| Statin | LDL Reduction | Starting Dose | Safety Notes | Avg. Monthly Cost |
|---|---|---|---|---|
| Rosuvastatin | 45-55% | 5-10 mg | Low muscle risk, modest liver impact, may raise blood sugar | $55-$70 |
| Atorvastatin | 35-45% | 10-20 mg | Higher muscle-pain risk at >40 mg, liver monitoring needed | $25-$40 |
| Simvastatin | 25-35% | 20-40 mg | Significant drug-interaction potential (CYP3A4), higher myopathy risk above 40 mg | $15-$30 |
| Pravastatin | 20-30% | 10-40 mg | Very low drug-interaction risk, gentle on liver enzymes | $20-$35 |
| Lovastatin | 20-30% | 20-80 mg | May cause gastrointestinal upset, moderate interaction risk | $12-$25 |
When it comes to lowering bad cholesterol, patients and doctors often ask, "Rosuvastatin compare to other options?" The short answer is: it’s the strongest statin on the market, but that strength comes with a higher price tag and a specific side‑effect profile. This guide breaks down the most common alternatives-atorvastatin, simvastatin, pravastatin, and lovastatin-so you can decide which fits your health goals, wallet, and lifestyle in 2025.
Statins belong to the same drug class, but they differ in four key areas that matter for everyday use:
We’ll score each statin across these criteria in the table below, then dive deeper into the specifics.
| Statin | Typical LDL Reduction* | Starting Dose (mg) | Key Safety Notes | 2025 Avg. Cost (AU$ per month) |
|---|---|---|---|---|
| Rosuvastatin high‑potency statin | 45‑55% | 5‑10 | Low muscle risk, modest liver impact, may raise blood sugar | $55‑$70 |
| Atorvastatin widely used medium‑high potency statin | 35‑45% | 10‑20 | Higher muscle‑pain risk at >40mg, liver monitoring needed | $25‑$40 (generic) |
| Simvastatin moderate‑potency statin | 25‑35% | 20‑40 | Significant drug‑interaction potential (CYP3A4), higher myopathy risk above 40mg | $15‑$30 (generic) |
| Pravastatin mild‑potency, liver‑friendly statin | 20‑30% | 10‑40 | Very low drug‑interaction risk, gentle on liver enzymes | $20‑$35 (generic) |
| Lovastatin first‑generation statin | 20‑30% | 20‑80 | May cause gastrointestinal upset, moderate interaction risk | $12‑$25 (generic) |
Rosuvastatin, sold under brand names like Crestor, was approved in 2003 and quickly became the go‑to choice for patients needing a big LDL drop. Its chemical structure gives it a long half‑life (about 19hours), allowing once‑daily dosing.
Efficacy: Clinical trials (e.g., the JUPITER study) showed a ~50% LDL reduction when starting at 10mg, translating to a 20‑30% drop in major cardiovascular events.
Typical Dosage: Most physicians begin with 5mg for moderate risk and jump to 10mg if LDL goals aren’t met. The maximum approved dose is 40mg, but few patients need that much.
Safety Profile:
Drug Interactions: Because rosuvastatin is metabolized mainly by CYP2C9 (not CYP3A4), it avoids many interaction pitfalls. Still, watch out for cyclosporine, certain HIV protease inhibitors, and strong CYP2C9 inhibitors.
Cost: In Australia, the PBS covers rosuvastatin for high‑risk patients, but many still pay a co‑payment of $30‑$45 per month. Generic versions have started appearing in 2024, bringing the price down to around $55.
Atorvastatin a medium‑high potency statin is the most prescribed lipid‑lowering drug globally. It hit the market in 1996 and remains a solid choice for both primary and secondary prevention.
Efficacy: A 20mg dose lowers LDL by ~35%. Dose‑response is fairly linear up to 80mg, which can achieve a 45‑% reduction.
Safety: Myopathy risk rises noticeably above 40mg, and atorvastatin can mildly raise liver enzymes. It also has a small impact on blood sugar.
Interactions: It’s metabolized by CYP3A4, so strong inhibitors (e.g., clarithromycin, itraconazole) can boost levels and muscle side effects. Grapefruit juice should be limited.
Cost: Widely generic, it’s the cheapest high‑potency option-often under $30 per month.
Simvastatin an older moderate‑potency statin entered the market in 1991. It’s still used, especially when budget constraints dominate.
Efficacy: At 20mg, LDL drops 25‑30%. Above 40mg, the marginal benefit tapers, but side‑effect risk climbs.
Key Concerns:
Cost: One of the cheapest statins-often $10‑$20 per month for the 20mg tablet.
Pravastatin a mild‑potency, liver‑friendly statin is a good fallback for patients with a history of liver sensitivity or multiple medications.
Efficacy: Typical LDL reductions of 20‑30% at 10‑20mg. Not enough for high‑risk patients needing aggressive targets.
Safety: Very low incidence of muscle pain and minimal effect on liver enzymes. Drug‑interaction profile is among the cleanest of the statin class.
Cost: Generic price hovers around $20‑$30 per month; widely covered by PBS.
Lovastatin the first statin approved for clinical use dates back to 1987. It’s less potent but still useful for mild hypercholesterolemia.
Efficacy: LDL reduction of about 20‑25% at 20‑40mg. Requires twice‑daily dosing with meals.
Safety: Slightly higher GI upset compared with newer statins, moderate interaction risk via CYP3A4.
Cost: Cheapest option on the market, often under $12 per month.
There’s no one‑size‑fits‑all answer. Below is a quick decision guide based on the four criteria we discussed.
Always discuss with your GP or cardiologist. They’ll run a baseline lipid panel, check liver enzymes, and consider your overall cardiovascular risk (e.g., age, smoking, blood pressure).
Yes. Most doctors will start you on a lower dose or try a gentler statin like pravastatin. Switching is usually done after a 2‑week washout period to avoid overlapping drug levels.
All statins carry a modest increase (about 10‑12%) in new‑onset type2 diabetes, especially at high doses. The cardiovascular benefits still outweigh this risk for most patients.
Rosuvastatin is not significantly metabolized by CYP3A4, so grapefruit has little effect. However, always check with your pharmacist if you’re on other meds that do interact with grapefruit.
Most patients see a 15‑20% reduction within 2weeks, with the full effect (up to 50%) reached by 4‑6weeks.
Baseline liver enzymes and CK, then repeat at 3‑6months. If you develop muscle pain, a CK test is recommended immediately.
If you’re ready to start or switch a statin, follow this quick plan:
With the right statin and regular monitoring, you’ll be on a clear path to lower LDL and a healthier heart.
Written by Diana Fieldstone
View all posts by: Diana Fieldstone