Crestor vs. Zocor
See how Crestor and Zocor compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Crestor (rosuvastatin) and Zocor (simvastatin) are both statins that lower LDL cholesterol, but Crestor produces bigger LDL drops per milligram and has fewer drug interactions because it bypasses the CYP3A4 pathway Zocor depends on.
Both are once-daily oral tablets, and both are now available as low-cost generics decades after their original FDA approvals.
Crestor carries a broader primary-prevention indication for at-risk adults without existing heart disease, while Zocor's heart-protection data mainly applies to people who already have heart disease or diabetes.
Crestor vs. Zocor Drug Summary
Crestor
Crestor (rosuvastatin) is a high-intensity statin approved to lower LDL cholesterol, triglycerides, and non-HDL cholesterol, and to reduce cardiovascular risk in at-risk adults. It is taken as a single oral tablet once a day, at any time, with or without food. It is also approved for familial hypercholesterolemia starting at age 7 for the homozygous form.
Zocor
Zocor (simvastatin) is a statin approved to lower LDL cholesterol in adults with high cholesterol and to reduce the risk of heart attack, stroke, and death in adults who already have heart disease or diabetes. It is taken as a single oral tablet once a day, usually in the evening. It is also approved for familial hypercholesterolemia starting at age 10.
Crestor vs. Zocor Side Effects
Crestor
Zocor
Crestor vs. Zocor Dosage
Crestor
Zocor
| STAGE | DOSE | WHEN |
| Starting dose | 5 mg once daily | At the start |
| Maximum dose | 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 mg once daily | At the start |
| Maximum dose | 40 mg once daily | If needed |
| Dose changes | 3 increases | As tolerated |
Zocor
| 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. Zocor Indications
Crestor
Crestor lowers LDL, total cholesterol, and triglycerides in adults with high cholesterol or mixed lipid disorders. It also carries a primary-prevention indication, reducing the risk of heart attack, stroke, and cardiovascular death in at-risk adults who do not yet have diagnosed heart disease. It is approved for both forms of familial hypercholesterolemia, including in young children.
Lowers LDL, total cholesterol, and triglycerides
Reduces CV risk in at-risk adults without heart disease
Approved for HoFH starting at age 7, HeFH at age 8
Adjunct option for very high triglycerides
Zocor
Zocor lowers LDL and total cholesterol in adults with primary hyperlipidemia. It also reduces the risk of heart attack, stroke, and death in adults who already have heart disease or diabetes with high cardiovascular risk. It is approved for familial hypercholesterolemia, with the homozygous form treated as an adjunct therapy.
Lowers LDL and total cholesterol in high-risk adults
Reduces CV risk in adults with existing heart disease or diabetes
Approved for HeFH starting at age 10
Adjunct therapy for homozygous familial hypercholesterolemia
Crestor vs. Zocor Pros and Cons
Crestor
Crestor delivers large LDL reductions even at low starting doses, and generic rosuvastatin has been widely available since 2016. Because it mostly bypasses the CYP3A4 liver pathway, it interacts with fewer common medications than older statins. It also carries a broader indication for people without existing heart disease.
Pros
Larger LDL drop per milligram than many other statins
Minimal CYP3A4 interaction risk, safer with many common medications
Approved for pediatric HoFH as young as age 7
Cons
Slightly increased risk of new-onset diabetes seen in trials
Requires a lower starting dose in Asian patients and those with kidney impairment
Fewer decades of real-world outcomes data than older statins like Zocor
Rare post-marketing reports of memory or cognitive issues
Zocor
Zocor has one of the longest track records of any statin, with cardiovascular outcome data going back to the early 1990s. It is fully generic and stocked at nearly every pharmacy. Its main drawback is heavier reliance on the same liver enzyme used by many other common drugs.
Pros
Decades of long-term cardiovascular outcomes data
Fully generic with predictable, widespread pharmacy stocking
Well-established safety profile across millions of patients
Cons
Contraindicated with strong CYP3A4 inhibitors like certain antibiotics and antifungals
80 mg dose restricted due to higher muscle-injury risk
Typically $75 to $100 per month before discounts, pricier than generic Crestor
No broad primary-prevention indication for adults without existing heart disease or diabetes
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