Crestor vs. Vytorin

See how Crestor and Vytorin compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Crestor is a statin that lowers cholesterol by blocking liver production, while Vytorin combines a statin with a second drug that blocks cholesterol absorption in the gut.

  • Both are taken once daily as oral tablets, but Crestor is dosed alone in five strengths from 5 mg to 40 mg, while Vytorin is dosed as a fixed combination in four strengths.

  • Crestor carries an added FDA approval to lower heart attack and stroke risk in adults without heart disease, a use Vytorin's label does not include.

Crestor vs. Vytorin Drug Summary

Crestor

Crestor (rosuvastatin) is a statin, or HMG-CoA reductase inhibitor, taken once daily as an oral tablet to lower LDL cholesterol and triglycerides while raising HDL cholesterol. It also carries an FDA approval to reduce the risk of heart attack, stroke, and artery-opening procedures in adults with cardiovascular risk factors but no diagnosed heart disease. Doses range from 5 mg to 40 mg depending on individual response and risk.

Vytorin

Vytorin combines ezetimibe, which blocks cholesterol absorption in the intestine, with simvastatin, a statin that reduces cholesterol production in the liver. It is taken once daily as a single tablet to lower LDL cholesterol, total cholesterol, and triglycerides, and to raise HDL cholesterol. It is also used for two rare inherited conditions, homozygous familial hypercholesterolemia and sitosterolemia.

Crestor vs. Vytorin Side Effects

Crestor

Most common
Headache (up to 3.7%)
Myalgia (up to 3.1%)
Asthenia (up to 2.5%)
Nausea (up to 2.2%)

Vytorin

Most common
Headache (up to 5.8%)
Myalgia (up to 3.6%)
Increased ALT (up to 3.7%)
Diarrhea (up to 2.8%)

Crestor vs. Vytorin Dosage

Crestor

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 5 mg once daily At the start
Maximum dose Up to 40 mg once daily If needed
Dose changes 3 increases As tolerated

Vytorin

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 10 mg/10 mg once daily At the start
Maximum dose 10 mg/80 mg once daily If needed
Dose changes 3 increases As tolerated

Crestor vs. Vytorin Indications

Crestor

Crestor is FDA-approved to treat primary hyperlipidemia and mixed dyslipidemia, lowering LDL, total cholesterol, and triglycerides while raising HDL. It is also approved to reduce the risk of heart attack, stroke, and artery-opening procedures in adults with cardiovascular risk factors but no known heart disease. Additional approved uses include slowing atherosclerosis and treating inherited high-cholesterol conditions in adults and children.

  • Lowers LDL cholesterol and triglycerides, raises HDL

  • Reduces heart attack and stroke risk in at-risk adults without heart disease

  • Slows the progression of atherosclerosis

  • Treats inherited high cholesterol (HeFH, HoFH) starting at age 7-8

Vytorin

Vytorin is FDA-approved to lower LDL cholesterol, total cholesterol, triglycerides, and Apo B, while raising HDL, in adults with primary high cholesterol. It is also approved for two rare inherited conditions, homozygous familial hypercholesterolemia and homozygous sitosterolemia. Unlike Crestor, its label does not include an approval for reducing cardiovascular risk in adults without heart disease.

  • Lowers LDL, total cholesterol, and triglycerides

  • Raises HDL cholesterol

  • Treats homozygous familial hypercholesterolemia

  • Treats homozygous sitosterolemia, a rare fat-absorption disorder

Crestor vs. Vytorin Pros and Cons

Crestor

Crestor works through a single, well-studied mechanism and has been available as a generic since 2016, so many patients pay very little for it. Its five dose strengths allow fine-tuning, and it is the only one of the two with a primary-prevention heart attack and stroke indication.

Pros

  • Generic rosuvastatin has been available since 2016, widely covered at low copays

  • Brand list price is roughly $280 to $370 per month, lower than Vytorin's brand price

  • FDA-approved to reduce heart attack and stroke risk in adults without heart disease

Cons

  • Works through only one cholesterol-lowering mechanism, the statin pathway

  • Still carries myopathy and rhabdomyolysis risk, highest at the 40 mg dose

  • Not approved for sitosterolemia

  • May need a second drug added if a statin alone isn't enough

Vytorin

Vytorin pairs two different cholesterol-lowering mechanisms in one tablet, which can help patients who don't reach goal on a statin alone. Its simvastatin component brings added restrictions on high-dose use and drug interactions, and it lacks a primary cardiovascular prevention indication.

Pros

  • Combines two mechanisms (absorption blocker plus statin) in a single tablet

  • Approved for homozygous sitosterolemia, a use Crestor's label lacks

  • Convenient for patients who need both mechanisms without two separate pills

Cons

  • Brand list price is roughly $600 to $650 per month, higher than Crestor's

  • 80 mg simvastatin dose restricted due to higher myopathy risk

  • More CYP3A4 drug interaction restrictions than Crestor

  • Not approved to reduce heart attack or stroke risk in adults without known heart disease

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