A statin (cholesterol-lowering medicine)
Rosuvastatin
A potent statin that strongly lowers LDL ("bad") cholesterol to reduce the risk of heart attack and stroke, taken once a day at any time.
What is Rosuvastatin?
Rosuvastatin is one of the most potent statins available in the UK and strongly lowers LDL ('bad') cholesterol to reduce the risk of heart attack and stroke. It is taken as a long-term once-daily tablet for prevention and for people who already have cardiovascular disease.
Education and reference only. This is a plain-language guide to Rosuvastatin — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Rosuvastatin is one of the most potent statins available in the UK. It lowers cholesterol — particularly LDL ("bad") cholesterol — and is used both to help prevent a first heart attack or stroke in people at raised cardiovascular risk (primary prevention) and to protect people who already have heart or vascular disease (secondary prevention). It is often chosen when a strong reduction in LDL is needed, or as an alternative for people who have not tolerated another statin. It is taken as a long-term, once-daily tablet and works quietly in the background.
How it works
Rosuvastatin blocks an enzyme in the liver (HMG-CoA reductase) that the body uses to make cholesterol. With less cholesterol being produced, the liver pulls more LDL cholesterol out of the blood, so circulating levels fall. Lower LDL means less cholesterol is laid down in artery walls, which is how statins reduce the risk of heart attacks and strokes over time. Rosuvastatin is highly effective at this and long-acting, so it can be taken at any time of day.
Company & origin
Originated / developed by: AstraZeneca (originated at Shionogi).
Rosuvastatin was originally synthesised by the Japanese company Shionogi in the early 1990s and subsequently developed and marketed by AstraZeneca. It was first approved by the FDA in 2003 and sold as Crestor.
What it treats
Conditions Rosuvastatin is used for
Practical use
How to take Rosuvastatin
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Taken once a day and can be taken at any time of day.
- Swallow the tablet whole with water, with or without food.
- If you miss a dose, skip it and take the next one as usual — do not double up.
- It has fewer grapefruit-related interactions than some statins, but check with your pharmacist about other medicines.
- Tell your doctor promptly if you get severe or widespread muscle pain or weakness, or dark-coloured urine.
- Keep taking it long-term to maintain the cholesterol-lowering benefit.
Weighing it up
Advantages & disadvantages of Rosuvastatin
Advantages
- One of the most powerful statins for lowering LDL cholesterol.
- Once daily and can be taken at any time of day.
- Fewer interactions than simvastatin and less affected by grapefruit.
- Strong evidence for reducing cardiovascular events.
Disadvantages
- Can cause muscle aches like other statins.
- Dose may need adjusting in people of certain ethnic backgrounds or with reduced kidney function.
- Requires occasional liver blood tests.
- Works silently — the benefit is long-term risk reduction, not a felt effect.
Practical use
Good to know
Rosuvastatin can be taken once a day at any consistent time, because it lasts well over the day. It is taken long-term, and stopping it allows cholesterol — and risk — to drift back up. It generally has fewer drug interactions than simvastatin, which can make it a convenient choice. Muscle aches should be reported, though most people tolerate it well. The starting level is approached more cautiously in people with significant kidney impairment and in people of South-Asian family background, as they can be more sensitive to it.
Who should not take it / use with caution
- People with active liver disease, or unexplained persistently raised liver blood tests.
- Women who are pregnant, planning pregnancy or breastfeeding — statins are stopped beforehand.
- Used cautiously, with a gentler approach, in significant kidney impairment, in people of South-Asian family background, and in significant muscle disease.
Monitoring
- Cholesterol (lipid) levels to confirm response
- Liver blood tests around starting and as advised
- Reported muscle symptoms; kidney function where relevant
Side effects
- Often none. The most talked-about effect is muscle aches; genuine muscle injury is uncommon but should be reported.
- Occasional headache, digestive upset, or disturbed sleep.
- Rarely, a rise in liver enzymes (checked on blood tests), protein in the urine, or, very rarely, serious muscle breakdown — report severe, widespread or persistent muscle pain, especially with dark urine.
Key interactions
- Generally fewer interactions than simvastatin, but care is still needed with certain medicines.
- Some medicines for HIV and hepatitis C, ciclosporin, and certain other drugs can raise its levels and muscle-injury risk.
- Care alongside other cholesterol or fibrate medicines, and certain antacids should be separated from it by a couple of hours.
Available as: Tablets (several strengths). A liquid or chewable form is available in some cases for people who cannot swallow tablets.
Answers
Rosuvastatin: frequently asked questions
When should I take rosuvastatin — morning or night?
Rosuvastatin is long-acting, so it works just as well taken at any consistent time of day; choose whenever you will remember it. This differs from shorter-acting statins like simvastatin, which are best taken in the evening.
Is rosuvastatin stronger than other statins?
Rosuvastatin is one of the most potent statins, meaning it produces a large drop in LDL cholesterol. The right statin and intensity is matched to your individual cardiovascular risk and how well you tolerate it, so "stronger" is not automatically "better" for everyone.
Why is the starting approach gentler for some people?
People with significant kidney impairment and people of South-Asian family background can be more sensitive to rosuvastatin, so prescribers begin more cautiously and build up if needed. This is a standard safety principle, not a sign of a problem.
It is giving me muscle aches — should I stop?
Tell your prescriber rather than just stopping. Muscle aches are common and often not actually caused by the statin; this can be tested by pausing and re-challenging or trying an alternative. Severe or widespread muscle pain, especially with dark urine, needs prompt review.
What is the difference between rosuvastatin and Crestor?
They are the same medicine — rosuvastatin is the generic (active-ingredient) name and Crestor is a brand name. Generic rosuvastatin contains the identical active ingredient.
The wider class
About Statins
Rosuvastatin belongs to the statins class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
Browse by body system
Authoritative sources
- BNF: Rosuvastatin.
- electronic Medicines Compendium (SmPC): Rosuvastatin (Crestor).
- NICE CKS: Rosuvastatin.
Keep reading
Related articles
Building a medicines information resource?
We create evidence-led, dose-free drug and formulary references for teams.