Two medicines, side by side
Atorvastatin vs simvastatin
Atorvastatin and simvastatin 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 simvastatin since 1991. Pharmacies paid $0.0228 per atorvastatin 10 mg tablet and $0.0321 per simvastatin 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 …”; Simvastatin, “Simvastatin is a prodrug and is hydrolyzed to its active β-hydroxyacid form, simvastatin acid, after administration.”
Check it at the source: the atorvastatin FDA label on DailyMed (effective April 15, 2024); the simvastatin FDA label on DailyMed (effective March 28, 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 simvastatin record
Simvastatin (Zocor) · label of March 28, 2025
Used for
From the label: indicationsZOCOR ® is indicated: To reduce the risk of total mortality by reducing risk of coronary heart disease death, non-fatal myocardial infarction and stroke, and the need for coronary and non-coronary revascularization procedures in adults with established coronary heart disease, cerebrovascular disease, peripheral vascular disease, and/or diabetes, who are at high risk of coronary heart disease events. […]
On the market
- Earliest approval on file
- December 23, 1991
- Generic labelers
- 27 labelers
- Pharmacy cost
- $0.0321 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 26
Source: FDA drug labels via openFDA (Atorvastatin label of April 15, 2024, Simvastatin label of March 28, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do atorvastatin and simvastatin 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 …”; Simvastatin, “Simvastatin is a prodrug and is hydrolyzed to its active β-hydroxyacid form, simvastatin acid, after administration.”
Both are in FDA's class HMG-CoA reductase inhibitors.
Generics: atorvastatin since 2011; simvastatin since 2006 (Drugs@FDA).
| Atorvastatin | Simvastatin | |
|---|---|---|
| Labeled for | High cholesterol, Angina, High triglycerides, Heart attack and coronary artery disease | Heart attack and coronary artery disease, High cholesterol, High triglycerides |
| 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. | Simvastatin is a prodrug and is hydrolyzed to its active β-hydroxyacid form, simvastatin acid, after administration. |
| 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 | December 23, 1991 |
| First generic approved | November 30, 2011 | June 23, 2006 |
| Generic labelers (NDC) | 59 labelers | 27 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0228 per tablet (Atorvastatin 10 mg tablet) | $0.0321 per tablet (Simvastatin 20 mg tablet) |
| 12-month price change | -8% | +5% |
| Boxed warning | No | No |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 53 | 26 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 245,894 | 248,728 |
| 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