Statins, Are They The Same?

[Jingthing]

There is a big study in the news about how Crestor is beneficial even for people WITHOUT high cholesterol in preventing heart events. This big study is based on Crestor. This confuses me. Does that mean other statin meds aren't as good? Another question, I am on 20 mg. of Pravachol/Mevalotin. What would the equivalent dose be for Crestor? Just looking for a rough estimate to see how much more it would cost to switch to Crestor.

[Jingthing]

http://www.reuters.com/article/rbssHealthc...941138920081110

OK, I just read this article and they seem to be saying contradictory things, first statins are good, and second, because this important study was done specifically with EXPENSIVE Crestor, that more people should specifically take Crestor. Obviously, profits are a big part of of this, so I don't really know what to think.

[cathyy]

Basically, yes, all the statins are the same in that they work in the same way. If the one you are using is effective in lowering your cholesterol you don't need to switch. If it's not, then keep trying until you find one that does, and I for one recommend starting with the older cheaper ones.

Some people have a problem called "familial hypercholesterolemia." If you have this your problem isn't too much cholesterol in your diet, but your body making too much cholesterol. Statins don't help very much in this case. There is another medication named ezetimibe that keeps your body from making so much cholesterol. If this is your problem, you would know about it from your family history. I figured out it was my problem, and it was verified for sure when my son's cholesterol was nearly 300, and he was only 30 at the time. He was glad I harassed him into seeing a doc and getting checked.

[Jingthing]

Hmmm. What appears to be revolutionary about this new study is that statins are good for people who DO NOT suffer from high cholesterol but have another risk factor for heart problems (like overweight, etc.). And because this study was done with Crestor (and only Crestor) the question about whether this result is specific to Crestor or not seems cloudy. The study says nothing about people who are already on statin meds who did have high cholesterol and have successfully treated it with any statin (my situation). If nothing else, people can take this as a stock market tip, because I am sure sales of Crestor are going to boom now.

Edited November 14, 2008 by Jingthing

[Thanyaburi Mac]

Hmmm. What appears to be revolutionary about this new study is that statins are good for people who DO NOT suffer from high cholesterol but have another risk factor for heart problems (like overweight, etc.). And because this study was done with Crestor (and only Crestor) the question about whether this result is specific to Crestor or not seems cloudy. The study says nothing about people who are already on statin meds who did have high cholesterol and have successfully treated it with any statin (my situation). If nothing else, people can take this as a stock market tip, because I am sure sales of Crestor are going to boom now.

On a strictly COST basis, check out Bestatin at your local pharmacy. I've been on the 20 mg tab for 3-4 years now and happy with the results, especially at baht 144 for 30 tabs, a month's worth. Lipitor was rather more expensive.

Bestatin is simvastatin, same as Zocor, which is also rather more expensive.

Mac

[PeaceBlondie]

I have no idea what I pay for Mevalotin, because I just pay about 4,400 baht quarterly to get 90 days' supply of Mevalotin, 300 mg aspirin tablets, and 10 mg tablets of Plendil. My daily does of Mevalotin is 20 mg, half of a 40 mg tablet.

[Jingthing]

Thanks, PB, we are on the same med, brother in cholesterolarity, Mevalotin 20 meg, I also split the pill. I am wondering what the equivalent dosage of 20 meg Mevalotin would be for Crestor to figure out how much more the Crestor would cost.

Edited November 15, 2008 by Jingthing

[PeaceBlondie]

Thanks, PB, we are on the same med, brother in cholesterolarity, Mevalotin 20 meg, I also split the pill. I am wondering what the equivalent dosage of 20 meg Mevalotin would be for Crestor to figure out how much more the Crestor would cost.

At least you know what you pay for Mevalotin, I don't. It says to take at night, but I take it in the morning. And before I read the dosage, I used to take 40 mg every morning. I think the govt. hospital govt. pharmacy gives me a good price.

[Mobi]

Hmmm. What appears to be revolutionary about this new study is that statins are good for people who DO NOT suffer from high cholesterol but have another risk factor for heart problems (like overweight, etc.). And because this study was done with Crestor (and only Crestor) the question about whether this result is specific to Crestor or not seems cloudy. The study says nothing about people who are already on statin meds who did have high cholesterol and have successfully treated it with any statin (my situation). If nothing else, people can take this as a stock market tip, because I am sure sales of Crestor are going to boom now.

