Crestor vs. Lipitor: Similarities & Differences
Medically reviewed by Femi Aremu, PharmD
Crestor (rosuvastatin) and Lipitor (atorvastatin) are statins (HMG-CoA reductase inhibitors), a class of drugs used to reduce cholesterol and triglyceride levels in the blood.
These brand-name medications work alone or with other drugs or non-medical therapies to reduce the risk of heart and blood vessel disorders.
High cholesterol levels are a significant health problem of the present age. Almost 2 in 5 adults in the United States have high cholesterol levels in the blood.
Too much cholesterol puts you at risk for cardiovascular disease and stroke, two leading causes of death in the United States.
If you present unhealthy cholesterol or triglyceride levels to your healthcare provider, you may be prescribed Crestor, Lipitor, or another orally administered statin.
As such, this article will provide an in-depth analysis of Crestor vs. Lipitor, examining each's specific uses, dosing requirements, potential side effects, storage requirements, and more.
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Understanding Cholesterol
Cholesterol is an essential component of cell membranes of body organs, which helps the body absorb fats and fat-soluble vitamins. The body can produce the required cholesterol levels and obtain it from food.
Another type of fat is triglycerides. In fat cells, triglycerides can be broken down to provide energy for the body’s metabolic processes, including growth.
High quantities of cholesterols and triglycerides can harm the body, causing various health problems. Cholesterols and triglycerides travel in the body and combine with proteins to make particles called lipoproteins.
There are different types of lipoproteins in the body with different purposes. Lipoproteins include:
Cholesterol transported by LDL is called LDL cholesterol LDL-C (bad cholesterol), and HDL is called HDL cholesterol HDL-C (good cholesterol).
What Is Crestor?
Crestor is the brand name of the active drug rosuvastatin, an HMG Co-A reductase inhibitor (statin) that is Food and Drug Administration (FDA)-approved for the following:
To reduce the risk of stroke, heart attack, and arterial revascularization procedures (a bypass surgery) in adults with a heart disease or at risk of developing a heart disease.
As a complement to diet to reduce bad cholesterol in adults with primary hyperlipidemia (increased lipids levels).
As a compliment to diet to reduce bad cholesterol and slow the progression of atherosclerosis (thickening of arteries due to plaque build-up) in adults.
As a complement to diet to reduce bad cholesterol in adults and children 8 and older with heterozygous familial hypercholesterolemia (HeFH, an inherited genetic disorder causing dangerously high cholesterol levels).
As a complement to other harmful cholesterol-lowering therapies or alone if such treatments are unavailable, to reduce these in adults and children 7 and older with homozygous familial hypercholesterolemia (HoFH is an inherited condition in which cholesterol cannot be typically removed from the body).
As a complement to diet for treating adults with primary dysbetalipoproteinemia (high amounts of cholesterol and triglycerides in the blood) and hypertriglyceridemia (high levels of triglycerides).
Your healthcare provider may prescribe Crestor for off-label indications. Always use this drug as prescribed.
How Does Crestor Work?
Crestor acts primarily in the liver to decrease the synthesis of VLDL and lower triglyceride (fat) to decrease cholesterol levels and slow plaque build-up in the blood vessels.
Crestor is available in coated 5-, 10-, 20-, and 40-milligrams (mg) strength tablets. It is FDA-approved to treat various conditions in adults and children 7 and older.
Crestor's active ingredient, rosuvastatin, is also available as a generic product administered via an oral tablet.
What Is Lipitor?
Lipitor is the brand name of the active drug atorvastatin.
This medication is also an HMG-CoA reductase inhibitor (statin) and is indicated to reduce the risk of:
Heart attack, stroke, heart surgeries, and angina (chest pain) in adults at risk for coronary heart disease (CHD).
Heart attack and stroke in adults with type 2 diabetes mellitus with multiple risk factors for CHD but without officially diagnosed CHD.
Non-fatal heart attack, fatal and non-fatal stroke, heart surgeries, hospitalization for congestive heart failure (CHF), and angina in adults with clinically evident CHD.
