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Simvastatin vs. Crestor: What You Need to Know



  1. Simvastatin and rosuvastatin (Crestor) are both cholesterol-lowering drugs.
  2. Simvastatin is a generic drug, whereas Crestor is a brand name. Because of this, simvastatin is less expensive.
  3. Simvastatin can be as effective as Crestor, but it interacts with more drugs than Crestor.

Simvastatin and rosuvastatin (Crestor) are both cholesterol-lowering drugs. They block an enzyme in the body to help prevent your body from making cholesterol. They belong to a group of drugs called statins.

Your body naturally produces cholesterol. Your diet may also include sources of cholesterol. Cholesterol or plaque can accumulate in your blood vessels. This can start to affect your blood circulation. If these plaques break off, they can block a vessel or travel to your brain, which could lead to a heart attack or a stroke. 


Statins can prevent the formation of plaques and may help reduce them. You may be prescribed statins if you:

  • have a buildup of cholesterol inside your blood vessels; this is also known as atherosclerotic cardiovascular disease (ASCVD)
  • have high LDL, or bad cholesterol, which is defined as a level greater than 190 mg/dL
  • have diabetes, are between 40 and 75 years old, and have LDL between 70 to 189 mg/dL, even without buildup of cholesterol inside your blood vessels
  • have LDL between 70 to 189 mg/dL, are between 40 and 75 years old, and have a risk of at least 7.5 percent for ASCVD

Other health problems can increase inflammation in your body and increase the risk of plaques. These include:

  • diabetes
  • high blood pressure
  • heart disease

Simvastatin vs. Crestor: What are the major differences?

genericbrand name
less expensivemore expensive
taken orallytaken orally
more drug interactionsstrong interaction with warfarin
interacts with grapefruit juicemore likely to cause kidney problems
more likely to cause muscle painmay cause fatigue
may cause fatigue


Simvastatin is a generic drug, whereas Crestor is a brand name. Because of this, simvastatin is less expensive.

Simvastatin may cost just $10 to $15 per month, while Crestor costs more than $150 per month. Both drugs have a range of doses available and are dispensed in every pharmacy.

Drug interactions

Simvastatin can be as effective as Crestor, but it interacts with more drugs than Crestor. Drug interactions can increase your risk of side effects from simvastatin.

The following drugs may interact with simvastatin or Crestor:

antibiotics and antifungals, like erythromycin, clarithromycin, itraconazole, and ketoconazolefenofibrate (Antara, Lipofen), used to treat high cholesterol and high triglycerides
anti-rejection drugs like cyclosporinegemfibrozil (Lopid), used to treat high cholesterol and high triglycerides
blood pressure drugs, including verapamil, diltiazem, and amlodipineniacin and fibrates (also used to lower cholesterol)
colchicine, a drug used to treat goutcolchicine, a drug used to treat gout
heart disease drugs, like amiodaronesimeprevir, used to treat hepatitis C
HIV drugs, including protease inhibitorsprotease inhibitors, including atazanavir/ritonavir and lopinavir/ritonavir
cholesterol lowering drugs like gemfibrozil, niacin, and fibrateswarfarin (a much stronger interaction than simvastatin)
warfarin (your doctor may have to adjust your dose)
grapefruit juice

If you’re taking a number of medications, it could be more complicated to manage them while taking simvastatin. Sometimes your doctor might have to change the dose of one or more drugs, or you might have to stop taking simvastatin for a short time.

Muscle aches and pains

Both of these statins can cause muscle aching and pain, but it’s more likely when taking simvastatin. This pain may develop over a few days or weeks, and it may feel like a muscle strain or pulled muscle.

If you’re an older adult and have chronic pain, you may be tempted to ignore the pain. Muscle aching that is ignored can get worse and lead to kidney problems or damage.


You may also experience fatigue. According to a study funded by the National Institutes of Health, women, in particular, have a substantial risk of fatigue from statins. This risk was greater from simvastatin.

Kidney and liver disease

If you have severe kidney disease, you may need a different dose of either simvastatin or Crestor. Talk to your doctor before taking either of these drugs.

A few people who take statins develop liver disease. If you experience darkened urine or pain in your side, call your doctor immediately.

Which drug is more effective?

In a large observational study in France, more than 100,000 patients without heart disease had taken either 20 mg of simvastatin or 5 mg of Crestor each day, for an average of about three years. Researchers found that both drugs were equally effective at preventing heart attack and stroke.

If you need low to moderate intensity treatment to reduce cholesterol, simvastatin may be the right choice. If your LDL is very high, you may need a high intensity treatment. Your doctor may choose Crestor instead, which can lower your cholesterol by more than 50 percent.

Higher doses can cause worse side effects, however. An observational study of more than 2 million statin users in Canada showed a 34 percent increased risk of kidney injury when people took high-dose statins. A high dose of Crestor (at least 10 mg) and a high dose of simvastatin (40 mg) both increased this risk, which happened during the first three months of treatment.

If you’re currently taking simvastatin or Crestor and are concerned about price, your risk for side effects, or other drug interactions, talk to your doctor. Each person is different and has different health risks. If your risk is high, your doctor will probably decide that lowering your cholesterol is a high priority. That may influence the decision about which drug to take.

Questions to ask your doctor

Don’t stop taking your statin without talking to your doctor. Statins only work if they are taken every day.

If your doctor recommends the use of statins, you may want to ask:

  • Why am I taking this drug?
  • How well is this drug working for me?

If you have a number of drug interactions, kidney disease, or a high risk for heart attack or stroke, your doctor can explain to you why you are taking the medication you are taking.

If you’re having side effects, like muscle pain, pain in your side or dark urine, or if you’re worried about kidney disease, discuss these issues with your doctor. They can check your lab work and adjust your treatment to help prevent problems.

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