Crestor vs. Lipitor: Differences, similarities, and which is better for you

Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ

According to the Centers for Disease Control and Prevention (CDC), about 38% of adults in the U.S. have high cholesterol. If you have high cholesterol, your doctor will most likely counsel you on the importance of diet and exercise. Your doctor may have also mention starting a statin medication. Statins are popular prescription medications, also known as HMG-CoA reductase inhibitors. They work by blocking an enzyme (called HMG-CoA reductase) that your body needs to make cholesterol.

Crestor and Lipitor are two popular brand-name statins used to lower cholesterol levels. Both drugs are approved by the U.S. Food and Drug Administration (FDA). They are used along with a diet low in saturated fat and cholesterol to lower cholesterol. Although Crestor and Lipitor are both statins, they are not the same. Continue reading to learn more about Crestor and Lipitor.

What are the main differences between Crestor and Lipitor?

Crestor (What is Crestor?) and Lipitor (What is Lipitor?) are both lipid-lowering medications. They are also known as statins, or HMG-CoA reductase inhibitors. Both medicines are available in brand and generic form and as tablets only. AstraZeneca manufactures the brand-name Crestor, and Pfizer makes the brand-name Lipitor. Crestor and Lipitor are mainly used in adults; however, in some instances, they may be used in children.

Main differences between Crestor and Lipitor
	Crestor	Lipitor
Drug class	HMG-CoA reductase inhibitor (also known as a statin or lipid-lowering agent)	HMG-CoA reductase inhibitor (also known as a statin or lipid-lowering agent)
Brand/generic status	Brand and generic	Brand and generic
What is the generic name?	Rosuvastatin	Atorvastatin
What form(s) does the drug come in?	Tablet	Tablet
What is the standard dosage?	Example: 10 mg daily	Example: 20 mg daily
How long is the typical treatment?	Long-term	Long-term
Who typically uses the medication?	Adults; children 7 years and older (in some instances)	Adults; children 10 years and older (in some instances)

Conditions treated by Crestor and Lipitor

Crestor and Lipitor are used to reduce cholesterol. Crestor or Lipitor should be used, along with a diet low in saturated fat and cholesterol, when diet alone has not adequately worked to lower cholesterol. Crestor and Lipitor lower total cholesterol, LDL, ApoB, and triglycerides. They also increase HDL cholesterol, the good kind of cholesterol.

Other indications are listed in the chart below. Crestor and Lipitor have not been studied in the treatment of Fredrickson Type I and V dyslipidemias.

Condition	Crestor	Lipitor
Hyperlipidemia and mixed dyslipidemia in adults	Yes	Yes
Familial Hypercholesterolemia in children	Yes	Yes
Hypertriglyceridemia in adults	Yes	Yes
Primary dysbetalipoproteinemia (Type III hyperlipoproteinemia) in adults	Yes	Yes
Homozygous familial hypercholesterolemia in adults	Yes	Yes
Slowing atherosclerosis progression in adults	Yes	Yes
Prevention of cardiovascular disease (heart attack, heart disease)	Yes	Yes

Is Crestor or Lipitor more effective?

Researchers compared several statins in a clinical trial called the STELLAR trial (Statin Therapies for Elevated Lipid Levels Compared Across Doses to Rosuvastatin). They looked at the effects of Lipitor, Crestor, Zocor, and Pravachol on lowering LDL (low-density lipoprotein) cholesterol after six weeks.

The study concluded that Crestor lowered LDL cholesterol by 8.2% more than Lipitor, and Crestor lowered total cholesterol significantly more than all the other statins studied. Crestor also increased HDL cholesterol (the good kind of cholesterol) more than Lipitor did. In patients who took Crestor, depending on dose, 82-89% achieved LDL cholesterol goals, compared to 69-85% of patients who took Lipitor. All statins were similarly tolerated.

Another study called the SATURN trial (Study of Coronary Atheroma by Intravascular Ultrasound: Effect of Rosuvastatin versus Atorvastatin) looked at high doses of Crestor—40 mg daily and Lipitor 80 mg daily—and their effect on the progression of coronary atherosclerosis. Coronary atherosclerosis is a narrowing of blood vessels and buildup of calcium and fatty deposits in the arteries, making it harder for blood to get to the heart, and increasing the risk of coronary heart disease.

The study also looked at safety and side effects. After two years of maximal dosing, the Crestor group had lower LDL levels and slightly higher HDL levels than the Lipitor group. (Although, it may be worth noting that AstraZeneca, manufacturer of Crestor, funded this study. Also, these drugs were given at the highest doses, which is not as common in a clinical setting for the average patient.) Both Crestor and Lipitor induced regression of atherosclerosis to a similar extent. Both drugs were well tolerated and had a low incidence of lab abnormalities.

In a clinical setting, both drugs are widely prescribed and well-tolerated. The most effective medication for you can be determined by your healthcare provider, who can consider your medical conditions, history, and medications you take that could interact with Crestor or Lipitor.

