Two medicines, side by side
Atorvastatin vs pitavastatin
Atorvastatin and pitavastatin are both labeled for high cholesterol. Drugs@FDA records approvals of atorvastatin since 1996 and of pitavastatin since 2009. Pharmacies paid $0.0228 per atorvastatin 10 mg tablet and $0.954 per pitavastatin 2 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 …”; Pitavastatin, “Pitavastatin is an inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, the enzyme that catalyzes the conversion of HMG-CoA to mevalonate, a rate-limiting step in the biosynthetic …”
Check it at the source: the atorvastatin FDA label on DailyMed (effective April 15, 2024); the pitavastatin FDA label on DailyMed (effective March 31, 2026).
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 pitavastatin record
Pitavastatin (Livalo) · label of March 31, 2026
Used for
From the label: indicationsLIVALO is indicated as an adjunct to diet to reduce low-density lipoprotein cholesterol (LDL-C) in: Adults with primary hyperlipidemia. Adults and pediatric patients aged 8 years and older with heterozygous familial hypercholesterolemia (HeFH). […]
On the market
- Earliest approval on file
- August 3, 2009
- Generic labelers
- 12 labelers
- Pharmacy cost
- $0.954 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 7
Source: FDA drug labels via openFDA (Atorvastatin label of April 15, 2024, Pitavastatin label of March 31, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do atorvastatin and pitavastatin 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 …”; Pitavastatin, “Pitavastatin is an inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, the enzyme that catalyzes the conversion of HMG-CoA to mevalonate, a rate-limiting step in the biosynthetic …”
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 …”; Pitavastatin, “The mean plasma elimination half-life is approximately 12 hours.”
Generics: atorvastatin since 2011; pitavastatin since 2016 (Drugs@FDA).
| Atorvastatin | Pitavastatin | |
|---|---|---|
| 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. | Pitavastatin is an inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, the enzyme that catalyzes the conversion of HMG-CoA to mevalonate, a rate-limiting step in the biosynthetic pathway for 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 mean plasma elimination half-life is approximately 12 hours. |
| Earliest approval on file (Drugs@FDA) | December 17, 1996 | August 3, 2009 |
| First generic approved | November 30, 2011 | December 20, 2016 |
| Generic labelers (NDC) | 59 labelers | 12 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0228 per tablet (Atorvastatin 10 mg tablet) | $0.954 per tablet (Pitavastatin 2 mg tablet) |
| 12-month price change | -8% | -34% |
| 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 | 10,225 |
| 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 next?
- Alternatives to atorvastatin
- every medicine labeled for the same conditions