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

Most common
Headache (up to 5.5%)
Nausea (up to 3.4%)
Myalgia (up to 2.8%)
Asthenia (up to 2.7%)

Zetia

Most common
Upper respiratory tract infection (up to 4.3%)
Diarrhea (up to 4.1%)
Arthralgia (up to 3.0%)
Sinusitis (up to 2.8%)

Crestor vs. Zetia Dosage

Crestor

Dosage
Dosage Table
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

Dosage
Dosage Table
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

Common Symptoms and Related Diseases You Can Explore

Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.