Coverage and cost comparison of Crestor vs. Lipitor

Crestor or Lipitor are covered by most insurance and Medicare prescription plans in their generic forms of rosuvastatin or atorvastatin. Choosing the brand-name product will likely result in a higher copay or may not be covered.

For a typical prescription of 30, 10 mg tablets of rosuvastatin (generic Crestor), the out-of-pocket price would be about $134. You can use a free SingleCare coupon to lower the price to $11 at participating pharmacies.

A typical prescription of 30, 20 mg tablets of atorvastatin (generic Lipitor) would cost approximately $82 if you paid out of pocket. A SingleCare generic Lipitor coupon can bring the price down to approximately $15.

As plans vary and can change, contact your insurance company for information regarding Crestor and Lipitor’s coverage.

	Crestor	Lipitor
Typically covered by insurance?	Yes (generic)	Yes (generic)
Typically covered by Medicare Part D?	Yes (generic)	Yes (generic)
Quantity	Example: 30, 10 mg tablets	Example: 30, 20 mg tablets
Typical Medicare copay	$0-$20	$0-$15
SingleCare cost	$11+	$15+

Get the SingleCare prescription discount card

Common side effects of Crestor vs. Lipitor

The most common side effects of Crestor are headache, muscle pain, abdominal pain, nausea, and weakness.

Lipitor’s most common adverse effects are the common cold, joint pain, diarrhea, pain in extremities, and urinary tract infections.

A rare but serious side effect of Crestor and Lipitor is myopathy (muscle weakness) and rhabdomyolysis (the breakdown of muscle tissue, which can be very damaging). See the warnings section for more information.

The occurrence of side effects may vary with dosage. This is not a full list of side effects. Other, serious side effects may occur. Talk to your healthcare provider about what side effects to expect from Crestor or Lipitor, and how to address them.

	Crestor		Lipitor
Side effect	Applicable?	Frequency	Applicable?	Frequency
Headache	Yes	5.5%	No	–
Nausea	Yes	3.4%	Yes	4%
Muscle aches/pain	Yes	2.8%	Yes	3.8%
Joint pain	Yes	Varies	Yes	6.9%
Pain in extremities	No	–	Yes	6%
Urinary tract infection	No	–	Yes	5.7%
Weakness	Yes	2.7%	Yes	6.9%
Indigestion	No	–	Yes	4.7%
Constipation	Yes	2.4%	No	–
Diarrhea	No	–	Yes	6.8%
Abdominal pain	Yes	≥2%	Yes	% not reported
Common cold	No	–	Yes	8.3%

Source: DailyMed (Crestor), DailyMed (Lipitor)

Drug interactions of Crestor vs. Lipitor

An important reaction to know about Lipitor is that you should not drink an excess amount of grapefruit juice (more than 1.2 liters per day). Too much grapefruit juice can increase Lipitor levels in your body, making you more likely to experience myopathy (muscle weakness) and rhabdomyolysis (muscle tissue breakdown, which can be very damaging).

These muscle problems are more likely to occur with higher consumption of grapefruit juice, but could potentially occur with lower amounts. If you eat grapefruit or drink grapefruit juice and take Lipitor, ask your doctor how much is safe to consume, or if it would be better to take a different medication that does not interact with grapefruit. Crestor does not have a grapefruit juice interaction.

Crestor and Lipitor have some of the same drug interactions, for example, with cyclosporine, gemfibrozil, niacin, fenofibrate, colchicine, and certain antiviral medications used for HIV. Combining Crestor or Lipitor with one of these drugs can increase the statin levels, leading to a higher risk of myopathy and rhabdomyolysis. Depending on the combination of drugs and your medical history/conditions, your doctor may need to adjust your medication dosage or select an alternate medication.

Before taking Crestor or Lipitor, tell your doctor about all of the medications you take, including prescription, over-the-counter (OTC), and vitamins, so they can determine if Crestor or Lipitor is safe for you.

Drug	Drug class	Crestor	Lipitor
Cyclosporine	Immunosuppressant	Yes	Yes
Gemfibrozil	Medication for high triglycerides	Yes	Yes
Certain antiviral HIV medications	Antiviral HIV medications	Yes	Yes
Itraconazole	Azole antifungal	No	Yes
Clarithromycin	Macrolide antibiotic	No	Yes
Darolutamide	Androgen receptor inhibitors for prostate cancer	Yes	No
Regorafenib	Kinase inhibitor for cancer	Yes	No
Warfarin	Anticoagulant	Yes	No
Niacin	Antilipemic agent	Yes	Yes
Fenofibrate	Antilipemic agent	Yes	Yes
Colchicine	Anti-gout agent	Yes	Yes
Maalox Mylanta Rolaids	Antacids	Yes	No
Grapefruit juice	Grapefruit juice	No	Yes
Rifampin	Antimycobacterial	No	Yes
Oral contraceptives	Oral contraceptives	No	Yes
Digoxin	Cardiac glycosides	No	Yes