On a strictly COST basis, check out Bestatin at your local pharmacy. I've been on the 20 mg tab for 3-4 years now and happy with the results, especially at baht 144 for 30 tabs, a month's worth. Lipitor was rather more expensive.

Bestatin is simvastatin, same as Zocor, which is also rather more expensive.

Mac

I've been using Bestatin (Simvastatin) for years, and was originally prescribed by my London specialist. It is extremely effective in controlling my cholesterol levels.

I'm surprised you only pay 144 Baht, as Fascino in Pattaya charge me 228 Baht for 30 tabs.

May I enquire where you buy your meds?

[zzdocxx]

FWIW, it is believed that the statins have anti-inflammatory properties which may help prevent "rupture" of coronary artery plaques. (Plaque rupture being a major cause of heart attack.)

Hope this helps your understanding of the benefits of statins.

[Thanyaburi Mac]

Hmmm. What appears to be revolutionary about this new study is that statins are good for people who DO NOT suffer from high cholesterol but have another risk factor for heart problems (like overweight, etc.). And because this study was done with Crestor (and only Crestor) the question about whether this result is specific to Crestor or not seems cloudy. The study says nothing about people who are already on statin meds who did have high cholesterol and have successfully treated it with any statin (my situation). If nothing else, people can take this as a stock market tip, because I am sure sales of Crestor are going to boom now.

On a strictly COST basis, check out Bestatin at your local pharmacy. I've been on the 20 mg tab for 3-4 years now and happy with the results, especially at baht 144 for 30 tabs, a month's worth. Lipitor was rather more expensive.

Bestatin is simvastatin, same as Zocor, which is also rather more expensive.

Mac

I've been using Bestatin (Simvastatin) for years, and was originally prescribed by my London specialist. It is extremely effective in controlling my cholesterol levels.

I'm surprised you only pay 144 Baht, as Fascino in Pattaya charge me 228 Baht for 30 tabs.

May I enquire where you buy your meds?

I buy these at what I call the "Lao Pharmacy" in the Rangsit Market opposite Future Park Rangsit. A "Lao" pharmacy as most of the gals working there are Issaners. Good place, large stock, no A/C which probably helps the prices. Been going there for 10+ years now.

Are your baht 228 a box tabs also 20 mg?

In any case, a lot better than when I was on Lipitor at, as I remember, some baht 60/tab!

Mac

[Jingthing]

I guess the gist of my inquiry has to do with whether the brand name statins, Lipitor, and especially Crestor because it was the only one tested in this new breakthrough study, are WORTH the extra money. I am already paying for a brand name one, Mevalotin. There is no generic Crestor, so it isn't a matter of generics being the same as brand names, if there isn't a generic. I really don't see how you can scientifically assert if there is a positive result for Crestor specifically that it necessarily means ALL statins would get the same result.

[cathyy]

It's a good question, Jingthing. You obviously cannot give a definitive answer without doing the same study using another statin. The study was done by the makers of Crestor to try to increase the categories of people who could be prescribed Crestor beyond simply those with high cholesterol. That it showed a benefit to taking statins in people without high cholesterol is a good thing for their marketing department for sure.

There is no reason whatever to believe that this benefit is limited to Crestor, though. A statin is a statin. The article about this study on WebMD is written in a way that suggests the results would not be limited to Crestor. http://www.webmd.com/cholesterol-managemen...ldl-cholesterol

Edited November 16, 2008 by cathyy

[Jingthing]

Thanks, Cathyy. Regardless, this is big news. Crestor has proven that this med prevents heart attacks and strokes for people WITHOUT high cholesterol. I think what this means is that everyone over a certain age should probably seek out the blood test that detects elevated levels of a protein (this is a different test than for cholesterol) and if they have elevated levels, they probably should take a statin. BTW, I recall a study some years ago that showed Lipitor outperformed the other major statins, so I am still not convinced that a statin is a statin is a statin. Don't the various ones have somewhat different formulations?

Edited November 16, 2008 by Jingthing

[billp]

There are some inaccuracies in this thread which I simply can't let go.

Some people have a problem called "familial hypercholesterolemia." If you have this your problem isn't too much cholesterol in your diet, but your body making too much cholesterol. Statins don't help very much in this case. There is another medication named ezetimibe that keeps your body from making so much cholesterol.

