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We often get focused on brand names when choosing a product: Hefty or Glad, Coke or Pepsi, Kleenex, or Puffs. But if we took a couple of extra seconds to examine the shelf, we might see that there’s a generic version of the same product that costs a fraction of any of the brand name options. It’s the same way with prescription medication. Maybe you recognize the names Lipitor and Crestor; they’re two of the biggest names in cholesterol-lowering drugs, but they’re also available in generic forms that may end up costing you a lot less—with no compromise on quality.
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What is Crestor?
Crestor (rosuvastatin calcium) is a statin drug made by AstraZeneca. Statins help to lower low-density lipoprotein or LDL cholesterol in people with abnormally high cholesterol levels. It does this in two ways: by blocking an enzyme in the liver that’s responsible for making cholesterol, and by encouraging your liver to break down cholesterol that’s already in the blood so it can be shuttled out of the body (Luvai, 2012).
But Crestor is approved by the U.S. Food and Drug Administration (FDA) for more than its cholesterol-lowering effects. Crestor may be prescribed to help lower bad cholesterol when diet and exercise alone aren’t enough to get levels to a goal set by a healthcare professional, but it may also be given to help lower triglycerides, raise levels of high-density lipoprotein or HDL cholesterol, or slow the buildup of plaque on artery walls (AstraZeneca, 2020).
What are statins, and how do they work?
Statins, also known as HMG-CoA reductase inhibitors, are a class of prescription drugs that aim to reduce elevated cholesterol levels in people with a high risk of developing cardiovascular disease (CVD). CVD refers to a group of conditions that may cause heart attack, chest pain, and stroke.
High cholesterol is one of the six primary risk factors for developing CVD (Texas Heart Institute, 2020). Medications in this drug class are also called HMG-CoA reductase inhibitors because they cholesterol by blocking HMG-CoA reductase, an enzyme that controls the rate at which cholesterol is made by the body. This class of medications includes medications such as Lipitor (atorvastatin), Pravachol (pravastatin), and Zocor (simvastatin), among others.
There are also some medications that combine statins with other cholesterol-lowering drugs, such as Advicor and Simcor, which are combinations of statins and a medication called niacin, and Vytorin, which is a combination of a statin and a medication called ezetimibe (FDA, 2014).
Crestor dosage: what you need to know
What is generic Crestor?
Generic Crestor is called rosuvastatin, which is the same chemical compound used in the brand-name medication. Drug companies that develop prescription medications get patents for these compounds, but those patents can expire. Once they’ve expired, a generic form of the mediation can be approved by the FDA for sale (FDA, 2018). For Crestor or rosuvastatin, this didn’t happen until April 2016. Watson Pharmaceuticals Inc. was the first company to receive approval to produce and market generic Crestor in multiple strengths, but other companies quickly followed (FDA, 2016; Sandoz, 2016).
But what you’re probably wondering is how this generic drug differs from the brand name, and that question has a simple answer: it doesn’t. Whoever makes the generic version of a drug has to prove to the FDA prior to getting approval that it’s the same as the brand-name drug. And that’s not just in terms of the active ingredient. These generic drugs have to be just as safe and effective as the original brand-name prescription medication and be offered in the same strength, dosage forms, and routes of administration (FDA, 2018).
Crestor and generic Crestor have some big differences compared to some of the other common statins, though. Past clinical trials on how various statin cholesterol drugs performed, for example, found that rosuvastatin more effectively lowered total cholesterol and LDL cholesterol than atorvastatin (brand name Lipitor), fluvastatin (brand name Lescol), lovastatin (brand names Altoprev and Mevacor), and simvastatin (brand name Zocor) (CADTH, 2011). Rosuvastatin is also available in the smallest dose of any statin: 5mg. This may help people who are sensitive to many of the common side effects of statin drugs.
Also, while you may have heard that statins can’t be taken with grapefruit juice, this was never an issue when it came to rosuvastatin. This citrus fruit contains furanocoumarins, a family of chemicals that impairs CYP3A4, an enzyme that helps break down many prescription medications in your body (Bailey, 2013; Fukazawa, 2004). But rosuvastatin is not one of these statins affected by grapefruit. Past research has found that fluvastatin, rosuvastatin, and pravastatin can all be taken along with a diet that includes grapefruit without adverse side effects (Lee, 2016).
How to lower cholesterol: medication and lifestyle
Are there any differences between Crestor and the generic?
The biggest differences between Crestor and generic rosuvastatin are the price and whether or not your health insurance will cover the medication cost. Generic drugs are generally cheaper than prescription drugs. Health insurance may cover part of your prescription cost, but the out-of-pocket cost on a generic form of a drug is still generally lower than that of brand-name drugs. Health insurance companies frequently offer access to generic medications for less money than brand name alternatives. If you don’t have health insurance, your healthcare provider or pharmacist may be able to answer questions about medication cost.
