Skip to main content

Two medicines, side by side

Atorvastatin vs pravastatin

Atorvastatin and pravastatin 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 pravastatin since 1991. Pharmacies paid $0.0228 per atorvastatin 10 mg tablet and $0.058 per pravastatin sodium 20 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 …”; Pravastatin, “Pravastatin is a reversible inhibitor of HMG-CoA reductase, the rate-limiting enzyme that converts HMG-CoA to mevalonate, a precursor of cholesterol.”

Check it at the source: the atorvastatin FDA label on DailyMed (effective April 15, 2024); the pravastatin FDA label on DailyMed (effective July 31, 2026).

Highlights of the atorvastatin record

Atorvastatin (Lipitor) · label of April 15, 2024

Used for

From the label: indications

LIPITOR 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 pravastatin record

Pravastatin (Pravachol) · label of July 31, 2026

Used for

From the label: indications

Pravastatin sodium tablets are indicated: To reduce the risk of myocardial infarction, myocardial revascularization procedures, and cardiovascular mortality in adults with elevated low-density lipoprotein cholesterol (LDL-C) without clinically evident coronary heart disease (CHD). […]

On the market

Earliest approval on file
October 31, 1991
Generic labelers
37 labelers
Pharmacy cost
$0.058 per tablet

Supply and safety

Shortage
No current entry
Recalls
17

Source: FDA drug labels via openFDA (Atorvastatin label of April 15, 2024, Pravastatin label of July 31, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)

How do atorvastatin and pravastatin 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 …”; Pravastatin, “Pravastatin is a reversible inhibitor of HMG-CoA reductase, the rate-limiting enzyme that converts HMG-CoA to mevalonate, a precursor of cholesterol.”

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 …”; Pravastatin, “Following single dose oral administration of 14 C-pravastatin, the radioactive elimination t ½ for pravastatin is 1.8 …”

Generics: atorvastatin since 2011; pravastatin since 2006 (Drugs@FDA).

AtorvastatinPravastatin
Labeled forHigh cholesterol, Angina, High triglycerides, Heart attack and coronary artery diseaseHeart attack and coronary artery disease, High cholesterol, High triglycerides
Pharmacologic classHMG-CoA Reductase InhibitorHMG-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.Pravastatin is a reversible inhibitor of HMG-CoA reductase, the rate-limiting enzyme that converts HMG-CoA to mevalonate, a precursor of 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.Following single dose oral administration of 14 C-pravastatin, the radioactive elimination t ½ for pravastatin is 1.8 hours in humans and the elimination half-life (t ½ ) for total radioactivity (pravastatin plus …
Earliest approval on file (Drugs@FDA)December 17, 1996October 31, 1991
First generic approvedNovember 30, 2011April 24, 2006
Generic labelers (NDC)59 labelers37 labelers
Pharmacy cost (NADAC, each one's most listed form; strengths differ)$0.0228 per tablet (Atorvastatin 10 mg tablet)$0.058 per tablet (Pravastatin sodium 20 mg tablet)
12-month price change-8%-18%
Boxed warningNoNo
Shortage nowNo current entryNo current entry
Recalls recorded5317
FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used)245,89419,683
DEA schedulenonenone

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