Actually, MOST people who are taking statins have familial hyperlipidemia (the proper term - an inherited tendency to produce too much fat in the blood) because doctors first try to get them to reduce their dietary fats, and when that still doesn't work, they put them on the medication. Usually they have this inherited condition.

What counts is FATS in the diet, particularly SATURATED fats. Cholesterol as such in the diet seems to have been shown to be not such an important factor in arteriosclerosis (so it's OK to eat those shrimp and lobsters, just not in butter garlic sauce).

Statins indeed DO work on the liver to reduce total cholesterol in the blood, and the later generations of statins also are better at helping get the balance between HDL ("good cholesterol") and LDL ("bad cholesterol") in order. Many scientists think this balance is more important than the total cholesterol count.

One of the problems with statins is some of the cholesterol they remove from the liver gets re-absorbed through the bowel. Ezetimibe was designed to inhibit this re-absorption, at the border of the small intestine. However, it's become controversial because of a recent study showing that, combined with simvastatin, it could actually be ecouraging growth of fatty plaques on the artery walls instead of the opposite. But the study was inconclusive.

In any case ezetimibe does NOT "keep your body from making so much cholesterol." That's simply wrong. As a longtime use of combined Lipitor and ezetimibe, whose doctor says my total cholesterol and HDL/LDL balance are ideal, I intend to continue using ezetimibe at least until more conclusive studies come out.

A statin is a statin.

This is just not true. If it were, Bayer would not have had to withdraw its statin drug cerivastatin (Baycol, Lipobay) from the market in 2001 after it was attributed to 52 people dying from kidney failure. The deaths resulted from a complication that is very rare in other statins, fortunately. All the statins have different properties, and as the technology becomes more developed, newer generations have greater ability to control total cholesterol and HDL/LDL balance.

If the early statins like simvastatin (Zocor and I guess Bestatin in Thailand) work for you, fine. It's time-tested and relatively inexpensive because it's now off-patent. Personally, Zocor worked for me, but the results from Lipitor were even better. I'm looking forward to 2011 when its patent expires and the cost plummets. And when I started taking ezetimibe as well, the numbers got even better. (However, one of the current debates is how much those numbers really show about your artery plaque risk.) But if new generations of statins prove to be even better, I'll go with them - as long as I have a medical insurance paying for it anyway.

But no, all statins are NOT the same, so the study might well be specific to Crestor.

Edited November 16, 2008 by billp

[zzdocxx]

Yes that is right.

Also, on a related note, as far as the benefits are concerned, I am not sure that it's clearly established that they outweigh the risks, considering the potential for side effects and so forth.

You have got to realize "conclusions" drawn from early studies are often very much modified or even contradicted later, and it can take years for it to be all sorted out. There is a saying in the medical community about not being the first or last one to prescribe a new medication or perform a new procedure.

I realize that this may not directly answer your specific question, I am just trying to fill in some details so people will have a better understanding of the big picture. Unfortunately the nature of the subject matter is not always so simple as to give a "yes or no" answer. In other words, it'd like trying to drugfalloon these medications.

[billp]

The study was not that revolutionary, by the way. There've long been studies suggesting that statins might be effective in preventing strokes and other cardiovascular diseases - even Alzheimer. And plenty of scientists have come out and said not just people with high choleserol should be taking them. But what makes the Crestor study so important is its size (15,000) and how well recently-approved Crestor has come out already in several comparisons with rival statins. I'm going to buy Astra-Zeneca stock.

[Jingthing]

I'm going to buy Astra-Zeneca stock.

I don't know the specifics about their stock but you can sure bet Crestor sales are going to skyrocket. This study is important because what it means that doctors are going to order these protein tests as routine and put non-high chol patients on statins, probably mostly Crestor, as routine.

[zzdocxx]

oops this double posted!

Edited November 16, 2008 by zzdocxx

[zzdocxx]

NOVEMBER 11, 2008

Crestor Study's Impact Assessed

AstraZeneca PLC's chief executive said it is too early to say how an important new study of the cholesterol pill Crestor will affect the drug's sales.

