Two medicines, side by side
Atorvastatin vs niacin
Atorvastatin and niacin are both labeled for heart attack and coronary artery disease, high cholesterol and high triglycerides. Drugs@FDA records approvals of atorvastatin since 1996 and of niacin since 1957. Pharmacies paid $0.0228 per atorvastatin 10 mg tablet and $0.193 per niacin ER 500 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). In FDA's classes, atorvastatin is a hmg-coa reductase inhibitor and niacin a nicotinic acid.
Check it at the source: the atorvastatin FDA label on DailyMed (effective April 15, 2024); the niacin FDA label on DailyMed (effective February 14, 2023).
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 niacin record
Niacin (Niacor) · label of February 14, 2023
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 hyperlipidemia. Niacin therapy is indicated as an adjunct to diet when the response to a diet restricted in saturated fat and cholesterol and other nonpharmacologic measures alone has been inadequate. […]
On the market
- Earliest approval on file
- July 24, 1957
- Generic labelers
- 13 labelers
- Pharmacy cost
- $0.193 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 7
Source: FDA drug labels via openFDA (Atorvastatin label of April 15, 2024, Niacin label of February 14, 2023); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do atorvastatin and niacin differ on the record?
In FDA's classes, atorvastatin is a hmg-coa reductase inhibitor and niacin a nicotinic acid.
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 …”; Niacin, “The mechanism by which niacin alters lipid profiles has not been well defined.”
Generics: atorvastatin since 2011; niacin since 1972 (Drugs@FDA).
| Atorvastatin | Niacin | |
|---|---|---|
| Labeled for | High cholesterol, Angina, High triglycerides, Heart attack and coronary artery disease | High cholesterol, Heart attack and coronary artery disease, High triglycerides |
| Pharmacologic class | HMG-CoA Reductase Inhibitor | Nicotinic Acid |
| 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. | The mechanism by which niacin alters lipid profiles has not been well defined. |
| 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. | n/a |
| Earliest approval on file (Drugs@FDA) | December 17, 1996 | July 24, 1957 |
| First generic approved | November 30, 2011 | September 15, 1972 |
| Generic labelers (NDC) | 59 labelers | 13 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0228 per tablet (Atorvastatin 10 mg tablet) | $0.193 per tablet (Niacin ER 500 mg tablet) |
| 12-month price change | -8% | +17% |
| Boxed warning | No | No |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 53 | 7 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 245,894 | 11,548 |
| 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)
Do their labels mention each other?
Atorvastatin label, drug interactionsNiacin Clinical Impact: Cases of myopathy and rhabdomyolysis have been observed with concomitant use of lipid modifying dosages of niacin (≥1 gram/day niacin) with LIPITOR. Intervention: Consider if the benefit of using lipid modifying dosages of niacin concomitantly with LIPITOR outweighs the increased risk of myopathy and rhabdomyolysis. …
Atorvastatin label, warnings and precautionsCases of myopathy/rhabdomyolysis have been reported with atorvastatin co-administered with lipid modifying doses (>1 gram/day) of niacin, fibrates, colchicine, and ledipasvir plus sofosbuvir [see Adverse Reactions (6.1) ].
Source: FDA drug labels via openFDA
What next?
- Alternatives to atorvastatin
- every medicine labeled for the same conditions