Things to consider when choosing a cholesterol-lowering medication
If you’ve already been taking a cholesterol-lowering medication and you or your healthcare provider are interested in switching to a different option, it’s important to remember that your healthcare provider may want to switch you to another generic cholesterol drug rather than generic Crestor.
If your Crestor hasn’t been effective for reducing your cholesterol, they may opt for something other than rosuvastatin to help get your cholesterol levels moving again. Just as with Crestor, there are potential drug interactions you need to be aware of while taking this medication, and you should discuss all the medicines and supplements you’re taking with a healthcare professional.
Generic Crestor is prescribed as an additional therapy to a diet design to reduce cholesterol (FDA, 2010). Cholesterol-lowering medications such as rosuvastatin are actually most effective when combined with a cholesterol-lowering diet. Research has shown that a fruit- and vegetable-rich diet can lower your risk of developing heart disease (such as stroke and heart attack) (Sotos-Prieto, 2015). Smoking and not getting enough exercise can also contribute to high cholesterol.
Crestor vs. other statins: side effects related to weight loss
The most common side effects of rosuvastatin are headache, muscle aches, abdominal pain, weakness, and nausea. There have been reports of memory loss and confusion while taking this drug.
Seek medical attention from a healthcare professional right away if you have unexplained muscle pain or weakness, especially in combination with dark urine or fever while taking generic Crestor. This may be a sign of rhabdomyolysis, a serious condition that can cause kidney damage. You should also call your healthcare provider if you feel unusually tired or experience loss of appetite, or yellowing of the whites of your eyes or skin.
- AstraZeneca. (2020, July). CRESTOR FAQs. Retrieved Aug. 11, 2020 from https://www.crestor.com/cholesterol-medicine/faqs.html
- Bailey, D., Dresser, G., & Arnold, J. (2013). Grapefruit–medication interactions: Forbidden fruit or avoidable consequences? Canadian Medical Association Journal, 185(4): 309-316. Retrieved from https://www.cmaj.ca/content/185/4/309
- Canadian Agency for Drugs and Technologies in Health (CADTH). (2011, February 15). Comparative Effectiveness of Rosuvastatin Versus Other Statins: A Review of Clinical Effectiveness. Retrieved Aug. 11, 2020 from https://www.cadth.ca/sites/default/files/pdf/htis/feb-2011/L0247-Rosuvastatin_final.pdf
- Food and Drug Administration (FDA). (2010, August 2). Crestor (rosuvastatin calcium) tablets. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/021366s016lbl.pdf
- Food and Drug Administration (FDA). (2016, April 29). FDA approves first generic Crestor. Retrieved Aug. 10, 2020 from https://www.fda.gov/news-events/press-announcements/fda-approves-first-generic-crestor
- Food and Drug Administration (FDA). (2018, June 01). Generic Drug Facts. Retrieved Aug. 9, 2020 from https://www.fda.gov/drugs/generic-drugs/generic-drug-facts
- Fukazawa, I., Uchida, N., Uchida, E., & Yasuhara, H. (2004). Effects of grapefruit juice on pharmacokinetics of atorvastatin and pravastatin in Japanese. British Journal of Clinical Pharmacology, 57(4), 448-455. doi:10.1046/j.1365-2125.2003.02030.x. Retrieved from https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1046/j.1365-2125.2003.02030.x
- Lee, J. W., Morris, J. K., & Wald, N. J. (2016). Grapefruit Juice and Statins. The American Journal of Medicine, 129(1), 26-29. doi:10.1016/j.amjmed.2015.07.036. Retrieved from https://www.amjmed.com/article/S0002-9343(15)00774-3/abstract
- Luvai, A., Mbagaya, W., Hall, A. S., & Barth, J. H. (2012). Rosuvastatin: A Review of the Pharmacology and Clinical Effectiveness in Cardiovascular Disease. Clinical Medicine Insights: Cardiology, 6, 17-33. doi:10.4137/cmc.s4324. Retrieved from https://journals.sagepub.com/doi/10.4137/CMC.S4324
- Sandoz. (2016, July 21). Sandoz launches generic version of Crestor®. Retrieved Aug. 10, 2020, from https://www.us.sandoz.com/news/media-releases/sandoz-launches-generic-version-crestorr-1
- Sotos-Prieto, M., Bhupathiraju, S. N., Mattei, J., Fung, T. T., Li, Y., Pan, A., et al. (2015). Changes in Diet Quality Scores and Risk of Cardiovascular Disease Among US Men and Women. Circulation, 132(23), 2212-2219. doi:10.1161/circulationaha.115.017158. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26644246/
- Texas Heart Institute. (2020, February 3). Heart Information Center: Heart Disease Risk Factors. Retrieved Aug. 10, 2020, from https://www.texasheart.org/heart-health/heart-information-center/topics/heart-disease-risk-factors/
Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.