As AstraZeneca's stock rose Monday on news of the study, CEO David Brennan tried to manage expectations that Crestor sales will soar as a result. "We've seen a flurry of estimates from analysts about the commercial impact of [the study], some of them pretty bullish," he told journalists on a conference call. "I would urge caution when forecasting the speed of such changes." AstraZeneca shares rose more than 3% in London Monday, to £27.70 ($43.41).

The study, presented at a cardiology conference in New Orleans Sunday, showed that Crestor sharply lowered the risk of heart attacks in patients who wouldn't normally take a cholesterol-lowering pill. People in the study had normal levels of bad cholesterol but high levels in their blood of C-reactive protein, or CRP, which signals inflammation in the body.

Some analysts say they believe the findings open Crestor to a large group of new patients, and are predicting a significant sales jump. UBS pharmaceutical analyst Gbola Amusa said in a note Monday that Crestor sales could grow to more than $7 billion in 2012, from $2.7 billion last year.

Mr. Brennan said that will depend in part on how widely testing for CRP is adopted. Previous studies have shown a link between high CRP levels and heart disease, but few physicians currently test for CRP. "For all the excitement, we need to remind ourselves that we are only at the starting gate with" CRP, Mr. Brennan said.

Groups such as the American College of Cardiology, which advise physicians on the best treatments, will help determine how widely CRP tests are used. The ACC and other groups will be updating their treatment guidelines for heart disease next year, and it is "reasonable to think" such groups will consider the new Crestor data as they draft those guidelines, Mr. Brennan said.

AstraZeneca won't be able to promote Crestor for use in people with high CRP until regulators such as the Food and Drug Administration approve a change to the drug's prescribing label. AstraZeneca said it will apply for this change in the first half of 2009.

Crestor is part of a class of drugs called statins. Some analysts caution that Crestor sales might not grow as much as expected if doctors view the new Crestor benefits as something that a cheaper generic statin could also deliver.

http://online.wsj.com/article/SB1226344405...=googlenews_wsj

(I bolded and underlined a few things in the above.)

[Jingthing]

OK, it sounds like I am not the only one asking if Crestor is worth the money. On the other hand, those drug sales reps that visit doc's offices can be awful persuasive, wink wink nod nod ...

[cobra]

Crestor is very effective if you can tolerate it,

When they say consult you Doc immediately if you experience joint / muscle pain, a serious side effect they mean it.

After two weeks I couldn't make a fist in one hand, one foot was continually aching, then some other random area, on and on

Went off it for a few months, started up again to confirm and within days the joint / muscle pain was back.

Google Crestor side effects, (as well as other popular statin drugs like Lipitor), plenty of side effects, now there's possible links to related neuropathy's, nerve damage, short term memory loss and other.

Cholesterol being essential for membrane and cellular repair, the thinking is reduced production from the liver leads to the body robbing it from other areas as needed as well as other theories, etc. Only thing we can take away with this is all meds have side effects, if you don't need the drug don't take it.

http://www.medicationsense.com/articles/ma...nes_053005.html

.. To avoid side effects with statin medications, it is vital to use the correct dosage. If you get 10 mg of Crestor when you only need 1 mg, your risks go way up. For example, with each doubling of a statin dosage, the risk of liver injury also doubles.7 Excessive dosages also dramatically increase the risks of other side effects such as muscle pain, kidney injury, memory problems, fatigue, or abdominal discomfort.

Another way to look at it: 10 mg of Crestor, which is the initial dose that doctors usually prescribe, is far stronger than the maximum dose of Mevacor, which is 80 mg. The usual initial dose of Mevacor is only 20 mg. In other words, the usual initial dose of Crestor (10 mg ) is about six times more powerful than the usual initial dose of Mevacor (20 mg). This extra potency comes with extra risks of side effects. ...

http://www.adrugrecall.com/crestor/effects.html

[rak sa_ngop]

I started a thread about the variation of cost of Crestor tablets in BKK a few months ago:

http://www.thaivisa.com/forum/Cost-Medicat...&hl=crestor

Basically the cheapest I found was 1100 baht for 28 days Crestor 10 mg, and 1600 baht for 20 mg. See thread for details.

[Tolley]

Sorry to sound cynical but it sounds like another medical miracle myth to me to boost drug sales.

Statins are big business and reap drug companies billions of dollars but whether the benefits actually outweigh the advantages of taking statins for the majority of people is an open question.