Additionally, Lipitor is also FDA-approved as a complement to diet to reduce LDL-C for the following:
Adults with primary hyperlipidemia.
Adults and children 10 and older with HeFH
Adults and children 10 and older with HoFH
Lipitor also treats adults with primary dysbetalipoproteinemia (elevated cholesterol and triglyceride levels leading to heart disease) and/or hypertriglyceridemia.
How Does Lipitor Work?
Lipitor reduces the production in the body to decrease the amount of cholesterol that may build up on the walls of the arteries and reduce blood flow to the heart, brain, and other parts of the body.
Lipitor is available in coated tablets of 10-, 20-, 40-, and 80-mg strengths. It is FDA-approved to treat various conditions in adults and children 10 and older.
Dosing Comparison
The following outlines basic dosing guidelines for Crestor and Lipitor. Note, however, that your dosage may vary based on the discretion of your healthcare provider.
Various factors, too, may affect your dosing volume and schedule, such as weight, preexisting conditions, or past heart surgeries.
Crestor
The recommended dosing range for Crestor is between 5 mg and 40 mg orally once daily. It can be administered as a single dose with or without food.
The initial dose or when switching from another statin drug therapy, the starting dose should be minimal and then increased if needed according to the individual's response and goal of treatment.
The 40-mg dose of Crestor should be used only for those who have yet to achieve their LDL-C goal utilizing the 20-mg dose.
Crestor dosing guidelines are as follows:
Hyperlipidemia, mixed dyslipidemia, hypertriglyceridemia, primary dysbetalipoproteinemia (type III hyperlipoproteinemia), and slowing of the progression of atherosclerosis:
The recommended starting dose of Crestor is 10 mg once daily. Your healthcare provider will increase the initial dose to 20 mg in people to achieve aggressive lipid targets and again after evaluation at four weeks.
HoFH:
The recommended starting dose is 20 mg once daily.
Dosage in people of Asian descent:
Start at an initial dose of 5 mg once daily.
Use with other drugs:
In people taking a combination therapy with Niacor (niacin), Lipofen (fenofibrate), or Lopid (gemfibrozil), the dose of Crestor should be reduced. Ask your healthcare provider before taking any drug for an accurate dose.
Dose in people with severe renal impairment:
The starting dose should be 5 mg once daily and not more than 10 mg once for people with severe renal impairment not on hemodialysis.
Lipitor
Take Lipitor orally once daily at any time, with or without food.
Your healthcare provider will check the LDL-C four weeks after initiating Lipitor and adjust the dosage if necessary.
Lipitor dosing guidelines are as follows:
Recommended dosage in adults:
The recommended starting dosage of Lipitor is between 10 mg and 20 mg once daily.
The recommended dosage range is 10 mg to 80 mg once daily.
People who require a reduction in LDL-C greater than 45% may start at 40 mg once daily.
Recommended dosage in children 10 or older with HeFH:
The recommended starting dosage of Lipitor is 10 mg once daily.
The recommended dosage range is between 10 mg and 20 mg once daily.
Recommended Dosage in children 10 or older with HoFH:
The recommended starting dosage of Lipitor is between 10 mg and 20 mg once daily.
The recommended dosage range is between 10 mg and 80 mg once daily.
Dosage modifications due to drug interactions:
Simultaneous use of Lipitor with some other drugs may require dosage modification of Lipitor.
Ask your healthcare provider for dose adjustment before taking any medication.
How Fast Does Crestor vs. Lipitor Work?
A statin drug takes about six weeks to stabilize cholesterol levels. Usually, the healthcare providers would re-check your cholesterol after about eight weeks.
The clinical studies of Crestor vs. Lipitor show that both these drugs start working a few weeks after the initial dose.
Crestor and Lipitor show a visible reduction in cholesterol and triglyceride levels in various medical conditions within six weeks of treatment.
