Two medicines, side by side
Fluvastatin vs pitavastatin
Fluvastatin and pitavastatin are both labeled for high cholesterol. Drugs@FDA records approvals of fluvastatin since 1993 and of pitavastatin since 2009. Pharmacies paid $2.88 per fluvastatin ER 80 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. How each works, in its label's words: 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 …”; 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 fluvastatin FDA label on DailyMed (effective April 21, 2025); the pitavastatin FDA label on DailyMed (effective March 31, 2026).
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
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 (Fluvastatin label of April 21, 2025, Pitavastatin label of March 31, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do fluvastatin and pitavastatin differ on the record?
How each works, in its label's words: 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 …”; 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: Fluvastatin, “The elimination half-life (t 1/2 ) of fluvastatin is approximately 3 hours.”; Pitavastatin, “The mean plasma elimination half-life is approximately 12 hours.”
Generics: fluvastatin since 2012; pitavastatin since 2016 (Drugs@FDA).
| Fluvastatin | Pitavastatin | |
|---|---|---|
| Labeled for | High cholesterol | High cholesterol |
| Pharmacologic class | HMG-CoA Reductase Inhibitor | HMG-CoA Reductase Inhibitor |
| How it works (label) | 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. | 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) | The elimination half-life (t 1/2 ) of fluvastatin is approximately 3 hours. | The mean plasma elimination half-life is approximately 12 hours. |
| Earliest approval on file (Drugs@FDA) | December 31, 1993 | August 3, 2009 |
| First generic approved | April 11, 2012 | December 20, 2016 |
| Generic labelers (NDC) | 4 labelers | 12 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $2.88 per tablet (Fluvastatin ER 80 mg tablet) | $0.954 per tablet (Pitavastatin 2 mg tablet) |
| 12-month price change | +4% | -34% |
| Boxed warning | No | No |
| Shortage now | A presentation being discontinued | No current entry |
| Recalls recorded | 2 | 7 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 7,505 | 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 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 fluvastatin
- every medicine labeled for the same conditions