Lipitor vs. Crestor

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

Key Takeaways

  • Both Lipitor and Crestor are statins that lower LDL cholesterol and reduce cardiovascular risk, but they differ in dosing range, drug interactions, and specific FDA-approved uses.

  • Crestor produces slightly greater LDL reduction at its starting dose and has fewer drug interactions, while Lipitor offers decades more real-world data and no kidney dose adjustments.

  • Both statins are available as low-cost generics, so brand-name pricing differences matter mainly for patients not yet using the generic version.

Lipitor vs. Crestor Drug Summary

Lipitor

Lipitor (atorvastatin) is a statin, or HMG-CoA reductase inhibitor, used to lower LDL cholesterol and triglycerides and to reduce the risk of heart attack, stroke, and certain heart procedures. It's taken as a single tablet once a day, at doses ranging from 10 mg to 80 mg, with or without food.

Crestor

Crestor (rosuvastatin) is also a statin that lowers LDL cholesterol, total cholesterol, and triglycerides while reducing cardiovascular risk in at-risk adults. It's taken as a single tablet once a day, usually starting at 5 mg or 10 mg and adjusted up to a maximum of 40 mg based on response.

Lipitor vs. Crestor Side Effects

Lipitor

Most common
Nasopharyngitis (up to 8.3%)
Arthralgia (up to 6.9%)
Diarrhea (up to 6.8%)
Pain in extremity (up to 6.0%)

Crestor

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

Lipitor vs. Crestor Dosage

Lipitor

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

Crestor

Dosage
Dosage Table
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

Lipitor vs. Crestor Indications

Lipitor

Lipitor lowers LDL cholesterol and triglycerides in adults and children 10 and older with dyslipidemia, and it reduces the risk of heart attack, stroke, and certain heart procedures in adults with cardiovascular risk factors. It's also approved for adults with type 2 diabetes who have additional risk factors, and for treating heterozygous and homozygous familial hypercholesterolemia.

  • Lowering LDL cholesterol and triglycerides in adults and kids 10+

  • Reducing heart attack, stroke, and surgery risk in high-risk adults

  • Reducing cardiovascular risk in adults with type 2 diabetes

  • Treating heterozygous familial hypercholesterolemia in adolescents

  • Treating homozygous familial hypercholesterolemia

Crestor

Crestor lowers LDL cholesterol, total cholesterol, and triglycerides in adults with high cholesterol, and it slows the progression of atherosclerosis. It's approved to reduce the risk of heart attack, stroke, and artery procedures in at-risk adults, including some with normal cholesterol but elevated hsCRP, and it treats familial hypercholesterolemia in children as young as 8.

  • Lowering LDL, total cholesterol, and triglycerides in adults

  • Reducing heart attack, stroke, and artery procedure risk in at-risk adults

  • Slowing the progression of atherosclerosis in adults

  • Treating heterozygous familial hypercholesterolemia in children 8+

  • Treating homozygous familial hypercholesterolemia

Lipitor vs. Crestor Pros and Cons

Lipitor

Lipitor has more than two decades of real-world outcomes data behind it and remains one of the most prescribed statins for lowering cholesterol and preventing heart disease. It is broken down by a liver enzyme that many other medications also use, which can lead to interactions some patients need to watch for. Its brand-name list price runs higher than Crestor's, though both are available as inexpensive generics.

Pros

  • No dose adjustment needed for kidney problems, since it clears through the liver.

  • More than two decades of real-world use and outcomes data across large trials.

  • Available as a low-cost generic since 2011, so long-term costs stay low for most patients.

  • Comes in an 80 mg dose for patients who need the strongest LDL-lowering option in one pill.

Cons

  • Processed by the CYP3A4 liver enzyme, leading to more drug interactions than Crestor.

  • Costs more than Crestor at list price, roughly $450 to $530 a month without insurance, before savings programs.

  • Lacks an FDA indication for primary prevention based on elevated hsCRP with normal cholesterol.

Crestor

Crestor tends to lower LDL cholesterol more at its starting dose than Lipitor and is minimally processed by liver enzymes, so it interacts with fewer common medications. It also carries a distinct FDA approval for people with normal cholesterol but elevated inflammation markers, based on the JUPITER trial. Its brand-name list price is generally lower than Lipitor's, and a low-cost generic has been available since 2016.

Pros

  • Produces greater LDL-lowering at its starting dose, often cutting LDL by about 45 to 50%.

  • Minimally processed by liver enzymes, so it interacts with fewer common medications.

  • Approved to reduce cardiovascular risk in adults with normal cholesterol but high hsCRP.

  • Lower list price than Lipitor, roughly $280 to $370 a month without insurance, before savings programs.

Cons

  • Needs a lower starting dose in Asian patients due to higher drug levels in the blood.

  • Requires dose adjustments and caps for patients with significant kidney impairment, unlike Lipitor.

  • Has fewer decades of real-world outcomes data behind it compared with Lipitor's long track record.

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