Comparing Efficacy
Crestor and Lipitor are first-line medications that treat various cholesterol and lipid profile-related problems. These effectively control these problems when used alone or as an aid to dietary and lifestyle changes.
Various studies have compared the effectiveness of statins to show which drug is better than the other or has more effectiveness than the rest.
Crestor generally is more practical and shows early symptom improvement compared to other statins.
For example, in one such meta-analysis, Crestor has proved to be more effective at treating hypercholesterolemia (high cholesterol) in people compared to Lipitor and Zocor (simvastatin).
Another study comparing Crestor with Lipitor for the reduction of LD-C in people with type 2 diabetes compares the effectiveness of the two drugs.
Crestor was significantly more effective than atorvastatin at reducing LDL-C and achieving European LDL-C goals at the initial and following doses.
Alternative Treatment Optons
Drug therapy with statins and other cholesterol-lowering agents can lower cholesterol and reduce cardiovascular disease risks. But, other non-pharmaceutical methods can help to lessen the effects of cholesterol.
Various dietary strategies, including the Ornish and Mediterranean diets are designed to lower lipid levels. Additionally, phytosterols, fiber, soy products, or fish oil consumption has been linked to lowering lipid levels.
Drug companies note that over 30% of people who started on statins for cholesterol-lowering therapy do not continue their prescriptions.
Other lifestyle changes can also be helpful. Obesity raises harmful cholesterol levels in the body. Excess body fat affects cholesterol metabolism and reduces the body’s ability to remove LDL cholesterol.
It increases the risk of heart disease and stroke. Physical activity and regular exercise can help maintain a healthy weight and lower the cholesterol and blood pressure levels.
Alcohol and smoking also increase the risk of vascular diseases. Smoking damages the blood vessels and increases the risk of heart disease. Excessive alcohol intake can also raise cholesterol and triglyceride levels in the blood.
Quitting smoking and limiting alcohol also reduces the risk and improves your heart and overall health.
Side Effects & Safety
Like all drugs, Crestor and Lipitor carry the potential for adverse side effects. Therefore, be sure to closely monitor yourself or a loved one for the emergence of any symptoms.
Furthermore, the FDA has approved new labeling changes for statins regarding their side effects and possible drug interactions to ensure their safe and effective use.
Common Side Effects
The FDA has updated statin labels to outline the potential for non-serious and reversible side effects, which include:
Memory loss and confusion
Increased blood sugar
Increased hemoglobin A1c levels
Some other common side effects of Crestor and Lipitor include:
Stomach pain
Confusion
The use of Crestor may cause depression and difficulty sleeping or staying asleep.
Additionally, using Lipitor is sometimes associated with urinary tract infections (UTIs).
Severe Side Effects
Some side effects of Crestor and Lipitor may be severe and need immediate medical attention.
Keep a close check on the following symptoms and call your healthcare provider if you experience any of the following:
Chest pain
If you are allergic to Crestor, Lipitor, or any of their components, symptoms may include:
Rash
Itching
Swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
There have been rare reports of severe liver problems with statins.
Call your healthcare professional right away if you have the following symptoms:
Weakness
Unusual bleeding or bruising
Loss of appetite
Dark colored urine
This may be a partial list of adverse effects. Call your healthcare provider or seek medical help if you develop new or worsening symptoms.
Precautions:
Crestor and Lipitor are safe when used as prescribed by your healthcare provider. However, there are a few exceptions.
A person with the following conditions should avoid taking both these drugs to avoid adverse effects:
Crestor and Lipitor are unsuitable for pregnant or breastfeeding people. They may cause fetal harm. They can also harm the breastfed infant and can cause severe adverse effects.
Crestor is not recommended for use in children under 10. On the other hand, Lipitor is not for use in children younger than 7.
Satins such as Crestor and Lipitor may cause autoimmune myopathy (IMNM, an inflammatory disease of muscles). Discontinue taking these drugs if the symptoms appear.
It is recommended to test liver enzymes before taking these medicines. Discontinue these drugs if liver injury or symptoms such as jaundice are present.
