Crestor vs Lipitor

Crestor’s (Rosuvastatin) and Lipitor’s (Atorvastatin) - liver, safety, benefits, cost, Dosing, depression, diabetes, effectiveness, side effects

What is Crestor? What is Crestor used for?

Crestor is a Brand name for a medicine that contains a lipid-reducer drug called rosuvastatin. This drug belongs to the class of drugs pharmacologically called HMG CoA reductase inhibitors, but it is most commonly known as “statins”. Rosuvastatin works by reducing the levels of “bad” LDL cholesterol and triglycerides in the blood, and by increasing levels of “good” HDL cholesterol.  Crestor is prescribed for adults and children who older than 8 years to lower cholesterol and triglycerides in the blood and to slow building of fatty deposits in blood vessels.  Diet and lifestyle changes are most commonly used in combination with this drug.  Crestor’s FDA approved structured indications are:

  • Atherosclerosis
  • Atherosclerotic Cardiovascular Disease
  • Cardiovascular Disease
  • Dysbetalipoproteinemia
  • Heterozygous Familial Hypercholesterolemia
  • Homozygous Familial Hypercholesterolemia
  • Hypertriglyceridemia
  • Primary Hyperlipidemia
  • Mixed hypercholesterolemia

Crestor is available in the form of tablet to be taken by mouth in following doses: 5 mg, 10 mg, 20 mg and 40 mg.  FDA approved rosuvastatin in 2003 and is originally manufactured by AstraZeneca.

What is Lipitor? What is Lipitor used for?

Lipitor is a Brand name for a medicine that contains a lipid-lowering drug called atorvastatin. Atorvastatin belongs to the class of drugs pharmacologically called HMG CoA reductase inhibitors, but it is most commonly known as “statins”. Atorvastatin works by reducing the levels of “bad” LDL cholesterol and triglycerides in the body, and by increasing levels of “good” HDL cholesterol.  Lipitor is prescribed for adults and children who older than 10 years to lower cholesterol and triglycerides in the blood and to slow building of fatty deposits in blood vessels.  Diet and lifestyle changes such as exercises and smoke quitting are most commonly used in combination with this drug.  Lipitor’s FDA approved structured indications are:

  • Cardiovascular Disease
  • Dysbetalipoproteinemia
  • Heterozygous Familial Hypercholesterolemia
  • Homozygous Familial Hypercholesterolemia
  • Hypercholesterolemia
  • Hypertriglyceridemia
  • Primary Hyperlipidemia
  • Mixed hypercholesterolemia
  • Prophylaxis of cardiovascular event

Lipitor is available in the form of tablet to be taken by mouth in following doses: 10 mg, 20 mg, 40 mg and 80 mg.  FDA approved atorvastain in 1996 and is originally manufactured by Pfizer.

Difference between Crestor’s  (Rosuvastatin) and Lipitor’s (Atorvastatin) mechanism of action

Atorvastatin from Lipitor and rosuvastatin from Crestor are selective and competitive inhibitors of the hepatic enzyme HMG-CoA reductase. Inhibition of this enzyme stops the conversion of HMG-CoA to mevalonate in the biosynthesis of cholesterol, resulting in a decrease of hepatic cholesterol levels. Decreased levels of cholesterol in the liver stimulate upregulation of hepatic LDL-C receptors thus increasing liver uptake of LDL cholesterol and reduces its levels in blood. Both drugs also work by decreasing serum levels of triglycerides and by increasing the levels of “good” HDL cholesterol.  Rosuvastatin also inhibits synthesis of very low density lipoprotein (VLDL) in the liver.  In vitro and in vivo studies also showed that rosuvastatin possess vasoprotective effects which are independent of its lipid-lowering properties. It has anti-inflammatory effects on microvascular endothelium by attenuating leukocyte rolling, adherence and transmigration. This drug also modulates expression of nitric oxide synthase (NOS) enzyme and reduces ischemic-reperfusion injuries in animal models.

Differences and similarities between Crestor and Lipitor

what is the difference between simvastatin and rosuvastatin

There are many similarities but also differences between Crestor and Lipitor. Active ingredient of Crestor is rosuvastatin while Lipitor’s active ingredient is atorvastatin. Both drugs belong to the therapeutic group of HMGCoA inhibitors commonly known as statins.

Chemically they have differences.  Rosuvastatin belongs to the class of organic compounds known as phenylpyrimidines, polycyclic aromatic compounds with a benzene ring connected to a pyrimidine ring through a CC or CN bond.  Atorvastsatin belongs to the class of organic compounds known as diphenylpyrroles, aromatic heterocyclic compounds with a structure built on a pyrrole ring connected with two phenyl groups.

