Crestor vs Lipitor: What’s the Difference?

Key Takeaways

Lipitor and Crestor are both stains commonly prescribed for elevated lipid levels or “high cholesterol.”
Data shows that Crestor (rosuvastatin) increased “good” cholesterol and lowered “bad” cholesterol by a higher percentage than Lipitor (atorvastatin), Zocor (simvastatin), and Pravachol (pravastatin).
82% to 89% of people who took Crestor achieved their cholesterol goals compared to 69% to 85% of patients who took Lipitor.

Crestor (rosuvastatin) and Lipitor (atorvastatin) belong to a drug class called statins. They are FDA-approved to treat high cholesterol and lower the risk of heart disease. But there are some key differences between Crestor vs Lipitor. Please continue reading to find out how Lipitor and Crestor are different and which one may be better for you.

What are the main differences between Lipitor & Crestor?

The two drugs, Lipitor and Crestor, are brand name medications commonly prescribed for elevated lipid levels. Generics are available for both brand name drugs. Both Lipitor and Crestor are statin medications. Both drugs treat high cholesterol, but there are some key differences between them.

Generic Forms

Crestor is made by AstraZeneca and contains a statin medication called rosuvastatin as the active ingredient (generic form).

Lipitor is made by Pfizer and contains a statin medication called atorvastatin as the active ingredient (generic form).

Prescribing Information and Typical Dosage

The usual starting dose of Crestor is 10 to 20 mg daily. The maintenance dose of Crestor ranges between 5 mg and 40 mg daily, taken once a day, with or without food.

The usual starting dose of Lipitor is 10 mg to 20 mg daily. For maintenance, Lipitor’s dosage ranges between 10 mg and 80 mg daily, taken once a day, with or without food.

Your doctor will instruct you on the dosage that’s right for you. The initial dosage may be adjusted based on response and side effects.

Age Range

Both Crestor and Lipitor are approved for use in adults with hyperlipidemia, or elevated blood lipid levels. Both Crestor and Lipitor are approved to treat heterozygous familial hypercholesterolemia (HeFH) and homozygous familial hypercholesterolemia (HoFH) in adults.

Heterozygous familial hypercholesterolemia (HeFH) and homozygous familial hypercholesterolemia (HoFH) are inherited conditions affecting the body’s ability to process cholesterol; people who are born with these conditions can have dangerously high levels of cholesterol if left untreated.

Below are the differences between Crestor and Lipitor regarding the approved age range.

Crestor:
- Approved to be used in addition to diet in children 8 years and older with HeFH.
- Approved to be used in addition to diet in children 7 years and older with HoFH.
Lipitor:
- Approved to be used in addition to diet to treat HeFH and HoFH in children 10 years and older.

Effectiveness

Clinical trials comparing rosuvastatin versus atorvastatin (Crestor vs Lipitor) have been done.

STELLAR* Trial

The STELLAR* trial compared the safety and efficacy of rosuvastatin (Crestor) to other statin medications, including atorvastatin (Lipitor), simvastatin (Zocor), and pravastatin (Pravachol) at various dosages. The findings showed:

At 6 weeks, Crestor (rosuvastatin) lowered LDL cholesterol by 8.2% more compared to Lipitor (atorvastatin).
Crestor was also superior to simvastatin and pravastatin in lowering cholesterol.
Crestor treatment increased HDL cholesterol (good cholesterol) by 7.7% to 9.6% compared to 2.1% to 6.8% with the other statins.
Different statin doses are associated with different percentages that are dose-dependent for simvastatin and pravastatin. Atorvastatin 10 mg leads to 5.7% increase in HDL cholesterol levels. At a higher dose (80 mg), atorvastatin only raises HDL cholesterol by 2.1%.
Crestor (rosuvastatin) reduced total cholesterol significantly more than the other statins. It also reduced triglycerides significantly more than simvastatin (Zocor) and pravastatin (Pravachol).
82% to 89% of people who took rosuvastatin (Crestor) achieved their cholesterol goals compared to 69% to 85% of patients who took atorvastatin (Lipitor).
Both Crestor and Lipitor were equally well tolerated.

SATURN Trial

The SATURN trial sponsored by AstraZeneca, the manufacturer of Crestor, studied the safety and efficacy of high-dose Crestor vs Lipitor and found:

Crestor (rosuvastatin) resulted in lower LDL-C (bad cholesterol) levels compared to atorvastatin (Lipitor).
More people taking Crestor achieved an LDL-C level below 70 mg/dL compared to Lipitor.
Crestor resulted in lower total cholesterol levels compared to Lipitor.
Taking Crestor led to higher HDL-C (good cholesterol) levels compared to Lipitor.
Despite the lower level of LDL cholesterol and the higher level of HDL cholesterol achieved with Crestor (rosuvastatin), there was no significant difference in the ability of these two drugs to slow the progression of coronary atherosclerosis (cholesterol plaques in the blood vessels that supply the heart).

