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Friday, February 10, 2012

Generic Lipitor is here!

PHILIP S. CHUA M.D FACS, FPCS

‘Lifestyle changes are the major factors in the battle against obesity, high cholesterol, high blood sugar (among diabetics and borderline diabetics), and high blood pressure.’

LAST November, atorvastatin (generic name of Lipitor), the cholesterol-lowering pill (the best selling prescription drug in world history), became available in its generic form.

Ranbaxy and Watson, two generic drugmakers with good track records, started selling atorvastatinimmediately in the United States, but generic laws mandated a 180-day wait (till May 2012) before other companies may offer their own generic version

Pfizer. the giant pharmaceutical firm that introduced Lipitor, was not about to surrender its Lipitor golden egg, which made 100 billion dollars for Pfizer, and announced its plan "to make brand-name Lipitor competitive with atorvastatin." Watson is actually distributing the "authorized generic" form, manufactured by Pfizer, through a deal between the two firms.

Will atorvastatin be as good as Lipitor?
The more than 8.7 million persons taking Lipitor in the United States can take comfort in knowing that "the FDA imposes strict manufacturing parameters on the makers of generic drugs" says John Santa, MD, MPH, director of the Consumer Reports Health Ratings Center, on WebMD. In some countries, there may be fake but similarly-looking pills labeled "atorvastatin" being sold at bargain prices, so it is prudent to be vigilant and careful. We suggest buying medications at reputable and known pharmacies.

Is atrovastatin also a precription drug?
Yes, all cholesterol-busting drugs are a class of drugs called "statins," and all of them are prescription medications. Besides atorvastatin (Lipitor), the others are resuvastatin (Crestor), fluvastatin (Lescol), pitavastatin (Livalo), lovastatin (Mevacor), pravastatin (Pravacol), and simbastatin (Zocor). Like Lipitor, the last three are available in generic form.

Will Lipitor still be available?
Yes, the company "will make the brand name Lipitor available to customers at or below the cost of the generic atorvastatin for at least the next six months," states the WebMD report. This will make the transition smoother for patients. To compete and maintain dominance in the Lipitor business, Pfizer will surely continue marketing strategies that could be "hard to resist," given the integrity and trust Lipitor has attained all these years.

Who should take statin drug?
Anyone whose cholesterol level is abnormally high and could not be controlled by a disciplined healthy lifestyle (daily exercise, no smoking, fish and plant-based diet, minimal, if any, red meat at all, whole grain, nuts, fruits), are candidates for statin therapy. Your attending physician, who has interviewed and examined you, will tell you if statin, and which one, is right for you. A healthy lifestyle is a must, not only in lowering your cholesterol and triglycerides, but for boosting overall health and disease prevention, especially of cancer/diabetes/heart attack/stroke.

What are the normal cholesterol values?
The healthy levels are as follows: Total Cholesterol – less than 200 mg/dL, preferably about 160; HDL (High Density Lipoprotein, the Good Cholesterol) – 40 mg/dL or higher for men and 50 or higher for women; LDL (Low Density Lipoprotein, the Bad Cholesterol) – less than 130 mg/dL; and Triglycerides – less than 150 mg/dL

Is statin therapy for life?
No. If healthy lifestyle (diet and exercise, no smoking, moderation in alcohol intake) is able to lower the cholesterol, triglyceride, and blood sugar, to normal level and maintain them, without medications, and the physician finds the statin drug noit to be needed anymore, then it could be stopped. If needed in the future, it may be resumed. Lifestyle changes are the major factors in the battle against obesity, high cholesterol, high blood sugar (among diabetics and borderline diabetics), and high blood pressure.

What are the effects of a healthy lifestyle?
A disciplined lifestyle alone, through healthy diet (amount and quality control), daily exercises, and maintenance of proper weight, has been shown to reduce the bad cholesterol (LDL) by 5 to 10%, and a 10 to 30% reduction in triglycerides. If this drug-less treatment is not sufficient to control the cholesterol and triglycerides levels, then statins may be added to the lifestyle regimen. Statins can rapidly reduce the bad cholesterol (LDL) by 50% or more, and increase the good cholesterol (HDL) by up to 15%. All these good effects become evident within 2 to 4 weeks of starting statins.

Does high cholesterol increase cancer risk?
Yes, definitely. Red meat eaters have higher risk to develop cancer (colon, breast, prostate, pancreas, etc) compared to those whose diet consists mainly of fish, vegetables, beans, tofu, whole grains, nuts and fruits. This is why physicians recommend low saturated fat, low cholesterol, high fiber diet. Daily exercise, abstinence from tobacco, and disciplined alcohol use, together with proper diet, have been shown to also lower the risk for cancer, diabetes, obesity, heart attack, stroke and Alzheimer’s.

What are the side-effects of statins?
Statins are usually taken once a day, commonly at night. However statins affect sleep among some patients, who should take them during daytime. Statins are safe medications, with proven track record. Some of the side effects are: muscle and joint pains, gastrointestinal irritation, skin rash, and very rarely, muscle or liver damage. Some reports show that taking statins among some patients lowers the level of CoQ10, a vitamin-like substance that helps provide energy to cells for proper bodily function. For these individuals, a supplement of CoQ10 may be needed. The usual dosage of atorvastatin could range from 10 mg to 80 mg, sometimes higher, depending on the clinical response to this treatment.

While a disciplined lifestyle is the cornerstone in disease prevention and for maximal longevity, it is comforting to know that amidst us today are effective drugs like the statins, which could reduce our risk for cancer, obesity, diabetes, heart attack, stroke, Alzheimer’s dementia, and other maladies, when combined with healthy living.

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