Even though six highly effective statins were already on the market, the FDA approved a seventh statin, pitavastatin (Livalo) in 2009.
Studies have shown that pitavastin is as safe and effective as the other potent statins in lowering total cholesterol and LDL cholesterol. Let's look at why.
How is pitavastatin different?
Most statins are broken down by one of the enzymes in the liver and intestine. This same enzyme is responsible for the metabolism of about 60 percent of prescribed medications.
Pitavastatin has one important trait not shared by other statins: It is only minimally processed in the liver while traveling down a common metabolic pathway there. This much-used route can break down the other statins (and many other medications) so they can be used by the body, but pitavastatin chooses a road less taken. And this lonelier route is good because the other statins pick up some of their (modest) side effects when they compete against other drugs for the use of this well-traveled path. Such competition—which pitavastatin stays away from almost entirely—also happens to bring on the life-threatening and severe muscle inflammation associated with the earlier statins that can release a kidney-damaging protein.
Advantages of pitavastatin
The new statin sidesteps these side effects, which become ever more common as the doses of the older statins are increased and other drugs are needed to lower LDL cholesterol levels. (As a matter of fact, many other drugs taken by the elderly and people with diabetes or other chronic diseases can also increase the risk of these side effects.) So, people who have had problems with side effects while taking statins should consider discussing with their doctor a switch to this new drug when it becomes available.
Other advantages: in at least one study pitavastatin raised levels of HDL cholesterol more than other statins. In addition, pitavastatin did not raise blood glucose levels and may be less likely than the other statins to increase the development of type 2 diabetes.
Disadvantages of taking pitavastatin
The cost of pitavastatin is much higher than most of the other statins, which are available as less expensive generics. Although pitavastatin is effective in lowering cholesterol levels, long term studies are needed to confirm that the drug reduces the number of heart attacks, strokes, and deaths from cardiovascular disease.