Question: I have high bad cholesterol and don’t tolerate Lipitor very well. What is the best way to find the right statin drug? Is it just trial and error?

Dr. Hibberd's answer:
A total of six so-called statin drugs are on the market. Direct comparisons of the potency of the various statin drugs are limited. One study (STELLAR trial) reported in the American Journal of Cardiology compared LDL lowering effect of Lipitor (atorvastatin), Zocor (simvastatin), and Pravachol (pravastatin) with the newest, Crestor (rosuvastatin), across a range of doses. That study concluded Crestor and Lipitor lowered LDL the best and in addition, triglycerides also. Both drugs are FDA-approved oral medications used to lower cholesterol and triglyceride levels. Although the advantages bestowed with Crestor are slightly better than the generic versions of Lipitor, the cost is much higher for Crestor. Your doctor can determine why Lipitor does not suit you, and then switch you to either a different dose to the one that you are taking (in accordance with your LDL (bad) levels, or he may switch your statin. Yes, the selection is often an educated guess, but sometimes there are other benefits that will make your doctor choose one over the other. This may include cost factors and insurance company guidelines your doctor is by contract bound to follow (if you didnt know that, you need to read your insurance contract carefully...the age of free choice of drugs paid by insurance has all but gone). Rebate and sampling situations as well as personel preference also play a role.