Rosuvastatin (Crestor)
Rosuvastatin (Crestor) is a once-daily statin available as a generic. In a pooled analysis of short-term studies, rosuvastatin lowered LDL cholesterol by an average of 41% at 5 mg daily to 55% at 40 mg daily. [2]
How much does rosuvastatin lower LDL?
In a pooled analysis of studies lasting 3–12 weeks, rosuvastatin reduced LDL cholesterol by an average of 41% at 5 mg daily and 55% at 40 mg daily. Individual responses to rosuvastatin vary. [2]
| Dose | LDL reduction |
|---|---|
| 5 mg | |
| 10 mg | |
| 20 mg | |
| 40 mg |
Rosuvastatin also lowers ApoB, a measure of the number of atherogenic particles. The LDL percentages above should not be used as ApoB percentages. Compare ApoB-lowering treatments →
Explore the full atorvastatin guide, ezetimibe guide, and all cholesterol medications.
How does rosuvastatin compare with atorvastatin?
Rosuvastatin can achieve similar LDL lowering at a lower milligram dose than atorvastatin. In the six-week PULSAR trial, rosuvastatin 10 mg lowered LDL by 44.6%, compared with 42.7% for atorvastatin 20 mg. Both are available as generics; the choice also depends on other medicines, kidney function, and cost. [9]
| Comparison | Rosuvastatin | Atorvastatin |
|---|---|---|
| LDL reduction at commonly used doses | 44.6% at 10 mg daily in PULSAR. [9] | 42.7% at 20 mg daily in the same trial. [9] |
| LDL reduction at higher doses | 52% at 20 mg daily in STELLAR. [5] | 51% at 80 mg daily in the same trial. [5] |
| Drug interactions | Does not substantially rely on the CYP3A4 enzyme, but still has important interactions, including with cyclosporine and some antivirals. [5] | CYP3A4 inhibitors, including certain antibiotics and antifungals, can increase atorvastatin levels and require dose limits. [10] |
| Severe kidney impairment | Start at 5 mg and do not exceed 10 mg daily in patients not on hemodialysis. [5] | No kidney-based dose adjustment; kidney impairment still increases muscle-injury risk. [10] |
| Example cash price | $10.92 for 30 × 10 mg tablets, including standard shipping from Cost Plus Drugs. [11] | $10.66 for 30 × 20 mg tablets, including standard shipping from Cost Plus Drugs. [11] |
PULSAR and STELLAR are head-to-head trials, so their averages differ from the pooled estimates above. Prices were checked October 6, 2026, before any tax. These dose comparisons are not instructions for switching medicines.
Which medications can be combined with rosuvastatin?
Rosuvastatin can be combined with ezetimibe, a PCSK9 treatment, or bempedoic acid when additional LDL lowering is needed. A clinician chooses the combination based on your cholesterol goal, medication tolerance, and access.
Rosuvastatin + ezetimibe (Zetia)
Rosuvastatin 40 mg plus ezetimibe 10 mg daily lowered LDL by 69.8% in total in EXPLORER, compared with 57.1% for rosuvastatin 40 mg alone. These were six-week results in high-risk patients. [3]
Rosuvastatin + evolocumab (Repatha)
Adding evolocumab lowered LDL by an additional 63–75% versus placebo across the statin groups in LAPLACE-2, which included rosuvastatin 5 mg and 40 mg. Results were averaged over weeks 10 and 12 using injections of 140 mg every two weeks or 420 mg monthly; the range covers several statins and doses. [7]
Rosuvastatin + bempedoic acid (Nexletol)
Bempedoic acid 180 mg daily lowered LDL by a further 16.5% from the statin-treated baseline at 12 weeks in CLEAR Harmony, an 18.1-percentage-point difference versus placebo. Participants were taking maximally tolerated statins; this was not a rosuvastatin-only trial. [8]
How much does rosuvastatin cost?
For 30 tablets of rosuvastatin 10 mg, Cost Plus Drugs quotes $10.92 including standard shipping, and GoodRx lists a $14.07 coupon price. Prices were checked October 6, 2026, before any tax, and vary by pharmacy and location. [4] [11]
| Source | Price and conditions |
|---|---|
| GoodRx | GoodRx lists $14.07 for 30 tablets of rosuvastatin 10 mg in its dosage-price table. Coupon prices vary by pharmacy and location and are used instead of insurance. Check local GoodRx prices ↗ |
| Cost Plus Drugs | Cost Plus Drugs quotes $10.92 for 30 tablets of rosuvastatin 10 mg, including standard shipping: $5.67 for the prescription plus $5.25 shipping. Final price is confirmed at checkout. Check Cost Plus prices ↗ |
| Amazon RxPass | RxPass includes generic rosuvastatin for $5 per month for eligible Prime members; Prime membership costs extra. The subscription does not use insurance and excludes Medicaid/CHIP members and shipping to California or Washington. Check RxPass eligibility ↗ |
If you need brand-name Crestor
The manufacturer advertises a savings card for eligible patients, with payments as low as $3 and savings limits. Government-insured patients are excluded; eligibility and coverage restrictions apply. Read the current offer and full terms →
Does insurance cover rosuvastatin?
