Pravastatin Vs. Rosuvastatin: Drug Comparison

Pravastatin is a statin medication used to lower cholesterol by inhibiting HMG-CoA reductase, an enzyme responsible for cholesterol production in the liver, which helps reduce LDL cholesterol and triglycerides while increasing HDL cholesterol. Its FDA-approved indications include treating high cholesterol, preventing cardiovascular events like heart attacks or strokes, and managing lipid disorders in individuals at risk. Off-label uses may include managing lipid levels in individuals with genetic conditions such as familial hypercholesterolemia. Pravastatin is available in oral tablet form, taken once daily. Common side effects include muscle pain, nausea, and headache, while serious risks such as liver damage or muscle breakdown may occur.

Rosuvastatin is the active ingredient in the brand-name medication Crestor^®. The information below is about brand name Crestor. According to the FDA, “Generic medicines use the same active ingredients as brand-name medicines and work the same way, so they have the same risks and benefits as the brand-name medicines.”

Crestor (rosuvastatin) is a statin medication used to lower cholesterol levels by inhibiting the enzyme HMG-CoA reductase, which reduces the production of cholesterol in the liver. Its FDA-approved indications include the treatment of high cholesterol, prevention of cardiovascular disease, and reduction of stroke or heart attack risk in individuals with elevated cholesterol. Off label, Crestor may be used for conditions like familial hypercholesterolemia or for cardiovascular protection in certain high-risk groups. It is available in tablet form, taken orally. Common side effects include muscle pain, headache, and nausea, while serious warnings include the risk of muscle breakdown and liver damage.

HMG-CoA reductase inhibitor (statin)

HMG Co‑A reductase inhibitor (statin)

Pravastatin is indicated:

• To reduce the risk of myocardial infarction, myocardial revascularization procedures, and cardiovascular mortality in adults with elevated low-density lipoprotein cholesterol (LDL-C) without clinically evident coronary heart disease (CHD)

• To reduce the risk of coronary death, myocardial infarction, myocardial revascularization procedures, stroke or transient ischemic attack, and slow the progression of coronary atherosclerosis in adults with clinically evident CHD

• As an adjunct to diet to reduce LDL-C in adults with primary hyperlipidemia

• As an adjunct to diet to reduce LDL-C in pediatric patients ages 8 years and older with heterozygous familial hypercholesterolemia (HeFH)

• As an adjunct to diet for the treatment of adults with:

  • Primary dysbetalipoproteinemia

  • Hypertriglyceridemia

Crestor (rosuvastatin) is indicated:

• To reduce the risk of major adverse cardiovascular (CV) events (CV death, nonfatal myocardial infarction, nonfatal stroke, or an arterial revascularization procedure) in adults without established coronary heart disease who are at increased risk of CV disease based on age, high-sensitivity C-reactive protein (hsCRP) ≥2 mg/L, and at least one additional CV risk factor

• As an adjunct to diet to:

  • Reduce LDL-C in adults with primary hyperlipidemia

  • Reduce LDL-C and slow the progression of atherosclerosis in adults

  • Reduce LDL-C in adults and pediatric patients aged 8 years and older with heterozygous familial hypercholesterolemia (HeFH).

• As an adjunct to other LDL-C-lowering therapies, or alone if such treatments are unavailable, to reduce LDL-C in adults and pediatric patients aged 7 years and older with homozygous familial hypercholesterolemia (HoFH)

• As an adjunct to diet for the treatment of adults with:

  • Primary dysbetalipoproteinemia

  • Hypertriglyceridemia

• Typically taken orally once daily

• Comes in 10 mg, 20 mg, 40 mg, and 80 mg tablets

• Typically taken orally once daily

• Comes in 5 mg, 10 mg, 20 mg, and 40 mg tablets

In short-term clinical trials, the most commonly reported adverse reactions (≥2% and greater than placebo) were:

• Musculoskeletal pain

• Nausea/Vomiting

• Upper respiratory infection

• Diarrhea

• Headache

Most frequent adverse reactions (rate ≥2%) are:

• Headache

• Nausea

• Muscle aches

• Weakness

• Constipation

• Hypersensitivity to pravastatin or any excipient in pravastatin

• Acute liver failure or decompensated cirrhosis

• Drug interactions: bile acid sequestrants, see the full prescribing information for details regarding concomitant use of pravastatin with other drugs that increase the risk of myopathy and rhabdomyolysis

• Acute liver failure or decompensated cirrhosis

• Hypersensitivity to rosuvastatin or any excipients in Crestor

• Drug interactions: aluminum and magnesium hydroxide combination antacids, warfarin

• Myopathy and rhabdomyolysis

• Immune-mediated necrotizing myopathy (IMNM)

• Liver dysfunction

• Myopathy and rhabdomyolysis

• Immune-mediated necrotizing myopathy (IMNM)

• Liver dysfunction

• Pregnancy: May cause fetal harm

• Breastfeeding: Breastfeeding not recommended during treatment with Crestor

*This information is from the pravastatin sodium label used by Accord Healthcare Inc. See the Full Prescribing Information for more complete information. This information may not be accurate for all medications that include the active ingredient pravastatin.

*This information is from the label for brand name Crestor^®. See the Full Prescribing Information for more complete information. Rosuvastatin, the active ingredient in Crestor, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient rosuvastatin.