Doc wont let me switch form simvastatin to lovastatin. Is he right?

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me@privacy.net - 19 Mar 2007 17:06 GMT

I pay for my statins totally out of pocket. I do not
have prescription coverage

As would be expected keeping the cost of my statins
down is of prime concern.

I was taking 20 mg Lipitor but my doc did allow me to
switch to 40 mg simvastatin to save money.... which it
did.

he said that it takes abt double the dos of simvastatin
to equal same does of Lipitor

Now I'm wanting to change to lovastatin as its even
cheaper than simvastatin and on Walmart's $4 list

However he dos not want me to change to lovastatin
saying that of all the statins lovastatin is the least
powerful and I would have to take even more dose such
as 80 mg.

Is my doctor correct? Is there advantage to me
staying on 40mg simvastatin rather than lovastatin even
if it cost more money?

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Dan Warren - 20 Mar 2007 22:47 GMT

> Is my doctor correct? Is there advantage to me
> staying on 40mg simvastatin rather than lovastatin even
> if it cost more money?

Yes. the higher the mg dose the more likely to have an adverse reaction.

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Menno - 22 Mar 2007 20:01 GMT

>> Is my doctor correct? Is there advantage to me
>> staying on 40mg simvastatin rather than lovastatin even
>> if it cost more money?
>
> Yes. the higher the mg dose the more likely to have an adverse reaction.

Bollocks. Ever heard of biological availability? First pass effect?
You can't compare different substances on a milligram to milligram basis.

Menno

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Dan Warren - 22 Mar 2007 23:08 GMT

>>> Is my doctor correct? Is there advantage to me
>>> staying on 40mg simvastatin rather than lovastatin even
[quoted text clipped - 6 lines]
> You can't compare different substances on a milligram to milligram
> basis.

I was not referring to biological activity. At our hospital we subsitute
simvasatin for Lipitor and other statins. However, at the 2 to 1 ratio,
we only will only do an auto substitute to a max dose of simvastatin 40
mg. The is evidence that at 80 mg, there a higher incidence of adverse
reactions.

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Menno - 24 Mar 2007 00:29 GMT

> I was not referring to biological activity. At our hospital we subsitute
> simvasatin for Lipitor and other statins. However, at the 2 to 1 ratio,
> we only will only do an auto substitute to a max dose of simvastatin 40
> mg. The is evidence that at 80 mg, there a higher incidence of adverse
> reactions.

In that case, I misunderstood what you were trying to say. I thought you
were meaning to say that, for instance, simva 80 has more side-effects than
ator 40 _because_ it are more milligrams. That would of course be rubbish.

Menno

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