Livalo alternatives: What can I take instead of Livalo?

Compare Livalo alternatives | Crestor | Lipitor | Pravachol | Zetia | Repatha | Natural alternatives | How to switch meds

A brand-name form of pitavastatin, Livalo is a member of the well-known statin family of drugs. The ability of statins to lower cholesterol and reduce the risk of heart disease and stroke have led to their widespread use. If you are one of the vast numbers of people taking a statin like Livalo, you are probably aware of these benefits. Unfortunately, you may also know about their potential negative aspects, particularly the expense and side effects of statins. You could be experiencing muscle pain from Livalo, or you may be feeling the strain of Livalo’s cost, since there is no generic form available. Even if you are satisfied, your healthcare provider may want your low-density lipoprotein (LDL or bad cholesterol) level to be even lower than what Livalo is providing. Whatever your reason for seeking an alternative to Livalo, we will cover your options here.

What can I take in place of Livalo?

Alternatives to Livalo may be able to provide better cholesterol results and avoid the expense and adverse effects of the drug. Within the statin class, there are lower-priced, generic options and more potent members than Livalo. Outside the statin class, costs vary, and mechanisms of actions that differ from a statin’s inhibition of the HMG-CoA reductase enzyme could result in changes to the cholesterol results and side effect profile. Cholesterol absorption blockers, fibrates, and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors provide opportunities to avoid statins if necessary.

Other alternatives to Livalo

• Lovaza (omega-3-acid esters)
• Vascepa (icosapent ethyl)
• Nexletol (bempedoic acid)
• Juxtapid (lomitapide)
• Niaspan (niacin ER)

Top 5 Livalo alternatives

The following are some of the most common alternatives to Livalo.

1. Crestor

As a fellow statin, Crestor shares a mechanism of action with Livalo. They also have in common a list of common adverse effects like other statins.

• Myalgia (muscle pain)
• Constipation or diarrhea
• Elevated liver enzymes
• Elevated muscle enzymes
• Elevated glucose (blood sugar)
• Cognitive impairment (difficulty learning, remembering, or concentrating)

Livalo likely carries a lower risk of muscle pain than Crestor. However, Crestor is more potent. In fact, Crestor is the most potent statin, capable of lowering LDL levels over 50 percent. This provides you with a worthy alternative if Livalo is not getting your cholesterol numbers to the goals your healthcare provider has established. The generic form of Crestor, rosuvastatin, could also save you some money compared to either brand name version of pitavastatin, Livalo or Zypitamag.

2. Lipitor

Lipitor is another high-intensity statin, offering greater LDL reductions than Livalo. Like Crestor, it has a less expensive generic form and has a longer list of Food and Drug Administration (FDA) indications than Livalo as well. Lipitor and Crestor are the best statins for triglyceride reduction, so if your cholesterol profile includes both high LDL and triglycerides, these drugs may be better options than Livalo. If elevated triglyceride levels are your primary problem, the fibrate drug class, such as Tricor and Lopid, may also be considered.

Keep in mind that Lipitor is not the right choice for everyone. It may pose a greater risk of muscle pain and drug interactions, even being problematic if you consume a large amount of grapefruit juice.

RELATED: 13 Lipitor facts | Lipitor side effects and how to avoid them

3. Pravachol

Pravachol presents you with an effective but less potent statin option. This may be appealing if you are using cholesterol medication as a primary prevention strategy, meaning you have not been diagnosed with a cardiovascular problem but are looking to avoid this type of issue. If you do not require a large reduction in LDL to achieve your established goals, then Pravachol may be right for you if Livalo is causing adverse effects. The lower price of generic Pravachol, pravastatin, could be another reason to change from brand name Livalo. You could also present a SingleCare discount card at your local pharmacy to see if Livalo could be obtained at a lesser cost.

4. Zetia

If Livalo and other statins do not work out for you, Zetia could be a good pick. Generic Zetia, ezetimibe, could be a money saver in comparison to Livalo. Plus, Zetia works as a cholesterol absorption blocker, so the mechanism is different. This could mean that you are able to avoid side effects that you have experienced with Livalo. In a different situation, if Livalo alone is not quite enough to get your LDL to goal, adding Zetia would provide a complimentary cholesterol drug to help achieve the results you need. Welchol and Questran also block cholesterol absorption, albeit by a different mechanism (sequestering bile acids) and could play a similar role.

5. Repatha

Repatha is expensive and is unlikely to save you money in comparison to Livalo, but you should not discount it as a viable add-on or alternative to the statin. Repatha is an injectable monoclonal antibody that blocks the effect of the PCSK9 enzyme, thereby increasing LDL receptors in the liver which act to reduce circulating LDL levels. Less LDL circulating through your system means less cholesterol plaque buildup in your arteries. Repatha could give your treatment with Livalo a boost to result in lower LDL numbers, or it could be an alternative if statins are not agreeing with your system. 

Of note, Praluent also inhibits the PCSK9 enzyme, and Leqvio blocks the enzyme’s synthesis. Both can be used in a manner like Repatha.

RELATED: Praluent vs. Repatha

Natural alternatives to Livalo

Dietary modifications may be an effective method for improving your cholesterol, and if your health is good and your cholesterol reduction goals are modest, changes to your diet may be a viable alternative to Livalo. Low-carbohydrate and Mediterranean diets are two of the proven options. Adding proper exercise may assist as well. Talk to your healthcare profession to see if you should be doing anything different with your diet and exercise routine to supplement or replace the effects of Livalo.

Natural, herbal, and vitamin supplements are frequently of interest due to the prevailing perception that they are safer than prescription drugs. This is not universally true, and each should be judged independently on its own merits or risks. Fortunately, there is good news on this front as it relates to cholesterol management. Omega-3 fatty acids, from sources such as fish oil or prescriptions like Lovaza or Vascepa, can help with triglyceride reduction but not LDL levels typically. Red yeast rice, on the other hand, can lower LDL via a mechanism akin to statins. Accomplishing both LDL and triglyceride reduction may be possible with berberine, according to limited studies thus far. Dropping LDL and raising high density lipoprotein (HDL or good cholesterol) levels can be achieved with vitamin B3, better known as niacin. An extended-release form, Niaspan, is available by prescription and limits the flushing side effect of niacin. Unfortunately, several other adverse effects limit the usefulness of niacin products. Information is still being gathered by researchers on these and other natural alternatives, including vitamin D and turmeric, so use your healthcare provider as a resource in deciding whether any are worth a try.

RELATED: The best diet for high cholesterol | 7 steps to lower your cholesterol

How to switch to a Livalo alternative

The expense or adverse effects of Livalo may be motivating you to seek another option for your cholesterol management. Having a discussion with the prescribing provider is the most appropriate first step in your search. You should gain an understanding of your cholesterol treatment goals, why Livalo was chosen for the task, and what alternatives are recommended. Livalo is likely a valuable element of your treatment regimen. If you are going to change your therapy, a thoughtful approach is best.