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Feb 15, 2023




  • Currently there are two brand names for pitavastatin: Livalo and Zypitmag.
  • Pitavastatin is used to reduce elevated total cholesterol, low-density lipoprotein cholesterol (HDL-C), apolipoprotein B (Apo-B), triglycerides, and to increase high-density lipoprotein (HDL-C).
  • Pitavastatin has fewer drug interactions than other statins, making it a good choice for people who take multiple medications.

What is pitavastatin?

Pitavastatin belongs to a drug class of medications known as HMG-CoA reductase inhibitors, or “statins”. Currently there are two brand pitavastatins available: Livalo and Zypitamag.

Livalo vs Zypitamag

Zypitamag is an FDA-approved drug substitute for Livalo, and it’s also another brand name pitavastatin. Both have the same active ingredient: pitavastatin. The difference is the salt form they contain: calcium for Livalo and magnesium for Zypitamag.


Marley Drug offers Zypitamag for only $1.15/day cash price ($34.50/month). Plus the first month is free. Livalo is also available but for over $300/month. In some cases Livalo may be covered by insurance, however, out of pocket costs are typically over $100/month still.

How does pitavastatin work?

Your liver makes cholesterol, a sticky, fat-like material, using the enzyme called HMG-CoA reductase. By blocking this enzyme pitavastatin reduces cholesterol synthesis and lowers your cholesterol levels. For this reason statins are called HMG-CoA reductase inhibitors.

What is pitavastatin used for?

Pitavastatin lowers levels of bad cholesterol (LDL: low-density lipoprotein cholesterol) and while raising levels of good cholesterol (HDL: high-density lipoprotein cholesterol).

The conditions pitavastatin is used for:

  • Dyslipidemia—an abnormal balance between good and bad cholesterol levels
  • Hypercholesterolemia—high cholesterol levels in your blood
  • Heterozygous Familial Hypercholesterolemia (HeFH)
    —an inherited medical condition that causes high levels of LDL
    —pitavastatin is used in adolescents as young as 8 years to decrease total cholesterol and LDL cholesterol
  • Homozygous Familial Hypercholesterolemia (HoFH)
    —HoFH is a medical condition that develops when your body has trouble eliminating LDL from your blood, resulting in an increased risk of developing a heart attack at a young age.
  • Primary and secondary Atherosclerotic Cardiovascular Disease (ASCVD)—a condition caused by the development of cholesterol plaque (build-up) in your arteries.

To lower cholesterol and promote heart health, pitavastatin is taken in conjunction with a balanced diet and other lifestyle modifications.

How does pitavastatin compare to other statins?

Individuals who have not responded well to previous statins and require treatment with less muscular discomfort as adverse reactions may benefit from pitavastatin.

Pitavastatin also has fewer drug interactions than other statins, making it a better alternative for individuals who take numerous medications.

Yet, unlike other statins, pitavastatin has not been proven to lower the likelihood of heart attack and/or stroke.

How is pitavastatin administered?

Pitavastatin is available in tablet form and can be taken with or without food.

Pitavastatin is available in the following dosages:

  • Moderate-intensity: 1 mg, 2mg, 4 mg daily
    Can reduce LDL by approximately 30%–49%

What are the side effects of pitavastatin?

Although Pitavastatin is safe and effective for many individuals, it does cause an extensive amount of adverse effects, including the following:

  • Myopathy (skeletal muscle disorder causing muscle spasms, muscle stiffness and muscle weakness)
  • Myalgias (muscle pain and/or soreness)
  • Arthralgia (joint pain)
  • Cognitive impairment
  • Headache
  • Cold-like symptoms, including sore throat, stuffy nose, and/or sneezing
  • Insomnia
  • Nausea
  • Heartburn
  • Abdominal pain
  • Indigestion
  • Constipation

Do not abruptly discontinue taking pitavastatin if you believe you are encountering any negative side effects. Consult your doctor to determine whether a dose adjustment or switching to a different drug could be beneficial in your case.

Serious side effects
  • Difficulty raising your arms and/or difficulty rising or standing
  • Muscle aches in your hips, shoulders, neck, and back
  • Hepatic (liver) issues, such as upper abdominal pain, weakness, fatigue, decreased appetite, dark urine, and jaundice (yellowing of the skin or eyes)
  • Kidney issues, such as little to no urination, ankle or foot swelling, fatigue, or shortness of breath.

If you’re experiencing any of the serious side effects listed above, immediately call your doctor and stop taking this medication.

Learn more about Statin Intolerance

Can I take pitavastatin if I’m pregnant or breastfeeding?

When taking pitavastatin, you should inform your doctor if you become pregnant or think you could be pregnant. Your doctor will advise you on whether you should discontinue this medication during pregnancy and if you should temporarily stop using pitavastatin while nursing or breastfeeding.

Women who need statins and are at high risk of heart attack or stroke should not breastfeed; instead, they should use alternatives such as baby formula.

Kidney failure may result from muscle tissue degradation brought on by pitavastatin. If you experience inexplicable muscular pain, soreness, or stiffness while taking this medication, consult your physician immediately, particularly if you're also experiencing fever, unusual fatigue, or dark urine.

Studies on nursing mothers have shown negative effects on infants. Breastfeeding while taking pitavastatin is not recommended, otherwise, your doctor should prescribe an alternative.

Can pitavastatin interact with anything?

Your physician must be aware of any additional medications you are taking because some of them might significantly raise your chance of developing serious muscle issues.

Inform your physician of all prescription and over-the-counter (OTC) medications, including:

  • Atazanavir
  • Cyclosporine
  • Gemfibrozil
  • Retrovir
  • Colchicine
  • Erythromycin
  • Niacin
  • Red yeast rice

What should I avoid while taking pitavastatin?

You should avoid taking this medication if you also take cyclosporine or have liver problems, especially if you have abnormal liver enzyme testing.

Avoid taking pitavastatin with large consumption of alcohol.

What happens if I miss a dose?

Pitavastatin should be taken at roughly the same time every day so you don’t forget to take it.

However, if you do forget to take a dose, take it as soon as you remember unless it's almost time for your next dose. In this case, skip the forgotten dose and take the next one at the usual time. Do not take 2 doses together to make up for a missed dose.

Speak With Your Doctor

Pitavastatin is relatively considered a safe and effective medication when taken appropriately (as prescribed by your doctor). Talk to your doctor today about using pitavastatin and send your prescription to Marley Drug. Save up to 95% compared to your local pharmacy by using Marley Drug.

Marley Drug provides free nationwide shipping, allowing you to receive your medication at no additional cost straight to your door.

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