Crestor® (Rosuvastatin) – High‑Potency Statin for Lipid and Cardiovascular Protection
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Crestor (rosuvastatin) is a potent statin prescribed to lower LDL cholesterol, total cholesterol, triglycerides, and ApoB, while mildly increasing HDL. It’s indicated for hyperlipidemia, mixed dyslipidemia, primary and secondary cardiovascular prevention, familial hypercholesterolemia, and reducing stroke risk in high-risk patients. The JUPITER trial also found significant reduction in cardiovascular events among individuals with elevated CRP levels.

Product Overview
Brand Name: Crestor®

Generic Name: Rosuvastatin Calcium

Drug Class: HMG‑CoA Reductase Inhibitor (Statin)

Formulation: 5 mg, 10 mg, 20 mg, and 40 mg oral tablets

Prescription Status: Rx only

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Rosuvastatin Calcium – generic equivalent

Other brands: Ezallor, Roszocor; similar alternatives include atorvastatin (Lipitor®), simvastatin

Rosuvastatin selectively and competitively inhibits HMG‑CoA reductase in the liver, reducing mevalonate production and upregulating LDL receptors to increase LDL clearance. It also reduces C‑reactive protein, improves endothelial function, and has anti-inflammatory and plaque-stabilizing “pleiotropic” effects.
Verywell Health

Primary hypercholesterolemia (hetero/homozygous familial, mixed dyslipidemia, primary dysbetalipidemia)

Primary prevention of cardiovascular disease in individuals with elevated CRP levels, as seen in the JUPITER trial

Secondary prevention of cardiovascular events

Treatment of hypertriglyceridemia and reduction of non-HDL-C

Pediatric use in familial hypercholesterolemia (ages 8–17)

Adults: Start at 10 mg once daily; adjust to 5 mg in Asian patients or those with renal impairment. Max dose 40 mg only if LDL goals unmet on 20 mg.

Pediatrics (8–17 yrs): 5 mg up to 20 mg daily for heterozygous FH; 20 mg for homozygous cases
FDA Access Data

Timing: Can be taken any time with or without food; swallow whole

Monitoring: Lipid levels in 2–4 weeks; renal and hepatic function periodically
Verywell Health

Safety & Prescribing Guidelines
Contraindications: Active liver disease, pregnancy, breastfeeding, hypersensitivity

Precautions: Use lower doses in renal/hepatic impairment or Asian patients; monitor creatine kinase, TSH in hypothyroid patients
FDA Access Data
FDA Access Data

Discontinue temporarily: in serious illness (e.g., sepsis, surgery), or if CK >10× ULN, or CK >5× ULN with muscle symptoms

Side Effects
Common (>2%):

Headache, myalgia, abdominal pain, diarrhea, constipation, nausea, pharyngitis, urinary infection
FDA Access Data

Rare/Serious:

Myopathy/Rhabdomyolysis: İncidence ~0.1%, increased at 40 mg or with interacting drugs

Liver enzyme elevations: Transient; monitor ALT/AST

New-onset diabetes: Slight increase in risk, similar to other statins
PMC

Cognitive effects: Rare reversible memory loss, confusion

Monitor CK, liver enzymes regularly

Familiarize patients with signs of myopathy

Pregnancy/Lactation: Contraindicated—discontinue if pregnancy detected

Asian Ethnicity: Start at lower dose due to higher systemic exposure
FDA Access Data
Gemfibrozil & protease inhibitors: Increase rosuvastatin exposure – avoid or limit dose to ≤10 mg

Cyclosporine, regorafenib, darolutamide: Avoid or limit rosuvastatin to ≤5 mg/day

Warfarin: May increase INR – monitor when starting/stopping rosuvastatin
FDA Access Data

Colchicine: Increased myopathy risk
FDA Access Data

Fenofibrate, niacin: Increased muscle toxicity risk

Antacids containing aluminum or magnesium: Avoid within 2 hours of dosing

Grapefruit juice: Minimal interaction with rosuvastatin

Drug Classification
ATC Code: C10AA07

Therapeutic Class: HMG‑CoA reductase inhibitor

Prescription: Rx only

JUPITER Trial: 20 mg rosuvastatin reduced major CV events and all-cause mortality in patients with elevated CRP

SPARCEROCKET, IDEAL Trials: Demonstrated LDL reduction comparable to high-dose atorvastatin
PMC

Prove-It & ANDROMEDA Studies: Rosuvastatin 20 mg was as effective or more than high-dose atorvastatin in high-risk patients, including diabetics
PMC

Frequently Asked Questions (Q&A)
Q1. Why choose Crestor over other statins?
It offers superior LDL-lowering and anti-inflammatory action at moderate doses; ideal for high-risk patients and additional plaque stabilization benefits.

Q2. When does it start working?
Lipid levels decrease within 1–2 weeks; maximal effect seen by week 4–6.

Q3. How can I reduce muscle pain risk?
Lower dose in high-risk groups (elderly, Asians, renal impairment), avoid interacting drugs, and monitor CK if symptoms appear.

Q4. Is it safe for children?
Approved for familial hypercholesterolemia in ages 8–17; dose based on response.
FDA Access Data

Q5. Can I take it with grapefruit juice?
Yes; unlike many other statins, rosuvastatin is not significantly affected.

Store at 20–25 °C, away from moisture and light

Keep tablets in sealed container, out of children’s reach

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