Their mechanism of action is similar, however rosuvastain may also lower VLDL levels and have better vasoprotective effects. Both drugs are indicated for almost the same indications.

From pharmacokinetic standpoint these drugs have some differences. Atorvastain is faster absorbed than rosuvastatin with peak plasma concentrations achieved after 1 to 2 hours compared to rosuvastatin’s peak plasma concentrations 3 to 5 hours.  The absolute bioavailability of atorvastatin is approximately 14% while rosuvastatin’s is about 20%. Atorvastatin has a higher rate of protein binding with 98% compared to rosuvastatin’s 88%. Both drugs are metabolized in the liver but with different CYP450 enzymes. Atorvastatin is mostly metabolized with CYP3A4 and CYP3A5 liver enzymes while rosuvastatin is mostly metabolized with CYP2C9 and CYP2C19.  Atorvastatin has extensive metabolism to ortho- and parahydroxylated various beta-oxidation metabolites. Nearly 70% of inhibitory activity for HMG-CoA reductase is attributed to atorvastatin’s active metabolites. On the other hand, rosuvastatin is not extensively metabolized. Only ~10% is excreted as metabolite that contains 50 % of rosuvastatin’s pharmacological actions.

Studies have showed that rosuvastatin is more effective in reducing LDL cholesterol than atorvastatin. This study showed that patients who were on a therapy with one of these drugs had important reductions in their fatty plaque lining of the arteries, with just a few serious side effects. Rates of heart attacks, strokes and angioplasty procedures were fewer compared to patients on less aggressive statin regimens. Results showed that patients who were on Crestor therapy had better scores than those on Lipitor therapy. LDL levels in the Crestor group dropped to 62.6 mg/dL, compared to 70.2 mg/dL levels for patients on Lipitor. Patients taking Crestor also had higher levels of good cholesterol – HDL.

The FDA advisories note that patients who used Lipitor have complained of swelling in their hands and feet and joint pain while patients who used Crestor have problems with depression and sleep disturbances. In a study of more than 470,000 patients treated with a statins, it has been found that Lipitor presented the highest diabetes risk. Additional studies found that diabetes risk is higher for certain groups, such as elderly, women, and Asians.

Crestor Vs Lipitor side effects

Crestor (rosuvastatin) possible side effectsLipitor (atorvastatin) possible side effects
Myalgia (3-13%)Diarrhea (5-14%)
Arthralgia (10%)Nasopharyngitis (4-13%)
Diabetes mellitus, new onset (3%)Arthralgia (4-12%)
Pharyngitis (9%)Nsomnia (1-5%)
Headache (6%)Urinary tract infection (4-8%)
Asthenia (up to 5%)Nausea (4-7%)
Dizziness (4%)Dyspepsia (3-6%)
CPK increased (3%)Increased transaminases (2-3%)
Nausea (3%)Muscle spasms (2-5%)
Abdominal pain (2%)Musculoskeletal pain (2-5%)
ALT increased (2%)Myalgia (3-8%)
Constipation (2%)Limb pain (3-8%)
Flulike illness (2%)Pharyngolaryngeal pain (1-4%)
UTI (2%)
Jaundice (<1%)
Myopathy (<1%)
Rhabdomyolysis (<1%)

Which one is expensive Crestor or Lipitor

According to drugs.com:

·     The cost for Crestor tablets 5 mg is around $167 for a supply of 30 tablets

·     The cost for Crestor tablets 10 mg is around $167 for a supply of 30 tablets

×           The cost for Crestor tablets 20 mg is around $167 for a supply of 30 tablets

×           The cost for Crestor tablets 40 mg is around $134 for a supply of 15 tablets

×           The cost for Lipitor tablets 10 mg is around $138 for a supply of 30 tablets

×           The cost for Lipitor tablets 20 mg is around $106 for a supply of 15 tablets

×           The cost for Lipitor tablets 40 mg is around $193 for a supply of 30 tablets

×           The cost for Lipitor tablets 80 mg is around $128 for a supply of 15 tablets

Prices depend on the pharmacy you visit. Prices are for cash paying customers only and are not valid with insurance plans.

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About Miljan Krcobic 123 Articles
My name is Miljan Krčobić. I was born on 14th of November 1989. in Negotin, Serbia, where I finished elementary and high school. In June 2015 I graduated from the Faculty of Pharmacy in Belgrade and thus acquired the title Master of Pharmacy. From the July of 2015 to January 2016 I worked in a pharmaceutical company Hemofarm a.d.(Member of STADA group) based in Vrsac, Serbia, as an expert associate for GMP compliance within the sector Quality Assurance. I am currently working in a pharmacy called Zivkovic in Negotin. As a freelancer I write medical articles on Elance and Upwork.