Well, there are several principles. First of all, for people who need only a modest amount of lowering of LDL, the bad cholesterol, whenever possible we would like to use a generic statin because it's less expensive. And the most commonly used statins that are generic are pravastatin (known as Pravachol), or simvastatin (brand name Zocor). Pravachol is a relatively weak statin, but for people who only need a small amount of cholesterol reduction, it's adequate. Simvastatin, or Zocor, is a medium-potency statin. We can get the majority of patients to their goal level of cholesterol with simvastatin.
However, there are some people in whom the cholesterol levels are so high that we need a more powerful drug. And in those people we tend to use the higher potency statins, which are still branded—and that means they're more expensive. Those include atorvastatin, or Lipitor, and rosuvastatin, or Crestor. The most powerful of them is Crestor, which can lower LDL cholesterol by 50 percent or more.
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