In 2001, patients filled more than 57 million prescriptions for Lipitor, a drug that promises to reduce high levels of LDL (bad) cholesterol while increasing levels of HDL (good) cholesterol. Proponents of Lipitor and other statin drugs claim that they, in addition to normalizing cholesterol levels, can reduce inflammation and reduce the risk of heart attack, stroke and heart-related deaths in general. What doctors and pharmacists are less likely to explain in full to patients, however, are the potential side effects of drugs like Lipitor -- side effects that can outweigh any potential good the drugs might purport to do.
Undoubtedly, the huge number of prescriptions filled for Lipitor and other statin drugs in recent years correlates with the numerous direct-to-consumer advertisements screaming the benefits of these drugs over television and radio airwaves. But what about the list of possible side effects rattled off at the end of these ads -- usually at an auctioneer's pace or in a lulling, comforting voice that makes them sound insignificant compared to the drug's power to improve your health? As it turns out, the side effects mentioned by the ads' unseen spokesperson are just the tip of the iceberg.
Dr. Matthew Budoff, author of "Enhancing Heart Health," writes that cholesterol-lowering drugs like Lipitor "work by inhibiting the enzyme needed to manufacture cholesterol in the liver. However, these drugs also block the manufacture of important nutrients like CoQ10, which has been shown to benefit heart health. The other main drawback of this class of drugs is debilitating muscle pain ... Other side effects, according to the Physicians Desk Reference, include liver problems, nausea, diarrhea, abdominal pain, headaches and skin rash."
Aching muscles are especially common among statin drug users, and according to Bottom Line Yearbook 2002, muscle ache can actually be a sign that body tissues are breaking down, which can lead to serious kidney damage. Other, less common -- but no less disturbing -- side effects can also occur as a result of taking statin drugs, as is illustrated by the following patient account in "Overdose" by Jay S. Cohen: "Last of all my doctor prescribed Lipitor, and after several months I found I was having trouble remembering names and coming up with the right word. At dinner once, I said, 'Please pass the elephant,' though I wanted the bread. I told my husband that I thought I'd had a stroke. In January, a friend came to visit. She was worried about her memory and couldn't think of her daughter's name on the telephone. She too was on Lipitor. I asked my doctor to prescribe a different cholesterol medicine. Within a couple of weeks I was more mentally alert. But my friend (still on Lipitor) was in worse shape and afraid she would lose her job. Her doctor said forgetfulness could not be due to the drug. She finally stopped taking Lipitor and now is much sharper."
Cohen writes that he has heard more complaints about side effects from Lipitor than all of the other drugs in its class combined. "Perhaps this is because the standard dosage of Lipitor is so strong; it is far stronger than many patients actually need or can tolerate," he writes. Indeed, the recommended dosage of Pfizer's Lipitor is notably high -- usually 10 mg or higher. Cohen writes, "The Lipitor dosage guidelines do not distinguish between patients with or without heart disease. They do not distinguish between patients requiring large reductions and those needing small reductions. The recommended initial dose of Lipitor, 10 mg, is so powerful that doctors can treat many patients with the same dose and not have to bother matching the dose to individual patients."
In other words, Pfizer standardized its dosage recommendations for Lipitor in order to make it easier for doctors to prescribe the drug -- a convenience for the drug company and the doctor perhaps, but certainly not for the patient.
When it comes to statin drugs, Americans are being overdosed with prescription medications they probably don't even need in the first place. We now know that high doses of these drugs can have serious side effects in many areas of health. To avoid getting hooked on these dangerous drugs, talk to a health practitioner, like a naturopath, who can discuss with you natural ways to improve your cholesterol levels. Don't just turn to mega-doses of Lipitor for help.
The experts speak on Lipitor.
Statin drugs--the prototype of which is Lipitor (atorvastatin), though there are many others--not only lower high cholesterol, they also appear to have a protective anti-inflammatory effect against AD.
