From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Rosuvastatin is generally considered the best tolerated statin medication, with a lower incidence of muscle-related side effects compared to other statins while still being highly effective at lowering LDL cholesterol. This is based on the most recent and highest quality study available, which compared the efficacy and safety of rosuvastatin/ezetimibe with rosuvastatin monotherapy and simvastatin/ezetimibe in adults with hypercholesterolemia 1. The study found that rosuvastatin/ezetimibe was significantly more effective than rosuvastatin monotherapy or simvastatin/ezetimibe in reducing low-density lipoprotein cholesterol (LDL-C) and total cholesterol, and enabled significantly higher proportions of patients to achieve recommended LDL-C levels.
Some key points to consider when prescribing statins include:
- Starting with a low dose and gradually increasing as needed
- Taking the medication in the evening, particularly for simvastatin
- Ensuring adequate vitamin D levels
- Avoiding grapefruit juice, which can interact with some statins
- Considering alternative dosing strategies, such as every-other-day or twice-weekly regimens, for patients who cannot tolerate daily statin therapy
It's also worth noting that pravastatin is another well-tolerated option, particularly for patients who have experienced side effects with other statins, as it has minimal drug interactions due to its different metabolic pathway 2, 3. However, the most recent and highest quality study available suggests that rosuvastatin is the best tolerated statin medication 1.
In terms of specific dosing, rosuvastatin is typically started at 5-10 mg daily, with doses ranging from 5-40 mg depending on the patient's cholesterol levels and response 4, 1. The fixed-dose combination of rosuvastatin/ezetimibe is also available, which has been shown to be effective in reducing LDL-C and total cholesterol in adults with hypercholesterolemia 4, 1.
Overall, the choice of statin medication should be individualized based on the patient's specific needs and medical history, with consideration given to the potential benefits and risks of each medication. Rosuvastatin is a good option for many patients, due to its favorable tolerability profile and efficacy in lowering LDL cholesterol.