Side Effects

Common adverse effects of Crestor include abdominal pain, constipation, dizziness, sleep problems, headache, joint pain, memory problems, confusion, and depression.

Taking Lipitor can cause side effects such as gas, heartburn, diarrhea, joint pain, muscle aches, memory problems, and confusion.

Risks

There are reports of rhabdomyolysis (muscle breakdown) and liver damage in people taking statin medications such as Crestor and Lipitor. You should contact your doctor immediately if you develop severe muscle pain, extreme weakness, tiredness, and dark urine after taking a statin drug.

Contraindications

Both Crestor and Lipitor should be used with caution in people with a history of an allergic reaction to statin medications or liver problems. These medications may cause fetal harm if taken during pregnancy.

Interactions

Crestor and Lipitor are metabolized (broken down) in the body differently. As a result, Crestor has fewer drug interactions. Lipitor interacts with more drugs. Also, it is generally safe to drink grapefruit juice while on Crestor but not while on Lipitor. It may still be okay to take Lipitor with grapefruit juice, depending on the amount of grapefruit you consume.

Frequently Asked Questions:

Which is safer to take Crestor or Lipitor?

Both Crestor and Lipitor are well tolerated and cause similar side effects. There is no scientific evidence that one is significantly safer than the other. You may tolerate one statin better than another. For example, if you have muscle aches on one HMG-CoA reductase inhibitor (statin), your healthcare professional may try you on lower doses or another medication from the same drug class.

Why was Crestor taken off the market?

Patient advocacy groups petitioned the FDA in 2004 to take Crestor off the market due to reports of severe muscle damage and kidney failure associated with this drug. However, the FDA denied the petition but asked AstraZeneca, Crestor’s manufacturer, to add warnings to the label.

What is the best statin with the least side effects?

Simvastatin (Zocor) and pravastatin (Pravachol) tend to be better tolerated with fewer side effects compared to other statins. Note that all statins are safe and are generally well tolerated. Most of the common side effects tend to improve once the body gets used to it. Severe adverse effects are rare.

Which is the best statin to avoid muscle pain?

Hydrophilic statins such as rosuvastatin (Crestor) and pravastatin (Pravachol) tend to cause fewer muscle aches. Lipophilic statins such as atorvastatin (Lipitor), simvastatin (Zocor), and fluvastatin (Lescol) are more likely to cause muscle pain.

Which is better: Crestor vs Lipitor

In clinical practice, both Lipitor and Crestor are widely prescribed and well-tolerated. Your healthcare provider will choose the best statin medication for you based on your health factors, including medical conditions and other medications that could have drug interactions with Crestor or Lipitor.

What are normal cholesterol levels?

Cholesterol is a type of lipid (fat) that the body needs for many important functions. But, high blood cholesterol levels are harmful and a major risk factor for cardiovascular disease. Cholesterol plaques can build up inside blood vessels over time, causing a condition called atherosclerosis or “hardening of the arteries,” where blood vessels narrow.

Angina is the term describing chest pain caused by reduced blood flow to the heart. Worse, these cholesterol plaques can rupture, and blood clots form over the rupture can cause complete blockage inside these blood vessels. This blockage impairs the oxygen and blood supply to major organs. Heart attacks happen when blood clots block the artery supplying blood to the heart; similarly, strokes occur when the blood supply to the brain is impaired due to blood clots.

According to the Centers for Disease Control and Prevention (CDC), an unhealthy diet with a high intake of saturated fats and trans fats, lack of exercise, obesity, and smoking are the major modifiable risk factors for high cholesterol.

Some people have a genetic condition called heterozygous or homozygous familial hypercholesterolemia that predisposes them to elevated lipid levels compared to people who don’t have this condition. Additionally, people with chronic health conditions that can trigger inflammation, such as systemic erythematosus lupus (SLE) and rheumatoid arthritis (RA) are also at an increased risk of developing high cholesterol.

Your doctor can order blood tests to measure the amount of circulating cholesterol in your blood. Ideally, your total cholesterol level should be below 200 mg/dL (milligrams per deciliter); LDL (low-density lipoprotein) or the “bad” cholesterol should be below 100 mg/dL, and triglyceride levels below 150 mg/dL. On the other hand, HDL cholesterol (high-density lipoprotein), or the “good” cholesterol, should stay above 60 mg/dL.

How do statins treat high cholesterol?

Statins, also called hydroxymethylglutaryl-CoA (HMG-CoA) reductase inhibitors, help to lower cholesterol by blocking an enzyme that the liver needs to make cholesterol. These prescription drugs are used in addition to healthy diets and exercise when lifestyle changes alone are not successful in lowering cholesterol.

The US Food and Drug Administration (FDA) has approved 7 statin medications, namely, atorvastatin, rosuvastatin, simvastatin, pravastatin, lovastatin, fluvastatin, and pitavastatin.

Your doctor may recommend taking a statin drug alone or with other cholesterol-lowering medications. Lipid-lowering regimens are tailored based on side effects and clinical response.

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