Dr Isadore Rosenfeld's Breakthrough Health By Isadore Rosenfeld MD, page 9
There are several other statins sold by pharmaceutical firms (Lipitor,Pravachol. Zocor, Baycol, Lescol). All these lower cholesterol.
A Physicians Guide To Natural Health Products That Work By James Howenstine MD, page 223
Besides normalizing blood fats, statin drugs such as Lipitor (atorvastatin) and Pravachol (pravastatin) also reduce inflammation, thus stabilizing any plaques in your coronary arteries and reducing the likelihood of their clotting. They have been shown to lower C-RP by 15 to 25 percent. A recent study shows that high doses of statin drugs (80 milligrams of Lipitor) decreased C-RP levels by almost 30 percent in patients with type 2 diabetes (who are especially vulnerable to vascular disease).
Dr Isadore Rosenfeld's Breakthrough Health By Isadore Rosenfeld MD, page 127
Statin drugs, such as Lipitor or Pravachol, or Zocor, are commonly used to treat high lousy (LDL) cholesterol levels, and some of them, such as Lipitor, also increase healthy (HDL) cholesterol levels.
The Real Age Diet by Michael F Roizen MD and John La Puma MD, page 77
Researchers taking another approach are evaluating the effect of the cholesterol-lowering statin drugs on patients with MS. These medications include Zocor (simvastatin), Pravachol (pravastatin), Lipitor (atorvastatin), and Lescol (fluvastatin) and their benefits seem to be endless. Although they're mainly used to normalize elevated cholesterol levels, other beneficial effects include reducing the risk of Alzheimer's, shrinking obstructive plaques in the arteries, protecting against stroke, an anti-inflammatory effect on blood vessels, and perhaps reducing the risk of osteoporosis in vulnerable women.
Dr Isadore Rosenfeld's Breakthrough Health By Isadore Rosenfeld MD, page 190
When used properly, Pravachol, Zocor, Lipitor, Mevacor, Lescol, and Baycol are excellent drugs.
Overdose by Jay S Cohen, page 10
Zocor and Lipitor, which are taken to lower cholesterol, can produce symptoms that mimic the flu. Doctors can easily miss the connection, but muscle aches may signal tissue breakdown. That can lead to serious kidney damage.
Bottom Line Yearbook 2002 by Bottom Line Personnel, page 13
As it turns out, at least 81 more deaths were connected to Baycol's sisters -- Mevacor, Pravachol , Zocor, Lescol, and Lipitor.
Prescription Medicines, Side Effects and Natural Alternatives by American Medical Publishing, page 61
Five statins remain on the market--lovas-tatin (Mevacor), simvastatin (Zocor), pravas-tatin (Pravachol), atorvastatin (Lipitor) and fluvastatin (Lescol). Each of these can cause myositis.
Bottom Line Yearbook 2004 by Bottom Line Personnel, page 199
Marlene had a serious reaction to Lipitor, so her doctor switched her to Zocor. When another reaction occurred, he switched her to Pravachol. After another reaction, she quit treatment. "If a medication doesn't work or causes side effects," a pharmacist said years ago, "most physicians just switch from one to another, then another, then another, until they either find a drug that works, or they or the patient give up."
Disease Prevention And Treatment by Life Extension Foundation, page 724
Lipitor is the top-selling drug for treating high cholesterol and, prescribed 48,791,000 times in 2000, the second best-selling drug overall. Lipitor is marketed at a very strong initial dose, the most powerful initial dose in lowering cholesterol of all of the drugs of its group. Thus, Pfizer Inc can impress doctors and patients that the initial dose of Lipitor reduces cholesterol to preferred levels better than any other drug. This claim is used extensively in Lipitor's advertising, and it has been instrumental in Lipitor's surpassing well-established, better-proven competitors such as Zocor and Pravachol. The catch is that most side effects with these drugs are dose-related. The more potent the dosage, the greater the risk of side effects. Moreover, although patients will take Lipitor for decades, we have no idea whether unforeseen, long-term side effects may occur-- and potential long-term side effects will likely be dose-related. So while Pfizer boasts that Lipitor is so strong that doctors only have to prescribe the initial dosage to most patients, it doesn't mention that this dosage is 100 to 400 percent greater than millions of patients need. I have been contacted by patients who have had awful reactions to Pfizer's recommended initial dose of Lipitor. There are Web sites with hundreds upon hundreds of cases, some so severe that people are disabled. Many of these reactions might have been avoided by using lower, safer, proven-effective doses of Lipitor--doses that better fit these patients' needs and tolerances--but these doses are not even mentioned in Lipitor's package insert or PDR description.
