Crestor vs. Zetia
See how Crestor and Zetia compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Crestor is a statin that blocks the liver's cholesterol production and can lower heart attack and stroke risk, while Zetia blocks cholesterol absorption in the gut and is often added to a statin.
Both are once-daily pills, but Crestor's dose is adjusted from 5 mg to 40 mg based on response, while Zetia stays at one fixed 10 mg dose with no titration.
Crestor has outcome data showing it lowers cardiovascular risk on its own, while Zetia is mainly used to boost a statin's effect or as an option for people who can't tolerate one.
Crestor vs. Zetia Drug Summary
Crestor
Crestor (rosuvastatin) is a statin, a drug class that blocks a liver enzyme needed to make cholesterol. It is approved to lower LDL cholesterol and triglycerides, raise HDL, slow artery plaque buildup, and cut heart attack and stroke risk in people with risk factors. It is taken as one tablet by mouth once a day, at doses ranging from 5 mg to 40 mg.
Zetia
Zetia (ezetimibe) is a cholesterol absorption inhibitor, a non-statin drug that blocks cholesterol absorption in the small intestine. It is approved to lower LDL cholesterol on its own, added to a statin, or combined with fenofibrate for mixed cholesterol problems. It is taken as one 10 mg tablet by mouth once a day, with no dose adjustments.
Crestor vs. Zetia Side Effects
Crestor
Zetia
Crestor vs. Zetia Dosage
Crestor
Zetia
| STAGE | DOSE | WHEN |
| Starting dose | 5-10 mg once daily | At the start |
| Maximum dose | 5-40 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg once daily | At the start |
| Maximum dose | 10 mg once daily | Same as starting |
| Dose changes | None | Fixed dose |
Crestor
| STAGE | DOSE | WHEN |
| Starting dose | 5-10 mg once daily | At the start |
| Maximum dose | 5-40 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
Zetia
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg once daily | At the start |
| Maximum dose | 10 mg once daily | Same as starting |
| Dose changes | None | Fixed dose |
Crestor vs. Zetia Indications
Crestor
Crestor is FDA-approved to lower LDL cholesterol, total cholesterol, and triglycerides while raising HDL, in adults and children as young as 7 with high cholesterol. It is also approved to slow plaque buildup in artery walls and to lower the risk of heart attack, stroke, and artery-opening procedures in at-risk adults.
Primary hyperlipidemia (high LDL) in adults and children 7+
Homozygous familial hypercholesterolemia (very high LDL)
Slowing atherosclerosis progression
Reducing heart attack, stroke, and revascularization risk in at-risk adults
Zetia
Zetia is FDA-approved to lower LDL cholesterol in adults and children 10 and older with high cholesterol, either alone or combined with a statin. It is also approved with fenofibrate for mixed hyperlipidemia and with a statin for homozygous familial hypercholesterolemia, a severe inherited form of high cholesterol.
Primary hyperlipidemia, alone or with a statin
Heterozygous familial hypercholesterolemia in kids 10+, with a statin
Mixed hyperlipidemia, combined with fenofibrate
Homozygous familial hypercholesterolemia, combined with a statin
Crestor vs. Zetia Pros and Cons
Crestor
Crestor is one of the most potent statins available and can lower LDL cholesterol significantly at higher doses. It is backed by outcome trials showing reduced cardiovascular events, and generic rosuvastatin is now widely available and inexpensive. Routine blood monitoring is part of ongoing use.
Pros
Among the most potent LDL-lowering statins available
FDA-approved to reduce heart attack and stroke risk, not just lower cholesterol numbers
Approved for children as young as 7 and for the severe HoFH form of high cholesterol
Generic version widely available at low cost
Cons
Muscle aches (myalgia) are a common reason people stop taking it
Requires periodic liver enzyme and cholesterol monitoring
Interacts with several drugs (cyclosporine, gemfibrozil, certain HIV medications) requiring dose limits
People of Asian descent need a lower starting dose due to higher drug exposure
Zetia
Zetia works differently than statins, blocking cholesterol absorption in the intestine instead of production in the liver. It is often added to a statin for extra LDL lowering without adding statin-related muscle side effects, and it comes in one simple dose. Generic ezetimibe is also widely available and inexpensive.
Pros
Different mechanism than statins, so it adds LDL lowering without extra muscle-related side effects
Simple one-dose regimen with no titration needed
Fewer drug interactions than statins
Generic version widely available at low cost
Cons
Not proven to reduce heart attack or stroke risk when used alone
No FDA approval for primary cardiovascular risk reduction as monotherapy
Lowers LDL less on its own than a statin typically does
Contraindicated in combination with a statin or fenofibrate if those drugs are contraindicated for the patient
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