Comprehensive medication guide to Pitavastatin including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
Most Medicare Part D and commercial insurance plans do not cover pitavastatin or place it on a high formulary tier. When covered, copays range $0–$50/month. The Livalo Savings Program offers eligible commercially insured patients as low as $25/month.
Estimated Cash Pricing
$330–$445 retail for generic and brand Livalo; as low as $36–$47/month with a GoodRx or SingleCare coupon for a 30-day supply of generic pitavastatin 2 mg.
Medfinder Findability Score
82/100
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Pitavastatin is a prescription cholesterol-lowering medication belonging to the statin class of drugs. It is sold under the brand names Livalo (pitavastatin calcium) and Zypitamag (pitavastatin magnesium), and is also available as a generic medication. The FDA first approved pitavastatin in 2009 under the brand name Livalo, manufactured by Kowa Pharmaceuticals America.
Pitavastatin is FDA-approved to treat primary hyperlipidemia (high cholesterol) and mixed dyslipidemia in adults, and heterozygous familial hypercholesterolemia (HeFH) in adults and children aged 8 years and older. It comes as oral tablets in 1 mg, 2 mg, and 4 mg strengths, taken once daily with or without food.
As a moderate-intensity statin, pitavastatin typically reduces LDL cholesterol by 30–50% depending on dose. Its unique pharmacokinetic profile — minimal CYP3A4 metabolism, reliance on OATP1B1/1B3 transporters, and a more favorable glycemic profile than most statins — makes it a clinically distinct choice for specific patient populations.
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Pitavastatin works by competitively inhibiting HMG-CoA reductase, the enzyme that controls a key rate-limiting step in the liver's cholesterol synthesis pathway. By blocking this enzyme, pitavastatin reduces the liver's internal cholesterol production. In response, the liver increases LDL receptor expression on its surface to pull more LDL cholesterol from the bloodstream — resulting in lower blood LDL levels.
Pitavastatin's mechanism differs from most statins in that it is minimally metabolized by CYP3A4 and instead relies on OATP1B1 and OATP1B3 hepatic transporters for liver uptake. This OATP-dependent pathway explains its favorable drug interaction profile — fewer interactions with CYP3A4-sensitive medications — and also explains why OATP inhibitors like cyclosporine and gemfibrozil are contraindicated.
In addition to LDL reduction (38–50% depending on dose), pitavastatin also modestly reduces triglycerides (15–20%) and may raise HDL cholesterol. It appears to have a more neutral effect on blood glucose and HbA1c compared to rosuvastatin and atorvastatin — a clinically meaningful advantage for patients with prediabetes or type 2 diabetes.
1 mg — tablet
Starting dose for patients with severe renal impairment or those taking erythromycin; maximum dose when on erythromycin
2 mg — tablet
Standard starting dose for most adults and children 8+ with HeFH; most commonly prescribed strength
4 mg — tablet
Maximum daily dose; used when 2 mg does not achieve LDL-C goals
As of 2026, pitavastatin is not listed on the FDA Drug Shortage Database or the ASHP Drug Shortages Resource Center. There is no active national manufacturing shortage. However, pitavastatin is routinely harder to find than popular statins like atorvastatin or rosuvastatin because it is prescribed at much lower volumes. Many retail pharmacies stock it minimally or not at all, particularly for the 1 mg and 4 mg strengths.
Insurance coverage further complicates access: most Medicare Part D and commercial plans exclude pitavastatin or place it on a high formulary tier, reducing patient fills and therefore pharmacy reorder frequency. Patients on pitavastatin are best served by a larger chain or mail-order pharmacy that maintains consistent inventory.
If you're having trouble finding pitavastatin at your pharmacy, medfinder can help — we call pharmacies near you to find which ones have your specific dose in stock, and text you the results.
Pitavastatin is not a controlled substance and requires no special DEA registration or prescribing authority. Any licensed healthcare provider with prescriptive authority can prescribe it.
