Differences between Crestor and Lipitor

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Crestor vs. Lipitor

Crestor (rosuvastatin) and Lipitor (atorvastatin) are prescription medications belonging to the statin class of drugs, also known as HMG-CoA reductase inhibitors.[1][2] Both medications work by blocking an enzyme in the liver that is necessary for producing cholesterol.[2] They are prescribed to lower high cholesterol and triglyceride levels in the blood and to reduce the risk of cardiovascular events such as heart attacks and strokes.[3][2] Both drugs are available in generic form.[4] While they function in a similar manner, there are differences in their potency, how they are metabolized by the body, and their specific approved uses.[5]

Comparison Table

Category Crestor (rosuvastatin) Lipitor (atorvastatin)
Primary Mechanism HMG-CoA reductase inhibitor; blocks cholesterol production in the liver. HMG-CoA reductase inhibitor; blocks cholesterol production in the liver.
Potency Considered more potent; lower doses may achieve the same effect as higher doses of atorvastatin.[5] Potent, but generally considered slightly less potent on a milligram-to-milligram basis than rosuvastatin.
LDL ("Bad") Cholesterol Reduction Studies have shown it can lower LDL cholesterol by a greater percentage compared to equivalent doses of atorvastatin. In one trial, rosuvastatin 10 mg lowered LDL cholesterol by 8.2% more than atorvastatin.[1] Effective in lowering LDL cholesterol, though some studies show a slightly lesser reduction compared to rosuvastatin at similar dosages.
HDL ("Good") Cholesterol Increase Tends to increase HDL cholesterol more effectively than atorvastatin. Increases HDL cholesterol, but some studies show a lesser effect compared to rosuvastatin.
Metabolism Primarily metabolized by the CYP2C9 enzyme, with minimal involvement of the CYP3A4 enzyme. Extensively metabolized by the CYP3A4 enzyme in the liver.
Drug Interactions Has fewer potential drug interactions due to its metabolic pathway.[5] Does not have a significant interaction with grapefruit juice. Has more potential drug interactions because many other medications are also metabolized by the CYP3A4 enzyme. Grapefruit juice can increase drug levels in the body.
Approved Pediatric Use (for familial hypercholesterolemia) Approved for children aged 7 years and older for Homozygous Familial Hypercholesterolemia (HoFH) and 8 years and older for Heterozygous Familial Hypercholesterolemia (HeFH).[3] Approved for children aged 10 years and older for both HeFH and HoFH.[3]
Additional Approved Uses Approved to slow the progression of atherosclerosis (plaque buildup in arteries).[4][2] Not specifically approved to slow atherosclerosis, but can be prescribed off-label for this purpose.[4][2]
Venn diagram for Differences between Crestor and Lipitor
Venn diagram comparing Differences between Crestor and Lipitor


Efficacy

Clinical studies have compared the effectiveness of Crestor and Lipitor. The STELLAR trial, for example, found that rosuvastatin lowered LDL cholesterol by 8.2% more than atorvastatin and was more effective at increasing HDL cholesterol.[1] Another study reported that rosuvastatin 10 mg reduced LDL levels by 44.6% compared to 42.7% for atorvastatin 20 mg. A higher percentage of patients taking Crestor tend to achieve their LDL cholesterol goals compared to those on Lipitor.[1] Despite differences in cholesterol level reduction, some data suggest no significant difference between the two drugs in slowing the progression of coronary atherosclerosis.

Side Effects and Safety

Both medications are generally well-tolerated and share similar side effect profiles. Common side effects for both drugs can include muscle pain, headache, and abdominal pain.[1] Less common, but serious, side effects for all statins include the risk of muscle problems (myopathy and rhabdomyolysis) and potential liver damage.

Due to its reliance on the CYP3A4 metabolic pathway, Lipitor has a greater potential for drug-drug interactions compared to Crestor. A wide range of medications, including certain antibiotics, antifungals, and cardiovascular drugs, can interfere with Lipitor's metabolism, potentially increasing the risk of side effects. Crestor's metabolic pathway results in fewer such interactions.[5]

References

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  2. ↑ 2.0 2.1 2.2 2.3 2.4 Cite error: Invalid <ref> tag; no text was provided for refs named ref2
  3. ↑ 3.0 3.1 3.2 Cite error: Invalid <ref> tag; no text was provided for refs named ref3
  4. ↑ 4.0 4.1 4.2 Cite error: Invalid <ref> tag; no text was provided for refs named ref4
  5. ↑ 5.0 5.1 5.2 5.3 Cite error: Invalid <ref> tag; no text was provided for refs named ref5
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