Fluvastatin, “Fluvastatin sodium is a competitive inhibitor of HMG-CoA reductase, the rate limiting enzyme that converts 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) to mevalonate, a precursor of sterols …”
Check it at the source: the atorvastatin FDA label on DailyMed (effective April 15, 2024); the fluvastatin FDA label on DailyMed (effective April 21, 2025).
Highlights of the atorvastatin record
Atorvastatin (Lipitor) · label of April 15, 2024
Used for
From the label: indicationsLIPITOR is indicated: • To reduce the risk of: o Myocardial infarction (MI), stroke, revascularization procedures, and angina in adults with multiple risk factors for coronary heart disease (CHD) but without clinically evident CHD o MI and stroke in adults with type 2 diabetes mellitus with multiple risk factors for CHD but without clinically evident CHD o Non-fatal MI, fatal and non-fatal stroke, revascularization […]
On the market
- Earliest approval on file
- December 17, 1996
- Generic labelers
- 59 labelers
- Pharmacy cost
- $0.0228 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 53
Highlights of the fluvastatin record
Fluvastatin (Lescol) · label of April 21, 2025
Used for
From the label: indicationsTherapy with lipid-altering agents should be only one component of multiple risk factor intervention in individuals at significantly increased risk for atherosclerotic vascular disease due to hypercholesterolemia. Drug therapy is indicated as an adjunct to diet when the response to a diet restricted in saturated fat and cholesterol and other non-pharmacologic measures alone has been inadequate. […]
On the market
- Earliest approval on file
- December 31, 1993
- Generic labelers
- 4 labelers
- Pharmacy cost
- $2.88 per tablet
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 2
Source: FDA drug labels via openFDA (Atorvastatin label of April 15, 2024, Fluvastatin label of April 21, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do atorvastatin and fluvastatin differ on the record?
How each works, in its label's words: Atorvastatin, “LIPITOR is a selective, competitive inhibitor of HMG-CoA reductase, the rate-limiting enzyme that converts 3-hydroxy-3-methylglutaryl-coenzyme A to mevalonate, a precursor of sterols, including …”; Fluvastatin, “Fluvastatin sodium is a competitive inhibitor of HMG-CoA reductase, the rate limiting enzyme that converts 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) to mevalonate, a precursor of sterols …”
Both are in FDA's class HMG-CoA reductase inhibitors.
Half-life, in each label's words: Atorvastatin, “Mean plasma elimination half-life of LIPITOR in humans is approximately 14 hours, but the half-life of inhibitory …”; Fluvastatin, “The elimination half-life (t 1/2 ) of fluvastatin is approximately 3 hours.”
Generics: atorvastatin since 2011; fluvastatin since 2012 (Drugs@FDA).
| Atorvastatin | Fluvastatin | |
|---|---|---|
| Labeled for | High cholesterol, Angina, High triglycerides, Heart attack and coronary artery disease | High cholesterol |
| Pharmacologic class | HMG-CoA Reductase Inhibitor | HMG-CoA Reductase Inhibitor |
| How it works (label) | LIPITOR is a selective, competitive inhibitor of HMG-CoA reductase, the rate-limiting enzyme that converts 3-hydroxy-3-methylglutaryl-coenzyme A to mevalonate, a precursor of sterols, including cholesterol. | Fluvastatin sodium is a competitive inhibitor of HMG-CoA reductase, the rate limiting enzyme that converts 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) to mevalonate, a precursor of sterols, including cholesterol. |
| Half-life (label) | Mean plasma elimination half-life of LIPITOR in humans is approximately 14 hours, but the half-life of inhibitory activity for HMG-CoA reductase is 20 to 30 hours due to the contribution of active metabolites. | The elimination half-life (t 1/2 ) of fluvastatin is approximately 3 hours. |
| Earliest approval on file (Drugs@FDA) | December 17, 1996 | December 31, 1993 |
| First generic approved | November 30, 2011 | April 11, 2012 |
| Generic labelers (NDC) | 59 labelers | 4 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0228 per tablet (Atorvastatin 10 mg tablet) | $2.88 per tablet (Fluvastatin ER 80 mg tablet) |
| 12-month price change | -8% | +4% |
| Boxed warning | No | No |
| Shortage now | No current entry | A presentation being discontinued |
| Recalls recorded | 53 | 2 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 245,894 | 7,505 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What do the labels say about using others of their kind?
Fluvastatin label, drug interactionsBleeding and/or increased prothrombin times have been reported in patients taking coumarin anticoagulants concomitantly with other HMG-CoA reductase inhibitors.
Source: FDA drug labels via openFDA
What next?
- Alternatives to atorvastatin
- every medicine labeled for the same conditions