Lipitor vs Crestor: Which Statin Should You Take?

Lipitor and Crestor are the two most-prescribed statins in the United States — together they account for tens of millions of prescriptions every year. Both lower LDL cholesterol effectively, but they differ in potency, drug interactions, and cost. Here's how to know which one likely fits your situation, and what to ask your doctor before starting.

Quick comparison at a glance

How they work

Both Lipitor (atorvastatin) and Crestor (rosuvastatin) belong to the statin class of cholesterol-lowering drugs. They work by inhibiting HMG-CoA reductase, the enzyme your liver uses to make cholesterol. With less cholesterol production, your liver pulls more LDL out of your bloodstream — lowering "bad" cholesterol while modestly raising HDL.

The mechanism is identical between the two drugs. Differences come down to potency, half-life, and how the drug is metabolized — which affects who tolerates it well and what other medications interact with it.

Effectiveness: how much do they lower LDL?

At maximum doses, both drugs are highly effective, but Crestor is somewhat more potent on a milligram-for-milligram basis. Real-world averages from clinical trials:

• Lipitor 10mg: ~37% LDL reduction
• Lipitor 80mg: ~55% LDL reduction
• Crestor 5mg: ~45% LDL reduction
• Crestor 40mg: ~63% LDL reduction

That said, both drugs hit the cholesterol targets that matter clinically (most patients are aiming for LDL under 100, or under 70 if they have heart disease). The choice between them rarely comes down to potency — both can get the job done.

Side effects

The side effect profiles are similar but not identical. Both drugs can cause:

• Muscle pain (myalgia): 5–10% of users. Usually mild but occasionally severe (rhabdomyolysis is rare but serious).
• Liver enzyme elevation: Usually asymptomatic and reversible. Most doctors check liver function before starting and again after a few months.
• New-onset diabetes: Small increased risk (about 1 extra case per 200 people treated for 5 years).
• Memory issues, brain fog: Reported by some users, though large studies find no consistent effect on cognition.

Crestor tends to be slightly better tolerated for muscle symptoms in head-to-head studies, but individual response varies. Some patients tolerate Lipitor and not Crestor — and vice versa. Switching is reasonable if you have side effects on one.

Drug interactions

This is where the two drugs differ most. Lipitor is metabolized through CYP3A4, an enzyme that handles many other medications. That creates more potential for drug interactions, including:

• Certain antibiotics (clarithromycin, erythromycin)
• Certain antifungals (itraconazole, ketoconazole)
• Some HIV medications
• Grapefruit juice (avoid if on Lipitor)

Crestor has minimal CYP-mediated metabolism — it's mostly excreted unchanged. That means fewer drug interactions overall, which is why some doctors prefer it for patients on multiple medications.

Cost comparison

Both drugs are now generic, which has dramatically reduced cost. With insurance, expect a copay of $5–25 per month for either. Without insurance:

• Generic atorvastatin (Lipitor): $8–25 for 30 tablets at major pharmacies, often free with GoodRx coupon at warehouse stores
• Generic rosuvastatin (Crestor): $10–35 for 30 tablets, also significantly discounted with GoodRx
• Brand-name Lipitor: $200–400/month (rarely worth it given identical generic)
• Brand-name Crestor: $250–400/month (same — no clinical advantage)

Mark Cuban's Cost Plus Drugs lists generic atorvastatin at around $4/month and generic rosuvastatin at around $9/month — among the lowest cash prices in the country.

Which one should you take?

Lipitor (atorvastatin) is often the first choice when:

• You don't take many other medications
• You've been on it before with no issues
• Cost is the deciding factor (slightly cheaper generic)
• Your doctor has clinical experience and trust with it

Crestor (rosuvastatin) is often preferred when:

• You take multiple medications and need fewer drug interactions
• You need very aggressive LDL lowering at lower doses
• You've had muscle side effects on Lipitor
• You have impaired kidney function (Crestor is dosed lower in CKD)

Either drug is appropriate for most people with high cholesterol. If you tolerate one well, there's no clinical reason to switch. If you're starting a statin for the first time, your doctor will probably recommend whichever they have more experience with.

Frequently asked questions

Is Crestor stronger than Lipitor?

On a milligram basis, yes — Crestor is more potent. Crestor 5mg lowers LDL about as much as Lipitor 10mg. But at maximum doses, both reach similar effective LDL targets, so "stronger" doesn't necessarily mean "better" for any given patient.

Can I switch from Lipitor to Crestor?

Yes, switching is straightforward. Your doctor will typically choose a Crestor dose that produces similar LDL reduction to your current Lipitor dose. Most people transition without issues. Discuss any current side effects so the new prescription accounts for them.

Do statins cause memory loss?

Large clinical studies do not show consistent memory or cognitive effects from statins. Some individuals do report brain fog, but it's difficult to separate from age-related changes or other medications. The FDA does include a class label about reversible cognitive effects, so report any memory issues to your doctor.

Should I take statins at night or in the morning?

For Lipitor and Crestor specifically, time of day does not matter much — both have long enough half-lives that a single daily dose at any consistent time works. Older statins like simvastatin are best taken at night, but that doesn't apply to atorvastatin or rosuvastatin.

How long do statins take to work?

Cholesterol levels start dropping within 2 weeks. Maximum effect is reached at 4–6 weeks. Most doctors recheck a lipid panel 6–12 weeks after starting or changing dose. Heart-disease risk reduction takes longer (months to years) but begins immediately.

Related reading:

• Generic vs Brand Name Drugs: $300B Question
• 7 Ways to Cut Prescription Drug Costs in Half (2026)
• Cheapest Prescriptions Without Insurance 2026