Brand names for major cholesterol-lowering drugs have a poetic-sounding quality: Mevacor, Zocor, Lipitor, Crestor, Pravacol and Lescol. The generic names also have a distinguishing characteristic---they all end with the word "statin." As patent protection expires for each drug, companies other than the original manufacturer are able to offer competing generic versions. Prices for generics can be as low as a few pennies a day, so generics are worthy of consideration. Lovastatin, pravastatin and simvastatin are currently available as prescription generic drugs. There are also non-statin generic medications that help control cholesterol as well.
Lovastatin
Lovastatin is the generic name for Mevacor, which has been available as a generic drug since the patent expired in 2001. Development of lovastatin started in 1979, but it was not approved by the U.S. Food and Drug Administration (FDA) until 1987. Merck petitioned the FDA three times for permission to sell Mevacor as an over-the-counter drug without a prescription; the requests were all denied, the last in late 2007.
Pravastatin
The generic name for Pravachol is pravastatin. Pravastatin has been available as a generic drug since the patent expired in 2006. Like all of the statins, pravastatin functions by partially inhibiting cholesterol synthesis.
Simvastatin
Simvastatin is the generic name for Zocor. The patent expired in 2006, so simvastatin is available as a generic drug. When cholesterol synthesis is partially blocked by a statin drug, the body attempts to compensate by increasing cholesterol absorption from foods. This can be countered by combining a prescription statin drug with functional foods such as margarines which contain phytosterols or phytostanols. These plant-derived, cholesterol-like molecules block absorption while not being absorbed themselves. Phytosterols/stanols can be used in combination with statin drugs.
Atoravastatin
The generic name for Lipitor is atoravastatin. Lipitor's patent expires in 2011. At some point after that, it will be available as a generic drug. Pfizer does not look forward to that day, as once generic competition occurs, prices soon tumble to less than one-fifth of the pre-generic brand name cost.
Rosuvastatin
The generic name for Crestor is rosuvastatin. Crestor will not be available in generic form until after 2012. As of 2010, Crestor is the second most widely prescribed statin drug after Lipitor.
Fluvastatin
The generic name for Lescol is fluvastatin. Lescol will not be available in generic form until after 2012.
Niacin and Ezetimibe
There are non-statin drugs for cholesterol management as well. Niacor and Niaspan are the brand names for immediate release and extended release form of niacin. Prescription niacin in doses of up to 3,000mg per day not only lowers total cholesterol and LDL-cholesterol, but it also lowers triglycerides and raises high-density cholesterol, often referred to as the "good" cholesterol. Niacin is available as a non-prescription dietary supplement in addition to prescription drug form. The National Cholesterol Education Program advises, however, against using supplement niacin to try to manage lipids, as niacin at effective doses can also have potentially serious adverse effects, and should be used only under the supervision of a physician. The generic name for Zetia is ezetimibe. Zetia is a cholesterol absorption blocker. This mechanism contrasts with statins, which are synthesis inhibitors.