Pitavastatin can also be prescribed via telehealth in all 50 states. Many telehealth platforms can evaluate cholesterol levels and prescribe pitavastatin without an in-person visit — a convenient option for patients with straightforward dyslipidemia.
No. Pitavastatin is not a controlled substance and is not scheduled by the DEA. It can be prescribed by any licensed healthcare provider — including physicians, nurse practitioners, and physician assistants — without any special DEA registration or prescribing authority.
There are no restrictions on the quantity that can be prescribed (other than standard pharmacy supply limits), no mandatory prescribing monitoring programs, and no federal limits on refills. Patients can request 90-day supplies without any additional hurdles. A valid prescription from a licensed provider is required, but pitavastatin is otherwise unrestricted.
The most frequently reported side effects in clinical trials include:
Seek immediate medical attention for any of these:
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Atorvastatin (Lipitor)
High-intensity statin; most widely prescribed; generic as low as $4-$15/month; metabolized by CYP3A4 (more drug interactions)
Rosuvastatin (Crestor)
High-intensity statin; strong LDL lowering; minimal CYP2C9 metabolism; generic as low as $2-$15/month; slightly higher diabetes risk
Pravastatin (Pravachol)
Low-moderate intensity; no CYP metabolism; best glycemic profile of common alternatives; well-studied in HIV; as low as $4-$10/month
Simvastatin (Zocor)
Moderate-high intensity; cheapest generic option (~$4/month); more drug interactions via CYP3A4; grapefruit restriction applies
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Cyclosporine
majorAbsolutely contraindicated. Inhibits OATP1B1 transporters, causing dangerous spikes in pitavastatin blood levels with high rhabdomyolysis risk.
Gemfibrozil
majorNot recommended. OATP1B1 inhibitor significantly increases pitavastatin exposure and myopathy risk. Use fenofibrate if fibrate therapy is needed.
Erythromycin
majorDose restriction required — limit pitavastatin to 1 mg/day when co-administered. Consider azithromycin as an alternative antibiotic.
Rifampin
majorDose restriction required — limit pitavastatin to 2 mg/day. Complex transporter interaction requires careful monitoring.
Letermovir + Cyclosporine
majorContraindicated when letermovir is co-administered with cyclosporine. Dramatically increases pitavastatin concentrations.
Colchicine
moderateIncreased risk of myopathy and rhabdomyolysis. Use caution and monitor for muscle symptoms.
High-dose Niacin (>1g/day)
moderateIncreased myopathy risk with lipid-modifying niacin doses. Discuss risk-benefit before combining.
Fenofibrate
moderateMay increase myopathy risk; safer than gemfibrozil but still requires monitoring. Preferred fibrate if combination is necessary.
Warfarin
moderateMonitor INR when starting, adjusting, or stopping pitavastatin. Manageable with monitoring.
Red Yeast Rice
moderateContains lovastatin-like compounds that effectively double statin exposure. Avoid combining with pitavastatin.
Pitavastatin is a clinically valuable statin that serves specific patient populations particularly well — those with diabetes or prediabetes who need a lower-risk glycemic profile, patients on multiple medications where CYP3A4 interactions are a concern, and people living with HIV on antiretroviral therapy. While it's not the first-line choice for all patients with high cholesterol, for those who need it, it offers meaningful advantages over other options in its class.
The main challenge with pitavastatin in 2026 is access — both in terms of pharmacy availability and insurance coverage. The drug is generally available (no national shortage), but requires more effort than atorvastatin or rosuvastatin to find at a local pharmacy. Cost can also be a barrier, though GoodRx/SingleCare coupons ($36–$47/month) and the Livalo Savings Program ($25/month for eligible patients) make it manageable for most.
If you're having difficulty finding pitavastatin in stock, medfinder can help by calling pharmacies near you to find which ones have your specific dose available. Don't let a pharmacy stock issue result in a gap in your cholesterol treatment.
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Medfinder is actively checking pharmacy inventory for Pitavastatin. We don't publish a number until we have enough verified pharmacy checks to be accurate — start a search and our team confirms current availability near you, usually within 24 hours.
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