Lipitor vs Crestor: atorvastatin and rosuvastatin compared
Lipitor (atorvastatin) and Crestor (rosuvastatin) are high-intensity statins at their higher doses. Both lower LDL cholesterol substantially and are available as generics; they differ in strength per milligram, drug interactions and a few patient groups where one is preferred.
Updated October 15, 2026
At a glance
- High-intensity doses
- Lipitor
- 40 mg and 80 mg
- Crestor
- 20 mg and 40 mg
- When to take it
- Lipitor
- Any time of day
- Crestor
- Any time of day
- Drug interactions
- Lipitor
- More, through the liver enzyme CYP3A4
- Crestor
- Fewer through the liver, but dosing depends on kidney function
- Generic available
- Lipitor
- Yes
- Crestor
- Yes
Lipitor atorvastatin | Crestor rosuvastatin | |
|---|---|---|
| High-intensity doses | 40 mg and 80 mg | 20 mg and 40 mg |
| When to take it | Any time of day | Any time of day |
| Drug interactions | More, through the liver enzyme CYP3A4 | Fewer through the liver, but dosing depends on kidney function |
| Generic available | Yes | Yes |
Are the outcomes different?
Rosuvastatin lowers LDL more per milligram, but at matched intensity the two perform similarly. A 2023 randomized trial in Korea, LODESTAR, found no difference in deaths, heart attacks or strokes over three years, with slightly more new diabetes and cataract surgery in the rosuvastatin group. Guidelines treat both as standard high-intensity options.
Who might get one rather than the other
Rosuvastatin is often chosen when someone takes medicines that interact with atorvastatin through the liver, and is started at a lower dose in people of Asian descent, whose blood levels run higher, and in reduced kidney function. Atorvastatin needs no kidney adjustment. Muscle aches can occur with either, and switching from one to the other sometimes helps.
Cost
Both are available as generics, and each pharmacy sets its own cash price, so compare a ninety-day cash quote with your plan’s price for the same supply before you fill.
Side effects and monitoring
Most people take either without trouble. Muscle aches are the commonest complaint and, when tested carefully, are often unrelated to the statin; serious muscle injury is rare. Any statin can nudge blood sugar up, more so at high intensity, which is why the diabetes finding in LODESTAR drew attention. Large amounts of grapefruit raise atorvastatin levels, while rosuvastatin is little affected. Liver tests are checked before starting and when symptoms suggest a problem, rather than routinely, and statins are stopped in pregnancy.
Questions for your prescriber
- How soon should we recheck my cholesterol?
- What LDL level are we aiming for?
- Do any of my medicines interact with atorvastatin?
- What should I do if I get muscle aches?
Already have a prescription?
Upload it and licensed pharmacies respond with their own cash price. You choose, and pay the pharmacy.
Read more
Sources
- BMJ, rosuvastatin versus atorvastatin in coronary artery disease (LODESTAR)
- DailyMed, FDA-approved prescribing information
- MedlinePlus drug information (National Library of Medicine)
Written by the Script Unlock editorial team from the sources above. It is general information, not advice for you or your pet; your prescriber decides which medicine is right.
Script Unlock is a marketplace that lets licensed pharmacies quote a cash price on your prescription. It does not prescribe, dispense or sell medication, does not process patient payments, and does not give medical advice. Always follow the instructions of your prescriber and pharmacist and read the medication guide supplied with your medicine.