The plans below cover generic rosuvastatin or list it as a first-step treatment. Brand-name Crestor may require an exception or a trial of a generic first. Coverage and copays vary by plan.
| Insurer | Coverage policy |
|---|---|
| UnitedHealthcare | UHC’s commercial formulary covers generic rosuvastatin at Tier 2, with no listed prior authorization, step therapy, or quantity limit. Commercial PDL, September 2026 ↗ |
| Aetna | Aetna’s Advanced Control Plan covers rosuvastatin as a preferred generic, with no listed prior authorization or step therapy. Some 40 mg product codes are excluded. Brand-name Crestor requires a formulary exception. Advanced Control policy, October 2026 ↗ |
| Cigna | Cigna’s statin policy lists generic rosuvastatin as Step 1. Brand-name Crestor is Step 2, approved for one year after trying one Step 1 drug; a preventive-care exception is also available under the policy’s criteria. Statin policy, June 2026 ↗ |
| Anthem Blue Cross | Anthem’s California Individual Select plan covers generic rosuvastatin at Tier 2, with no listed prior authorization or step therapy. Doses of 5–20 mg have dose-optimization rules; 40 mg is limited to one tablet daily. Eligible preventive use of 5 or 10 mg has $0 cost sharing. California Individual Select policy, October 2026 ↗ |
| Blue Shield of California | Blue Shield of California’s Standard formulary covers generic rosuvastatin at Tier 1, limited to one tablet daily, with no listed prior authorization or step therapy. Standard formulary, October 2026 ↗ |
| BCBS Texas | BCBS Texas’s Performance Annual formulary covers rosuvastatin as a preferred generic, with no listed prior authorization, step therapy, or quantity limit. Performance Annual policy, October 2026 ↗ |
What are the side effects of rosuvastatin?
Rosuvastatin can cause muscle pain, headache, nausea, and constipation. Rosuvastatin can also increase blood sugar and the risk of developing diabetes. Comparing treatment with placebo helps put reported events in context. [5]
| Reported event | Rosuvastatin 20 mg | Placebo |
|---|---|---|
| Muscle pain | 7.6% | 6.6% |
| New diabetes | 2.8% | 2.3% |
| Constipation | 3.3% | 3.0% |
Rare serious muscle injury and liver injury can occur. Seek prompt medical advice for unexplained muscle pain or weakness, especially with fever or dark urine, or yellowing of the skin or eyes. Trouble breathing or swelling of the face or throat needs emergency care. [1]
Conditions and medicines to discuss before starting
Severe kidney impairment limits dosing. Acute liver failure and decompensated cirrhosis are contraindications. Some medicines, including cyclosporine and certain antivirals, require dose limits; gemfibrozil should generally be avoided. [5]
Tell your clinician about all medicines and supplements, pregnancy plans, pregnancy, and breastfeeding. Breastfeeding is not recommended during treatment. Take aluminum/magnesium antacids at least two hours after rosuvastatin. [1]
Does rosuvastatin reduce heart attacks and strokes?
Rosuvastatin reduces the risk of cardiovascular events. In HOPE-3, cardiovascular death, nonfatal heart attack, or nonfatal stroke occurred in 3.7% of participants taking rosuvastatin 10 mg daily versus 4.8% taking placebo over a median 5.6 years. The trial studied 12,705 people at intermediate risk without established cardiovascular disease. [6]
Calculated from the trial’s rounded rates: 48 per 1,000 with placebo versus 37 with rosuvastatin. Your absolute benefit depends on your starting risk and treatment duration.
A 50% LDL reduction does not mean a 50% reduction in cardiovascular risk. Your clinician can help weigh the likely benefit against side effects and your preferences.
When should you recheck cholesterol after starting rosuvastatin?
LDL cholesterol can be rechecked as early as four weeks after starting rosuvastatin, according to its prescribing information. Clinicians consider liver tests before treatment and later when indicated. Your follow-up LDL result helps guide the next step. [5]
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Explore the health panelCompare all LDL-lowering medications →Rosuvastatin sources & evidence
- MedlinePlus: Rosuvastatin. Patient information on use, precautions, and symptoms needing care.
- Adams et al. Rosuvastatin for lowering lipids. Cochrane, 2014. Overall efficacy table; pooled 3–12-week studies. Unrounded dose effects: 41.3%, 45.6%, 49.9%, and 54.9%.
- Ballantyne et al. EXPLORER. American Journal of Cardiology, 2007. Rosuvastatin 40 mg with or without ezetimibe 10 mg.
- Pricing sources: GoodRx rosuvastatin dosage-price table, Cost Plus Drugs rosuvastatin, and Amazon Pharmacy RxPass. Confirm current prices and eligibility before filling.
- Crestor prescribing information, DailyMed. Dosing, warnings, monitoring, and JUPITER adverse-event rates.
- Yusuf et al. HOPE-3. New England Journal of Medicine, 2016. Rosuvastatin 10 mg versus placebo for cardiovascular prevention.
- Robinson et al. LAPLACE-2. JAMA, 2014. Evolocumab added to moderate- or high-intensity statins, including rosuvastatin.
- Ray et al. CLEAR Harmony. New England Journal of Medicine, 2019. Bempedoic acid added to maximally tolerated statins.
- Clearfield et al. PULSAR. Trials, 2006. Rosuvastatin 10 mg versus atorvastatin 20 mg in 996 high-risk patients.
- Lipitor prescribing information, DailyMed. Atorvastatin interactions and kidney dosing.
- Cost Plus Drugs pricing, October 6, 2026: rosuvastatin 10 mg and atorvastatin 20 mg. Thirty-tablet cash prices include dispensing and standard shipping.