Risk factors of developing myopathy (a disease affecting voluntary control of muscles) and rhabdomyolysis (a disease-causing damaged muscle tissue to release proteins and electrolytes into the blood) may increase in people 65 or older using Crestor or Lipitor.
Finally, know that the chances of myopathy and rhabdomyolysis are higher in people of Asian origin when taking Crestor.
Potential Interactions
Crestor vs. Lipitor may interact with other medications. Some medications interact with both of these drugs. However, there are exceptions as well.
Crestor & Lipitor
The following drugs may interact with both Crestor and Lipitor:
Drugs used to prevent organ rejection after a kidney, liver, or heart transplant, such as Neoral (cyclosporine)
Other cholesterol-lowering medications, such as Lopid (gemfibrozil)
Fibrates (medicines prescribed to help lower high triglyceride levels) other than Lopid, such as Ticir (fenofibrate)
Anti-inflammatory medications, such as Colcrys (colchicine)
Antiviral medications (drugs used to treat hepatitis C), such as Mavyret (glecaprevir/pibrentasvir) or Harvoni (ledipasvir/sofosbuvir)
Crestor
The following are the medications that interact with Crestor. These drugs may need to change in dose or are completely inhibited when taking Crestor.
Tell your healthcare provider if you have or are currently taking any of the following:
Antacids, such as aluminum hydroxide or magnesium hydroxide
Blood thinning drugs, such as Jantoven (warfarin)
Antihistamines, such as Tagamet (cimetidine)
Drugs used for prostate cancer, such as Nubeqa (darolutamide)
Drugs used for adults with the cardiomyopathy of wild-type or hereditary transthyretin-mediated amyloidosis (ATTR-CM), such as Vyndamax (tafamidis)
Drugs used for the treatment of acute myeloid leukemia, such as Idhifa (enasidenib)
Lipitor
The following are the medications that interact with Lipitor. These drugs may need to change in dose or are completely inhibited when taking Lipitor.
Lipitor interacts with the following medications:
Antifungal medications, such as Sporanox (itraconazole) or Nizoral (ketoconazole)
Antiarrhythmic and blood pressure support drugs, such as Lanoxin (digoxin)
Oral contraceptives, such as Plan B (levonorgestrel)
Macrolide antibiotics, such as Biaxin XL (clarithromycin)
This is a partial list of drugs. Always consult your healthcare provider about all prescription, non-prescription, and over-the-counter (OTC) drugs and multivitamins you take before taking Crestor or Lipitor.
Your healthcare provider will determine the best dose to avoid drug-drug interactions.
Summary
Statins are a class of prescription drugs used together to reduce blood levels of bad cholesterol.
Crestor and Lipitor are frontline statin drugs marketed as single-ingredient products containing active drugs rosuvastatin and atorvastatin.
These drugs are sometimes used with lifestyle changes such as diet, weight loss, and exercise to reduce the risk of various diseases, including stroke, heart attack, heart surgeries, and other vascular diseases.
These drugs effectively treat these problems and improve the symptoms within a few weeks.
Like other drugs, they have a few limitations regarding their side effects, and when used in pregnancy, breastfeeding, older adults, and people with liver disorders.
Always use these drugs as your healthcare provider prescribes for maximum therapeutic benefits.
Frequently Asked Questions
How do I store Crestor vs. Lipitor?
Store Crestor and Lipitor at room temperature (between 68 and 77 degrees F) and in a dry place.
Keep your medicines away from the reach and sight of children and pets. Do not store it in the bathroom. Discard all unwanted and unused medicines. Call your local waste management department or pharmacist for details.
How do I dispose of Crestor or Lipitor safely, if needed?
Discard unused or expired medicine safely. Do not keep old or unused medicine around. Do not flush your medication down the toilet or throw medicine away in the trash.
A better way to dispose of unused medicines is to give them back to your pharmacist or use community "drug give back" programs if available.
Read the original article on Verywell Health.