Warnings of Crestor and Lipitor

• In rare cases, muscle weakness and breakdown may occur due to statin medication. This can happen with any dose but is more common with higher doses. Use with caution in patients ages 65 years or older, patients with kidney problems, and patients with hypothyroidism that is not under control. These risks also increase if certain other medications are taken in combination with Crestor or Lipitor, such as fenofibrate, niacin, cyclosporine, colchicine, or certain antiviral medicines used for HIV. If you have unexplained muscle pain, or muscle weakness, or tenderness, especially if you also feel tired and/or have a fever, notify your doctor immediately. Crestor or Lipitor should be stopped if you have significantly increased creatine kinase levels or suspected myopathy.
• In rare instances, a condition called immune-mediated necrotizing myopathy (IMNM) can occur from statin treatment. Signs and symptoms include muscle weakness and changes in labs.
• Patients should have liver enzyme lab tests before starting Crestor or Lipitor, during treatment if there are any signs of liver problems, and/or when the doctor feels it is appropriate for these blood tests. Statin medications may increase AST or ALT levels. In rare cases, liver failure (fatal or non-fatal) has occurred in patients taking statins. Crestor or Lipitor should be immediately stopped if serious liver injury occurs. If you have symptoms of fatigue, appetite loss, dark urine, or yellowing of the skin or eyes, contact your doctor right away.
• Use Crestor or Lipitor with caution in patients who drink a lot of alcohol.
• Use Crestor or Lipitor with caution in patients with a history of liver disease. People with active liver disease should not use Crestor or Lipitor.
• Changes in glucose levels and hemoglobin A1C levels may occur from Crestor or Lipitor. The risk increases with concomitant use of ketoconazole, spironolactone, or cimetidine.
• In rare cases, memory loss or confusion may occur. Contact your healthcare professional immediately for guidance if you or a loved one notice any changes.
• Do not take two doses of Crestor or Lipitor within 12 hours of each other.
• Crestor or Lipitor can be taken with or without food at any time of day. Swallow tablet whole.
• Crestor or Lipitor should never be used in pregnancy due to the risk of fetal harm. Do not breastfeed while taking Crestor or Lipitor.

Additional Crestor warnings:

• Patients who take an anticoagulant (such as warfarin) should be carefully monitored before taking Crestor, and frequently at the beginning of statin treatment, to ensure INR remains stable.
• Patients who take an antacid containing aluminum and magnesium should take the antacid at least two hours after taking Crestor.

Additional Lipitor warnings:

• Excess consumption of grapefruit and/or grapefruit juice (more than 1.2 liters daily) combined with Lipitor can increase myopathy and rhabdomyolysis risk.

Frequently asked questions about Crestor vs. Lipitor

What is Crestor?

Crestor is a statin, or HMG-CoA reductase inhibitor, commonly used to treat high cholesterol. Its generic name is rosuvastatin. Crestor is available in both brand and generic form and as a tablet.

What is Lipitor?

Lipitor, like Crestor, is a statin medication used for high cholesterol. Its generic name is atorvastatin. It is available in tablet form, in both brand and generic.

Are Crestor and Lipitor the same?

Crestor and Lipitor are both statins. They work the same way and have some similarities. However, they are not exactly the same. You can read about their differences in the information outlined above. Other statins you may have heard of include Pravachol (pravastatin), Zocor (simvastatin), Livalo (pitavastatin), Lescol (fluvastatin), and Mevacor (lovastatin).

Is Crestor or Lipitor better?

Studies show both drugs to be effective in lowering cholesterol (see above section). Some studies show Crestor to be slightly more effective; however, both drugs are effective and well-tolerated. Ask your healthcare provider if one of these drugs would be more appropriate for you, based on your medical history.

Can I use Crestor or Lipitor while pregnant?

No. Crestor or Lipitor should never be taken by a pregnant woman. Both medications are specifically contraindicated for use during pregnancy. They can cause harm to an unborn baby. If you are taking Crestor or Lipitor and find out that you are pregnant, stop taking the statin and contact your doctor immediately for medical advice.

Can I use Crestor or Lipitor with alcohol?

Generally, it is safe to consume a small to moderate amount of alcohol if you take Crestor or Lipitor. However, if you have liver problems, or drink an excessive amount of alcohol, check with your healthcare provider before mixing a statin and alcohol. People with chronic liver disease should avoid alcohol completely when taking a statin.

Is Crestor safer than Lipitor?

Crestor and Lipitor are both well tolerated. Any drug has side effects, with some rare but serious potential side effects, too. Studies (see above section) have shown that both medicines were tolerated well in trials.

What foods should be avoided when taking Crestor?

When you take Crestor (or Lipitor), you should eat a healthy diet low in saturated fat and cholesterol.

Some foods you’ll want to avoid are fatty meats, full-fat dairy, and sweets. Instead, focus on foods like fruits, vegetables, whole grains, beans, nuts, and lean protein like chicken and fish.

Although Lipitor interacts with (large amounts of) grapefruit juice, Crestor is safe to take with grapefruit juice.

Does Crestor make you gain weight?

Crestor is not directly linked to weight gain. If you are taking Crestor and notice a weight change, contact your healthcare provider.