willbill wrote:
> Charly Coughran wrote:
>
> > willbill <trek@worldwide.net> wrote
>
> >>my doc has also strongly suggested that
> >>i use a generic statin to lower my mildly
> >>high LDL? (i've got a great HDL/LDL ratio)
> >>
> >>supposedly that some of the generic statins
> >>are now decent
>
>
> fwiw, there are now 3 generic statins
> (that i know of):
>
> 1. Lovastatin (orig. brand = Mevacor)
> 2. Pravastatin (orig. brand = Pravachol)
> 3. Simvastatin (orig. brand = Zocor)
>
>
> > Statins in general -
> > The merits of the statin drugs are dual. They lower LDL and they provide
> > additional cardiovascular disease protection beyond that attributable to
> > the reduction of LDL. The mechanism of the former is well understood.
> > Several reasonable mechanisms for the latter have been proposed, but I
> > believe the jury is still out. The benefit of LDL lowering appears to
> > continue as LDL falls, i.e. there is no magic threshold which gets you
> > most of the benefit.
>
>
> thank you for doing this post (also to oldal
> and ratty), coz i then searched on "statin" thru
> my local copy of my old posts (Agent database; back
> to Feb. 2002) and saw both your own posts and
> those of oldal as well as those of doc biggs
>
>
> >
> > The additional cardiovascular protective effect of statins are strong
> > enough for very aggressive clinicians to recommend that all diabetics
> > should get at least a low dose statin (and an ACE inhibitor as well)
> > independent of cholesterol (or blood pressure) level. 1/3 of first heart
> > attacks are fatal in the general population and it appears to be somewhat
> > higher in the diabetic population, not to mention that heart attack rates
> > are higher in the diabetic population.
> >
> > Statins are generally well tolerated, but there are a few serious
> > problems, primarily acute renal failure. The occurrence rate is order
> > 0.5/10000pt-yr. The risk is dose associated and, presumably, your dose
> > would be small. Discuss initial monitoring and what to look out for with
> > your doctor.
> >
> > Generic -
> > Simvastatin (generic Zorcor), recently gone off patent, is the most
> > powerful of the generic statins (lowest dose for equal effect).
> >
> > Personal take -
> > I have been on atorvastatin (Lipitor) for a few years now. When the
> > research demonstrated the additional effects of further cholesterol
> > lowering I asked my doctor to double my initial, very low dose even
> > though I was at the then recommended 100mg/dl LDL level. He did. Since
> > then my insurance company has started pushing simvastatin by putting it
> > in the $10/month drug co-pay category. Atorvastatin was jumped up to the
> > $35/month category. I looked into the literature and all I could find to
> > justify staying with atorvastatin was an additional triglyceride lowering
> > effect that, as far as I could tell, was never tested for with
> > simvastatin. Both my endo and primary care physician believe that it is
> > probably a class wide effect. Last Friday, I chose to switch to
> > simvastatin.
>
>
>
> my doc wasn't too thrilled with
> either 1 or 2 of the generics,
> but seems to think best of the
> Zocor generic (#3 of my list above)
>
> anyhow, today i accepted his script
> for generic simvastatin and will get
> started with it next week
>
> the USA is a great place to live
> if all you need are generics, (God
> help you if you need an in-patent
> script drug and don't have the money)
>
> so it wouldn't surprise me if you shop
> around it might be cheaper to pay
> completely out of pocket for simvastatin
> (i don't yet know the current pricing)
>
> that is true for both my Thyroid hormone
> (T4 and T3) as well as my Ace (enalapril),
> and i don't have to buy into the hand
> to mouth nonsense that all too often
> you get forced into with "insurance"
>
> anyhow, roughly 5 years ago i remember
> doing a post on a new/better/cheaper
> test to correlate a persons risk
> of having cardiac problems (heart
> attack, stroke, etc.)
>
> yet all i see with the current lipid
> profile is the same LDL/HDL/total
> measurement that we had 5+ years ago
>
> have you come across any new test(s)
> that provide a more accurate assessment
> of a person's cardiac risk?
>
> thank you in advance
>
> bill t1 since '57
Perhaps you have seen the full page ads with Dr. Robert Jarvik,
inventor of the Jarvik Artificial Heart as a spokesman for
Lipitor.
Lipitor is an anti-cholesterol drug from Pfizer with 13 billion dollars
in sales last year. It was the best selling statin drug, the best
selling drug in the world, and most prescribed drug in the U.S. Jarvik
is best known for the 1982 media frenzy about Dr. Barney Clark, who
died after being tethered to the Jarvik Heart for 112 days. The new
revised Jarvik Heart is approved for use in heart transplant
candidates.
Dr. Jarvik's endorsement might help Lipitor maintain market share
against competing name brand statin drugs. However, the big problem is
that Zocor's patent expired last week, allowing a cheaper generic
statin drug to enter the market. Instead of three dollars a pill for
Lipitor, your generic statin drug will cost one dollar a pill.
Insurance plans are salivating at the potential cost savings which will
be enormous. Pfizer's ad campaign to encourage loyalty to Lipitor is
only the beginning of the drug wars. Over the next five years, 70 more
drugs go off patent to be replaced by the cheaper generics.
A recent poll reported by the New York Times showed only 9 percent of
Americans believe that drug companies can be trusted. Addressing this
issue directly, Dr. Jarvik says "he trusts Lipitor to help keep his
heart healthy". Dr. Jarvik implies that he takes Lipitor, and he
does not report to us muscle pain, weakness or memory loss commonly
described as side effects of the drug. One message board alone,
www.rxlist.com/rxboard.htm, lists four thousand messages posted by
people with statin drug side effects easily avoided by supplementing
with a vitamin called CoQ-10 available at most drug stores and health
food stores.
Why would Pfizer select a medical doctor like Dr. Jarvik for this
endorsement? A mechanical heart with a past history of media
notoriety and a drug that lowers cholesterol seem to have little in
common. In a flash of medical insight, the connection between statin
drugs and the Jarvik Heart suddenly occurred to me. Eight controlled
clinical trials have shown that statin drugs (such as Lipitor) deplete
the heart of an important vitamin called Co-Q10. This depletion in
turn has been shown to cause cardiac dysfunction leading to heart
failure. Deaths from heart failure have doubled nationwide since the
introduction of statin drugs in 1987. A fraction of these heart
failure patients will go on to cardiac transplantation and receive the
Jarvik Heart as a temporary measure. So in this bizarre fashion, the
Jarvik Heart is a beneficiary of the statin drug industry.
Instead of Dr. Jarvik, a more convincing Lipitor spokesman, in my
opinion, would be the Harvard trained John Abramson, M.D., author of
Overdosed America, The Broken Promise of American Medicine, and How the
Pharmaceutical Companies Distort Medical Knowledge, Mislead Doctors and
Compromise Your Health. (available at
www.overdosedamerica.com). He
no doubt would have given us realistic information about statin drug
research. He would have told us, for example, that statin drug use in
healthy people without heart disease and in the elderly is still under
question. And, although there is a benefit from the drug in middle aged
men with known heart disease, a mortality benefit for women has never
been shown by any statin drug study.
I would run to the corner drugstore and buy Lipitor for myself had Dr.
Duane Graveline agreed to do the endorsement instead of Jarvik. You
can't find anyone more popular than Dr. Graveline, a NASA astronaut
and an M.D. who wrote two books on Lipitor. His first book is Lipitor,
Thief of Memory. His new book, Statin Drug Side Effects and the
Misguided War on Cholesterol is available at:
www.spacedoc.net.
Jeffrey Dach MD
www.drdach.com drdach
Re: merits of generic statin drugs? 
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