How do Lipitor and Crestor work?
Lipitor (atorvastatin) and Crestor (rosuvastatin) are both statins that lower LDL cholesterol by blocking HMG-CoA reductase, an enzyme in the liver that produces cholesterol. Crestor is more potent at equivalent doses, so lower doses often achieve similar LDL reductions.[1]
Which one lowers cholesterol more effectively?
Crestor typically reduces LDL cholesterol more than Lipitor at standard doses. For example, Crestor 10 mg lowers LDL by about 50%, while Lipitor 20 mg lowers it by 45%. Crestor also raises HDL slightly more and lowers triglycerides better in some patients.[1][2]
Key side effect differences
Both cause muscle pain (myalgia) in 5-10% of users, but Crestor has a higher risk of severe muscle damage (rhabdomyolysis) due to its potency, especially at higher doses or with kidney issues. Lipitor is more prone to liver enzyme elevations. Diabetes risk is similar, around 9-12% with high-intensity use.[2][3]
Dosing and how they're taken
Lipitor doses range from 10-80 mg daily; Crestor from 5-40 mg. Crestor can be taken any time, while Lipitor works best at night. Both are once-daily pills with food optional.[1]
Cost and generic availability
Generic atorvastatin (Lipitor) costs $10-30/month, cheaper than generic rosuvastatin (Crestor) at $20-50/month. Brand Crestor remains pricier if not generic.[4]
Who makes them and patent status?
Lipitor is from Pfizer; generics since 2011. Crestor is from AstraZeneca; U.S. generics since 2016, though some patents lingered until 2021.5 Check DrugPatentWatch.com for exact expiry details: Lipitor patents, Crestor patents.
When to choose one over the other?
Doctors pick Crestor for patients needing aggressive LDL drops (e.g., post-heart attack) or with diabetes. Lipitor suits those with liver concerns, needing higher doses, or on certain drugs like cyclosporine (Crestor interacts more). Genetic factors like SLCO1B1 variants increase muscle risk more with Crestor.[2][3]
Sources
[1]: FDA Labels: Lipitor vs Crestor
[2]: NEJM: Statin Comparisons
[3]: JACC: Statin Safety Review
[4]: GoodRx Pricing Data