Overdose by Jay S Cohen, page 26
People with mild cholesterol elevations usually don't need high potency doses of Lipitor and Zocor, but doctors prescribe them anyway even when milder statins-- Pravachol, Mevacor, Lescol--would do.
Disease Prevention And Treatment by Life Extension Foundation, page 20
How might you know if you are responsive to low-dose Lipitor, Zocor, or other statin drugs? Easy: by starting low and, if necessary, increasing gradually. In other words, by working with a doctor who recognizes the importance of matching the dosage to the individual. Not only does this reduce the risk of side effects for people sensitive to these drugs, but it also reduces problems for people who ultimately require high dosages, because their bodies are given adequate time to adjust to the drug, and because they are assured that the higher dosage is necessary.
Overdose by Jay S Cohen, page 101
Liver enzyme elevations signify liver injury. So if you get 10 mg of Lipitor when you only need 2.5 mg, your risk of liver injury is also quadrupled.
Disease Prevention And Treatment by Life Extension Foundation, page 20
Statins, including Baycol, Lipitor and Zocor. These drugs have proven to be extremely effective in lowering cholesterol, and thus helping people avoid heart attacks, high blood pressure, strokes and other diseases. Yet, these drugs have now been proven to kill. That's because in addition to melting cholesterol, the statins also tend to dissolve healthy muscle tissue, causing muscles cells to foul the kidneys and kill people.
Disease Prevention And Treatment by Life Extension Foundation, page 711
Yet, there's no information about 2.5 or 5 mg of Lipitor in the package insert or PDR and no pills in these doses, so doctors start everyone at 10 mg, or even 20 mg or 40 mg.
Prescription Medicines, Side Effects and Natural Alternatives by American Medical Publishing, page 118
Doctors should tell the millions of patients who are taking Lipitor, Celebrex, Prilosec, Zoloft, and many other drugs that the long-term safety of these drugs has not been proven and that new side effects are often discovered years and decades after drugs are approved.
Overdose by Jay S Cohen, page 306
If you take atorvastatin (Lipitor) for lowering cholesterol or nifedipine (Procardia) for controlling high blood pressure, do not take ginkgo. Doing so could result in a dangerous buildup of the drugs in the bloodstream.
Bottom Line Yearbook 2004 by Bottom Line Personnel, page 70
Just because Pfizer says Lipitor should be dosed at 10 20 40 mg, it doesn't mean you must follow that regimen. Perhaps 15 mg is your ideal dose. Or 30 mg.
Overdose by Jay S Cohen, page 20
The American Medical Association states that the difference in people's response to a specific drug can vary "4- to 40-fold" (AMA 1994). With such variability, it isn't surprising that some people can drink a pot of coffee without problems while others can't handle a cup. Similarly, it isn't surprising that some people need 80 mg of the antidepressant Prozac or the cholesterol-lowering drug Lipitor, while others need just 2.5 mg.
Disease Prevention And Treatment by Life Extension Foundation, page 20
In the Prove It study, the people over the age of 65 derived no greater benefit from Lipitor than from Pravachol, one of the earlier statins.
