Crestor vs. other statins: side effects related to weight loss

For a medication to do its job, you need to take it as prescribed; in the case of statins like Crestor, that’s every day. Researchers have found that not adhering to statin therapy is associated with an increased risk of cardiovascular events and even death (Lansberg, 2018).

Unfortunately, many people quit taking their medicine due to side effects, expense, medical issues, and other reasons (Maningat, 2013). In response to this trend, other researchers have suggested that healthcare professionals discuss these potential effects thoroughly with patients and address their concerns (Maningat, 2013). Be sure to talk to your healthcare provider if you have any concerns about statin therapy. 

One common concern about new prescriptions is whether you will gain weight. Some medications are notorious for this side effect, but there’s been some debate about whether statins are one of them. Here’s what you need to know about Crestor and whether it will cause any weight gain or weight loss.

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Crestor (rosuvastatin calcium) is a statin drug made by AstraZeneca that helps lower low-density lipoprotein, or LDL cholesterol, in people with hypercholesterolemia (high cholesterol levels). It accomplishes this effect in two ways: by blocking cholesterol production and by encouraging your liver to break down cholesterol that’s already in the blood (Luvai, 2012). In addition to high cholesterol, Crestor is also approved by the U.S. Food and Drug Administration (FDA) to treat high triglyceride levels.

Weight gain is complicated with nuanced causes, which is why the answer to whether Crestor causes weight gain isn’t so cut and dry. Crestor does not appear to cause weight gain directly, but it may indirectly lead to increased weight. Crestor’s most common side effects in clinical trials include headaches, nausea, myalgia (muscle pain), asthenia (weakness or lack of energy), and constipation (FDA, 2010). 

Weight gain is not noted as an adverse effect in these clinical trials, which looked at the safety and efficacy of Crestor. But further studies have uncovered two ways rosuvastatin may indirectly encourage weight gain in people taking this common statin drug. One study showed an increase in caloric intake in statin users vs. non-users from 1999-2010.  

Researchers watched people on statin drugs—it was not limited to rosuvastatin—from 1999-2010 and compared them to non-users. Though statin users ate less fat and fewer calories overall than non-users in 1999-2000, their calorie consumption and fat consumption increased after 2000 and surpassed that of people not taking statins. Statin non-users showed stable eating patterns that didn’t change significantly over time. By the end of the study, those on statins had upped their caloric intake, and their BMIs had increased faster than non-users (Sugiyama, 2014). 

One theory for this trend is that seeing cholesterol improvement while taking statins may make people less inclined to follow dietary guidelines. Another possibility is that statins may affect the levels of leptin, a hormone that lets you feel full after eating and help regulate your appetite (Singh, 2018).

Clinical trials have conflicting data regarding this theory; however, laboratory studies suggest that statins decrease the amount of leptin your body makes (Singh, 2018). Lower levels of leptin decrease the feeling of fullness and encourage more eating. Further research is needed to know for sure.

The most common side effects of rosuvastatin are headache, abdominal or stomach pain, muscle aches, nausea, weakness, and constipation (FDA, 2010). Rarely, Crestor may cause more serious side effects like muscle damage and liver problems (FDA, 2010). Sometimes, muscle problems (myopathy) caused by rosuvastatin are a sign of muscle breakdown, also called rhabdomyolysis; in some severe cases, this may cause kidney failure.

Symptoms include muscle pain, tenderness, and weakness. Past research has also found that rosuvastatin may increase blood sugar levels, especially in people with risk factors for type 2 diabetes (FDA, 2010). Lastly, some people have also reported confusion and memory loss while taking this drug.

Seek immediate medical attention if you experience unexplained muscle pain (especially in combination with a fever), unusual tiredness or weakness, dark urine, loss of appetite, upper belly pain, or yellowing of the whites of your eyes or skin—these may be signs of muscle damage or liver damage. 

All statins have side effects—the important thing is to weigh the benefit of lower cholesterol and the reduced risk of heart disease from statin use against their potential side effects. Some people stop taking statins because of the side effects; for others taking a lot of medication, concurrent medical issues, expense, etc. may play a role (Ofori-Asenso, 2019). Unfortunately, stopping statins increases the risk of heart attacks and strokes. 

There is not a perfect statin for everyone. One study looking at adults older than 65 found that those who used atorvastatin (brand name Lipitor) or rosuvastatin were more likely to keep taking the drug than those on simvastatin (Ofori-Asenso, 2019). However, other studies have shown little difference between the side effect rates of the various statins (Bytyçi, 2017).  

One thing that we do know is that certain medications increase the risk of developing side effects if taken with statin medications. These potential drug interactions include cyclosporine, gemfibrozil, niacin, fibrates (such as Fenofibrate), and protease inhibitors such as ritonavir (FDA, 2010).  

You may have heard that you should not drink grapefruit juice with statins. From a chemical perspective, this only applies to statins that are metabolized by the CYP3A4 enzyme in the liver, because grapefruit interferes with this enzyme—these statins include atorvastatin, simvastatin, and lovastatin (Lee, 2016). However, some evidence exists that suggests that, from a practical standpoint, there may not be an issue drinking grapefruit juice with statins (Lee, 2016). If you are a big grapefruit juice drinker, get medical advice before starting statins.

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Current version

September 29, 2020

Written by

Linnea Zielinski

Fact checked by

Chimene Richa, MD

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About the medical reviewer

Chimene Richa, MD

Dr. Richa is a board-certified Ophthalmologist and medical writer for Ro.