From the FDA Drug Label
Rosuvastatin was compared with the statins (atorvastatin, simvastatin, and pravastatin) in a multicenter, open-label, dose-ranging study of 2,240 patients with hyperlipidemia or mixed dyslipidemia. Table 11: Percent Change in LDL-C by Dose of Rosuvastatin, Atorvastatin, Simvastatin, and Pravastatin From Baseline to Week 6 (LS MEAN 1) in Adult Patients with Hyperlipidemia or Mixed Dyslipidemia (Sample Sizes Ranging from 156–167 Patients Per Group)
The FDA drug label does not answer the question.
From the Research
Rosuvastatin has a similar side effect profile to other statins like atorvastatin and simvastatin, but the most recent and highest quality study suggests that atorvastatin may have the best safety profile among the statins. All statins can cause muscle pain, liver enzyme elevations, and rarely, serious muscle damage (rhabdomyolysis) 1. However, rosuvastatin is more potent at lower doses and has less drug interactions than some other statins because it's processed differently in the liver. Simvastatin typically has more drug interactions and higher risk of muscle problems, especially at higher doses. Atorvastatin falls somewhere in between.
Key Points to Consider
- The choice between statins should be individualized based on cholesterol-lowering needs, other medications being taken, and individual risk factors.
- Starting doses are typically rosuvastatin 5-10mg, atorvastatin 10-20mg, or simvastatin 20-40mg daily.
- If side effects occur with one statin, they don't necessarily occur with others, so switching to a different statin or adjusting the dose may help manage side effects while still providing cardiovascular protection.
Comparison of Statins
- A network meta-analysis of randomized trials with 94,283 participants found that atorvastatin and rosuvastatin were most effective in reducing CVD events, while atorvastatin appeared to have the best safety profile 1.
- Another study found that rosuvastatin was more efficacious than atorvastatin at similar doses, but there were no significant differences in adverse events between the two drugs 2.
- A review of the literature found that rosuvastatin reduces abnormal lipids more than atorvastatin on a milligram-per-milligram comparison, but its risk-benefit ratio is acceptable when compared with other statins on the market 3.