Overdosed America by John Abramson MD, page 247
Duane Graveline's first dose of Lipitor caused amnesia "so severe that I landed in the emergency room of a hospital near my Vermont home. I didn't remember any of it." Dr. Graveline, a retired family doctor, flight surgeon and astronaut (www.spacedoc.net), was perplexed. After all, he wasn't usually sensitive to medications, and he'd taken only 10 mg, the lowest dose recommended and marketed by the manufacturer. Yet, 10 mg of Lipitor is very strong, much stronger than many people need. It was much stronger than Dr. Graveline needed, because he needed only 2.5 mg of Lipitor--75% less medication than he got. How do we know? Experts advise doctors to select statin doses based on the reduction in LDL-C (the bad, low-density-lipoprotein cholesterol) that each person needs (NCEP 2001). Ten milligrams of Lipitor reduces LDL-C 39%, a strong response needed by cardiac patients and people with severely elevated cholesterol. But most people with high cholesterol have mild-to-moderate elevations and no cardiac history, and they require only 20% to 30% reductions in LDL-C. This can be attained with only 2.5 mg.
Disease Prevention And Treatment by Life Extension Foundation, page 713
Pfizer doesn't provide any information in its package insert or the PDR about the effectiveness and reduced risks of low-dose Lipitor, and it doesn't produce low-dose pills. Physicians have to discover the effectiveness of low-dose Lipitor on their own. Charles was 67 when his doctor prescribed Lipitor at the standard 10-mg dose. When Charles's muscles began to ache, his doctor told him to split the pill in half. The aching stopped, and three months later, Charles's LDL-C had dropped from 187 to 103--a 45-percent reduction with just 5 mg of Lipitor. Charles's response to low-dose Lipitor is not surprising. Although drug companies only provide information about "average" cholesterol reductions, the variability in response between patients is quite large. A 2000 study in the American Journal of Cardiology found: "Individual variation in LDL-C response to statin therapy is large (range 10% to 70%)." Many patients can obtain excellent responses with low-dose statins-- if their physicians remember that individual variation should be considered whenever prescribing any medication. There is another benefit of using low-dose statins: When his doctor reduced his dosage to one half of a pill, Charles's costs for the Lipitor, a very expensive drug, were also halved.
Overdose by Jay S Cohen, page 98
In 1998, Lipitor, the largest selling statin drug, was the third leading drug in the United States, accounting for over $1,544 billion in sales.
The Nutritional Cost of Prescription Drugs by Ross Pelton RPH and James B LaValle RPH, page 103
Claritin, Lipitor, Viagra, Prilosec, Celebrex, and Vioxx--these and other products worth $500 million or more in annual sales account for over 50 percent of total drug sales in the United States, up from 28 percent for the year ending July 1997, according to IMS Health.
The Big Fix by Katharine Greider, page 164
Settlement agreements in fraud cases with other pharmaceutical companies in recent years included $49 million from Pfizer Inc. over Lipitor, the cholesterol-lowering drug.
Critical condition by Donald L Barlett and James B Steele, page 9
"A decade ago we didn't worry about a person's cholesterol. Now we have Zocor, Mevacor, Lipitor--there are four or five drugs that are used by a very large proportion of the population for years."
The Big Fix by Katharine Greider, page 175
The best-selling statins as of 2003 were Lipitor, Pravachol, and Zocor.
Overdosed America by John Abramson MD, page 134
A British doctor, Dr. Sidney Wolfe, is head of a consumer advocacy group called Public Citizen. He is preparing a petition for the FDA to strengthen warnings on all other statin class drugs, including the popular Lipitor, Pravachol, and the others.
Prescription Medicines, Side Effects and Natural Alternatives by American Medical Publishing, page 57
Effective, safer, lower doses of top-selling drugs such as Prozac, Voltaren, Celebrex, Lipitor, many antihypertensive drugs, etc., have yet to be widely recognized, and important low-dose information has yet to be provided in drug-company product information or many drug references.
Overdose by Jay S Cohen, page 144
The alchemy of naming turns the rather awkward atorvastatin into Lipitor, which combines the word for blood fats, "lipid," with a hint of the avenging action hero.
The Big Fix by Katharine Greider, page 96