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Rosuvastatin is the most potent of the common statins and mainly lowers LDL cholesterol. It helps prevent heart attack and stroke – when taken reliably and correctly. Here you will learn everything about dosage, potency comparison and muscle pain.
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Do not stop rosuvastatin on your own. Cholesterol rises again after stopping – always discuss any changes with your practice. Rosuvastatin (brand name Crestor®) is a strong statin – a cholesterol-lowering drug from the group of CSE inhibitors. It mainly lowers the "bad" LDL cholesterol and is taken once daily as a tablet. Rosuvastatin is among the most effective statins available and is used for lipid metabolism disorders and to prevent cardiovascular disease.
| Property | Details |
|---|---|
| Active ingredient | Rosuvastatin |
| Brand name | Crestor® |
| ATC code | C10AA07 |
| Drug class | Statin (HMG-CoA reductase inhibitor) |
| Form | Tablets 5, 10, 20, 40 mg |
| Intake | Once daily, independent of meals and time of day |
| Standard dose | 10–20 mg/day (usually starting at 5–10 mg) |
| Monitoring | Blood lipids and liver values, more frequently at first |
| Prescription required | Yes |
A large part of the body's cholesterol is not absorbed from food but produced in the liver itself. The key to this is the enzyme HMG-CoA reductase. Rosuvastatin inhibits exactly this enzyme and thereby throttles the body's own cholesterol production. In response, the liver takes up more LDL cholesterol from the blood – the LDL level in the blood falls.
A lower LDL means less cholesterol is deposited in the vessel walls. In this way rosuvastatin slows the hardening of the arteries (atherosclerosis) and lowers the risk of heart attack and stroke. That is why it is prescribed for a lipid metabolism disorder and after cardiovascular events. How you can additionally support this through your lifestyle is explained in the guide Lowering cholesterol.
Rosuvastatin is taken once daily as a whole tablet with a little water – independent of meals. Unlike short-acting statins such as simvastatin, taking it in the evening is not mandatory: rosuvastatin acts for a long time, so you can take it at the time of day you keep to most reliably.
| Situation | Dose |
|---|---|
| Start of therapy | 5–10 mg once/day |
| Usual maintenance dose | 10–20 mg once/day |
| High risk / insufficient reduction | up to 40 mg once/day (only under medical supervision) |
| Impaired kidney function, Asian descent | lower dose, start at 5 mg |
A missed dose is skipped if the next intake is due soon – never take a double amount. What generally applies to a missed dose is explained in the guide Forgotten medication.
brite reliably reminds you of your daily rosuvastatin intake and documents it seamlessly.
A common question is: Is rosuvastatin stronger than atorvastatin? In short: yes, milligram for milligram rosuvastatin is the most potent of the three common statins. To lower the same LDL, you need less rosuvastatin than atorvastatin and considerably less than simvastatin. The following equivalence table shows which doses lower LDL to roughly the same extent.
| LDL reduction (approx.) | Rosuvastatin | Atorvastatin | Simvastatin |
|---|---|---|---|
| ~ 38 % | – | 10 mg | 20 mg |
| ~ 43 % | 5 mg | 20 mg | 40 mg |
| ~ 48 % | 10 mg | 40 mg | 80 mg* |
| ~ 53 % | 20 mg | 80 mg | – |
| ~ 58 % | 40 mg | – | – |
*Simvastatin 80 mg is barely prescribed any more because of the increased muscle risk. But "stronger" does not automatically mean "better for you": which statin and which dose is right depends on your LDL target value, your cardiovascular risk and tolerability. If a statin alone is not enough, it is often combined with ezetimibe.
Rosuvastatin is usually well tolerated. The most feared side effect is muscle pain. Important for perspective: mild muscle complaints are relatively common and as a rule harmless, whereas the dangerous breakdown of muscle tissue (rhabdomyolysis) is very rare.
| Side effect | Frequency | What to do? |
|---|---|---|
| Muscle pain, muscle weakness (mild) | Common | Raise it; a change of dose or preparation often helps |
| Headache, digestive complaints | Common | Usually temporary |
| Raised liver values | Occasional | Blood check; usually without symptoms |
| Rise in blood sugar / new diabetes | Occasional | Have blood sugar monitored |
| Rhabdomyolysis (muscle breakdown) | Very rare | Emergency – seek prompt medical assessment |
Some substances raise the rosuvastatin level in the blood and thereby the muscle risk. Check combinations in the interaction check.
| Substance / medication | Interaction | Recommendation |
|---|---|---|
| Gemfibrozil (fibrate) | Strongly raised rosuvastatin level, muscle risk | Avoid; if necessary fenofibrate |
| Ciclosporin | Markedly raised level | Strictly limit dose, monitor closely |
| Certain HIV / hepatitis C drugs | Raised level | Dose adjustment needed |
| Vitamin K antagonists (e.g. phenprocoumon) | INR may rise | Check INR more frequently |
| Antacids (aluminium/magnesium) | Reduced absorption | Take 2 hours apart |
How low LDL cholesterol should be lowered depends on the individual cardiovascular risk – not on a fixed normal value for everyone. The higher the risk, the lower the target value. The following orientation values come from the ESC/EAS guideline on the treatment of lipid metabolism disorders.
| Risk group | LDL target value (orientation) |
|---|---|
| Very high risk (e.g. after heart attack) | below 55 mg/dl (1.4 mmol/l) |
| High risk | below 70 mg/dl (1.8 mmol/l) |
| Moderate risk | below 100 mg/dl (2.6 mmol/l) |
Your personal target value is set by your practice. Rosuvastatin helps you reach it – often in combination with exercise, diet and, where appropriate, a second active ingredient.
With brite you document your LDL values and their progression – ready to hand for every doctor's appointment.