There is plenty of evidence to suggest that statins are not necessary for many who are prescribed it.

The cholesterol myth makes very interesiting reading.

[Jingthing]

Sorry to sound cynical but it sounds like another medical miracle myth to me to boost drug sales.

Statins are big business and reap drug companies billions of dollars but whether the benefits actually outweigh the advantages of taking statins for the majority of people is an open question.

There is plenty of evidence to suggest that statins are not necessary for many who are prescribed it.

The cholesterol myth makes very interesiting reading.

Your opinion, but I am a true believer that these meds are extending many millions of lives. And science is on my side, not yours.

Crestor is very effective if you can tolerate it,

Are the side effects for Crestor worse than for other popular ones like Lipitor, Pravachol/Mevalotin, etc. I have the same issues and warnings for Mevalotin. People on statins generally should do periodic liver study blood tests. I think the severe muscular side effects are serious, but rather rare.

Edited November 17, 2008 by Jingthing

[Tolley]

Sorry to sound cynical but it sounds like another medical miracle myth to me to boost drug sales.

Statins are big business and reap drug companies billions of dollars but whether the benefits actually outweigh the advantages of taking statins for the majority of people is an open question.

There is plenty of evidence to suggest that statins are not necessary for many who are prescribed it.

The cholesterol myth makes very interesiting reading.

Your opinion, but I am a true believer that these meds are extending many millions of lives. And science is on my side, not yours.

Crestor is very effective if you can tolerate it,

Are the side effects for Crestor worse than for other popular ones like Lipitor, Pravachol/Mevalotin, etc. I have the same issues and warnings for Mevalotin. People on statins generally should do periodic liver study blood tests. I think the severe muscular side effects are serious, but rather rare.

It is not really my opinion per se but the opinion of a number of medical researchers and doctors.

Google it and you will find plenty of very compelling arguments against using statins.

[Jingthing]

It is not really my opinion per se but the opinion of a number of medical researchers and doctors.

Google it and you will find plenty of very compelling arguments against using statins.

I don't doubt it. BTW, this new research should throw a new monkey wrench in such arguments because the new study shows that people WITH NORMAL CHOLESTEROL who have elevated blood levels of a certain protein will also prevent strokes and heart attacks by using statins. I wouldn't bet against statin use. It may be in the water someday.

Edited November 17, 2008 by Jingthing

[Tolley]

It is not really my opinion per se but the opinion of a number of medical researchers and doctors.

Google it and you will find plenty of very compelling arguments against using statins.

I don't doubt it. BTW, this new research should throw a new monkey wrench in such arguments because the new study shows that people WITH NORMAL CHOLESTEROL who have elevated blood levels of a certain protein will also prevent strokes and heart attacks by using statins. I wouldn't bet against statin use. It may be in the water someday.

That is why i am very dubious about this latest study.

It was I believe financed by the pharmaceutical industry who have too much of a vested interest for me not to be very suspicious.

[Jingthing]

It was I believe financed by the pharmaceutical industry who have too much of a vested interest for me not to be very suspicious.

Fair enough. But life is messy and not black and white. It is entirely possible for the study to be BOTH financially motivated AND correct. For people with risk factors for heart attacks and strokes, its not as if we have 1000 years to distill the absolute truth.

Edited November 17, 2008 by Jingthing

[jhc]

There is a big study in the news about how Crestor is beneficial even for people WITHOUT high cholesterol in preventing heart events. This big study is based on Crestor. This confuses me. Does that mean other statin meds aren't as good? Another question, I am on 20 mg. of Pravachol/Mevalotin. What would the equivalent dose be for Crestor? Just looking for a rough estimate to see how much more it would cost to switch to Crestor.

It is all about money as we know. Drug companies cares about money than our health. Given the two, I would pick voodoo medicine over modern medicine if you get the drift.

If we eat 100% fresh fruits and greens (with some nuts and seeds), aka low fat raw vegan diet, then we won't have high cholesterol problems. After all our cholesterol is made in our liver and we don't need external cholesterol source such as meats and dairy products.

For me I would rather spend money on fresh fruits and veggies (which is plenty in Thailand) and be healthy rather than staying with old eating habits and buying expensive drugs which is only a band-aid solution (hide your symptoms) as it does not solve the root cause of your problems which is the old eating habits aka SAD (Standard American Diet).