Rosuvastatin Vs. Simvastatin: Drug Comparison

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.

Simvastatin is the active ingredient in the brand-name medication Zocor^®. The information below is about brand name Zocor. 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.”

Zocor (simvastatin) is a statin medication used to lower cholesterol by inhibiting HMG-CoA reductase, an enzyme involved in cholesterol production in the liver, which helps reduce LDL cholesterol and triglycerides while increasing HDL cholesterol. Its FDA-approved indications include the treatment of hyperlipidemia and the prevention of cardiovascular events such as heart attacks and strokes in individuals at risk. Zocor is available in oral tablet form, typically taken once daily in the evening. Common side effects include muscle pain, headache, and digestive issues, while serious risks include liver damage and rare but severe muscle breakdown. Caution is advised when using Zocor with certain medications that can increase the risk of muscle-related side effects.

HMG Co‑A reductase inhibitor (statin)

HMG-CoA reductase inhibitor (statin)

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

Zocor (simvastatin) is indicated:

• To reduce the risk of total mortality by reducing risk of coronary heart disease death, non-fatal myocardial infarction and stroke, and the need for coronary and non-coronary revascularization procedures in adults with established coronary heart disease, cerebrovascular disease, peripheral vascular disease, and/or diabetes, who are at high risk of coronary heart disease events.

• As an adjunct to diet to reduce low-density lipoprotein cholesterol (LDL-C):

  • In adults with primary hyperlipidemia

  • In adults and pediatric patients aged 10 years and older with heterozygous familial hypercholesterolemia (HeFH)

• As an adjunct to other LDL-C-lowering therapies to reduce LDL-C in adults 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 5 mg, 10 mg, 20 mg, and 40 mg tablets

• Typically taken orally once daily

• Comes as 10 mg, 20 mg, and 40 mg tablets

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

• Headache

• Nausea

• Muscle aches

• Weakness

• Constipation

Most common adverse reactions (incidence ≥5%) are:

• Upper respiratory infection

• Headache

• Abdominal pain

• Constipation

• Nausea

• Acute liver failure or decompensated cirrhosis

• Hypersensitivity to rosuvastatin or any excipients in Crestor

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

• Concomitant use of strong CYP3A4 inhibitors (select azole anti-fungals, macrolide antibiotics, anti-viral medications, and nefazodone)

• Concomitant use of cyclosporine, danazol or gemfibrozil

• Acute liver failure or decompensated cirrhosis

• Hypersensitivity to simvastatin or any excipient in Zocor

• Drug interactions: coumarin anticoagulants, digoxin

• See full prescribing information for details regarding concomitant use of Zocor with other drugs or grapefruit juice that increase the risk of myopathy and rhabdomyolysis

• Myopathy and rhabdomyolysis

• Immune-mediated necrotizing myopathy (IMNM)

• Liver dysfunction

• Pregnancy: May cause fetal harm

• Breastfeeding: Breastfeeding not recommended during treatment with Crestor

• Myopathy and rhabdomyolysis

• Immune-mediated necrotizing myopathy (IMNM)

• Liver dysfunction

• Pregnancy: May cause fetal harm

• Breastfeeding: Breastfeeding not recommended during treatment with Zocor

*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.

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