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Niaspan vs. Atorvastatin

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Niacin ER (niacin) and Atorvastatin (Lipitor) are both used to manage cholesterol levels, but they belong to different classes of medications and work in distinct ways. Niacin ER is an antilipemic and a form of vitamin B3, which helps lower "bad" LDL cholesterol and triglycerides while raising "good" HDL cholesterol. On the other hand, Atorvastatin is a statin that primarily works by blocking an enzyme in the liver responsible for making cholesterol. Niacin ER is typically taken once daily at bedtime, while Atorvastatin can be taken at any time of the day. Niacin ER can cause flushing and stomach upset, whereas Atorvastatin may lead to muscle pain and liver issues. Both medications are not recommended during pregnancy or breastfeeding. While Niacin ER is often used when statins are not effective or cause side effects, Atorvastatin is considered a first-choice medication for lowering cholesterol.

niacin ER

 

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Atorvastatin

(Lipitor)

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Summary for Niaspan

Prescription or over-the-counter

Niacin ER (also known as vitamin B3) is a prescription antilipemic medication for adults. It's used to lower high cholesterol and triglycerides (a common form of fat) levels, but it's not a first-choice option for this condition. Niacin ER is taken by mouth once daily, while niacin (Niacor) is typically taken three times daily. Some side effects of niacin ER include flushing and stomach upset. Please note that niacin is also available over-the-counter to treat vitamin B3 deficiency.

Indications for Niaspan

  • High cholesterol and high triglycerides
  • Lower risk of repeat heart attack in people with a history of heart attack and high cholesterol
  • Slow plaque buildup in the arteries of people with a history of coronary artery disease (CAD) and high cholesterol (as an add-on medication)
  • Severely high triglycerides in people who are at risk of pancreatitis (as an add-on medication)

Pros and Cons for Niaspan

Pros

  • Can lower “bad” (LDL) cholesterol and raise “good” (HDL) cholesterol in people who have trouble doing so with diet and exercise alone
  • Can also lower triglycerides
  • An option for people who didn’t have success or had side effects with statins
  • Available as a lower-cost generic medication

Cons

  • Doesn’t work as well as statin medications in lowering cholesterol and triglycerides
  • Can cause flushing, a bothersome side effect
  • Need to take immediate-release form multiple times a day
  • Not recommended during pregnancy or breastfeeding

Common Side Effects for Niaspan

Extended-release tablets:

  • Flushing (up to 69%)
  • Diarrhea (up to 14%)
  • Nausea (up to 11%)

Warnings for Niaspan

  • Muscle breakdown that can lead to kidney and heart damage (rhabdomyolysis)
  • Liver damage

Summary for Atorvastatin

Prescription only

Atorvastatin (Lipitor) is a statin that helps lower cholesterol. As a moderate-to-high-intensity statin, it can lower cholesterol by a greater amount than many other statins. It can also help protect your heart health. The dosage is taken by mouth once a day. Atorvastatin tablets are available as brand-name Lipitor and a generic. There's also a liquid form that only comes as brand name Atorvaliq. It's possible to have side effects like muscle pain, joint pain, and stomach upset. Most times, atorvastatin (Lipitor) is taken along with a heart-healthy diet to get the most benefits from treatment.

Indications for Atorvastatin

Pros and Cons for Atorvastatin

Pros

  • Can lower cholesterol by more than 50% at higher doses
  • Taken just once a day
  • Approved for children as young as 10 years old with genetic cholesterol problems
  • Also available as a liquid (Atorvaliq) for those who have trouble swallowing pills

Cons

  • Can't take if you have liver problems
  • Higher risk of side effects for some people, like older adults and people who drink alcohol daily
  • Risk of a serious muscle problem called rhabdomyolysis
  • Not recommended while pregnant or breastfeeding

Common Side Effects for Atorvastatin

Warnings for Atorvastatin

  • Severe muscle pain and damage
  • Liver problems
  • Higher blood sugar levels
  • Possible higher risk of brain bleed in certain people taking the 80 mg dose
  • Possible risk of harm when taken while pregnant or breastfeeding

Prices with our coupons for Niaspan vs. Atorvastatin

Price Card Drug Icon
Niacin ER90 tablets / 500mg
$29.95$288.83
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Atorvastatin30 tablets / 40mg
$9.73$15.56
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