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Comment & Response
August 12/26, 2013

Why Physicians Favored Lipitor Over Simvastatin

Author Affiliations
  • 1Providence Medical Group, Torrance, California
JAMA Intern Med. 2013;173(15):1473. doi:10.1001/jamainternmed.2013.7747

To the Editor In their commentary on generic drug use, Alldredge and Kayser1(p233) state the following:

In 2011, fewer prescriptions for generic simvastatin were written than for Lipitor (atorvastatin calcium; Pfizer Inc) despite a significant cost differential and no apparent clinical differences in efficacy and safety.

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    1 Comment for this article
    Begging the question
    David Louis Keller | PMG
    Your reply to my letter implies that physicians could not have been aware of any problems with simvastatin before the first FDA warning in 2010. In fact, many physicians were well aware of the theoretical potential for problems with hepatic excretion of this drug due to multiple severe interactions, and patients themselves complained of myalgias which went away when they were switched to Lipitor. In my mind, there was little doubt of these facts long before the FDA finally acted, which is why this physician, for one, prescribed Lipitor for those patients who could obtain it and might benefit by switching to it from simvastatin. Less is more when discussing LDL levels, but not when it comes to CPK levels and the risk of rhabdomyolysis.