Die medizinischen Eigenschaften der Statine Crestor (Rosuvastatin) und Lipitor (Atorvastatin) unterscheiden sich kaum . Ein nicht medizinischer Faktor, der berücksichtigt werden muss, ist die Tatsache, dass das Patent von Lipitor im November 2011 abgelaufen ist, wodurch es etwa 80% billiger ist als das noch patentierte Crestor. Es gibt Studien, die zeigen, dass Crestor bei der Reduzierung von LDL wirksamer ist als Lipitor, aber Experten glauben, dass das Ausmaß der Wirksamkeit für Patienten nicht signifikant genug ist, um die teurere Option zu wählen.
Contents
Vergleichstabelle
| Crestor | Lipitor | |
|---|---|---|
| Introduction | Brand of rosuvastatin, a member of the drug class of statins, used in combination with exercise, diet, and weight-loss to treat high cholesterol and related conditions, and to prevent cardiovascular disease. It was developed by Shionogi. | Brand of atorvastatin, a member of the drug class of statins, used for lowering blood cholesterol. It also stabilizes plaque and prevents strokes through anti-inflammation and other mechanisms. |
| Generic Name | Rosuvastatin calcium | Atorvastatin calcium |
| Manufacturer | AstraZeneca | Pfizer |
| Functions | Reduces cholesterol and high blood pressure associated with heart disease. | Reduces cholesterol and high blood pressure associated with heart disease. |
| Price | Significantly more expensive than Lipitor. | Used to be expensive, but is 80% cheaper compared to previous price as well as Crestor and Zocor since its patent ran out in 2011. |
| Prescription | Required | Required |
| Effect | Reduces amount of cholesterol made by liver | Plasma concentrations occur within 1-2 hours |
| Side Effects | Constipation, heartburn , dizziness, difficulty falling and staying asleep, depression, joint pain, cough, memory loss, confusion | Both have minimal side effects including upset stomach, gas, heartburn, change of taste, diarrhea, constipation, skin rash, headache, dizziness or blurred vision that may occur the first few days as your body adjusts to the medication. |
| Oral administration | 5mg, 10mg, 20 mg, 40 mg | 10 mg, 20 mg, 40 mg, 80 mg |
| Dosage | 5-10 mg once daily | The recommended starting dose of Lipitor is 10 or 20 mg once daily |
| Time Lapse | Up to four weeks | Up to four weeks |
| Usage | With or without food | May be used in combination with a bile acid binding resin for additive effect |
| Legal status | Prescription only | Prescription only |
| Routes | Oral | Oral |
| Drug Interactions | Blood thinners, such as warfarin Cyclosporine, indinavir, Antacids Other high cholesterol medications HIV protease inhibitors. | Antifungal medications, oral contraceptives, other cholesterol-lowering medications, HIV protease inhibitors, medications that suppress the immune system. |
Indication
Crestor (generic name Rosuvastatin) and Lipitor (generic name Atorvastatin), are both statins, i.e., these drugs work to lower “bad” cholesterol (LDL) , fats and triglycerides, in the blood. They also helps raise “good” cholesterol (HDL) in the blood.
Crestor comes in the forms of 5, 10, 20 and 40-milligram tablets, and Lipitor comes in the form of 10, 20, 40 and 80-milligram tablets.
Directions for Use
Both Crestor and Lipitor can be taken with or without food . The tablet should be taken at the same time every day, preferably at night for optimum results. In each case, it may take up to four weeks to show maximum results.
Storage
Crestor and Lipitor should be stored at room temperature , away from light and moisture. Each has a shelf life of three years.
How Statins Work
Crestor, Lipitor, and Zocor work in basically the same way. They reduce the amount of cholesterol made by the liver. Both Crestor and Lipitor are meant to work along with a healthy, low-cholesterol diet. Lowering LDL and triglycerides and raising HDL in the blood reduces the risk of heart disease, stroke and heart attack.
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Efficacy
Studies [1] [2] have shown that rosuvastatin (Crestor) is more effective in reducing LDL than atorvastatin (Lipitor).
According to Time Magazine , a study conducted by Dr. Nicholls of Cleveland yielded similar results:
The new study led by Dr. Stephen Nicholls, clinical director of the Cleveland Clinic Center for Cardiovascular Diagnostics and Prevention, included more than 1,000 patients, average age 57, with coronary artery disease. Participants were randomly assigned to take high doses of either Lipitor (80 mg) or Crestor (40 mg) daily for two years. By the end of the study, both groups had significant reductions in the fatty plaque lining their arteries , with few serious side effects . They also had fewer heart attacks, strokes and angioplasty procedures than would typically be seen in patients on less aggressive statin regimens. “ Doctors have been reluctant to use high doses of statins, but in this study the drugs were safe, well tolerated and had a profound impact on lipid levels, the amount of plaque in vessel walls and the number of cardiovascular events,” said Nicholls in a statement. On some measures, patients taking Crestor did better than those on Lipitor: LDL levels in the Crestor group dropped to an average 62.6 mg/dL, compared with 70.2 mg/dL for patients on Lipitor. Also, more patients taking Crestor (72%) than Lipitor (56%) saw their LDL levels fall below the 70 mg/dL target set for high-risk heart patients. Patients taking Crestor also had higher levels of good HDL.
Medical History Precautions
When taking Crestor or Lipitor, patients should give a detailed medical history to their doctors, especially mention liver disease and kidney disease. Patients also need to be truthful about alcohol use as both drugs interact with the liver. Use of alcohol may increase patients’ risk of liver problems. Patients also need to undergo regular lab and medical tests to monitor their progress while taking either Crestor or Lipitor.
When taking Lipitor, patients should avoid eating grapefruit or drinking grapefruit juice as this may increase the amount of the drug in their blood.
Allergic Reactions
Patients may exhibit allergic reactions to Crestor or Lipitor. The doctor should be alerted in case of the following symptoms: rash, itching or swelling in any part of the body, dizziness or trouble breathing.
Side Effects
Common, non-serious side effects of Crestor include constipation, heartburn , dizziness, difficulty falling or staying asleep, depression , joint pain, cough, memory loss or confusion. Serious but rare side effects include foamy urine, yellowing eyes or skin, dark urine, severe stomach or abdominal pain, persistent nausea or vomiting, muscle pain or tenderness or weakness, unusual tiredness, change in the amount of urine, fever, chest pain or flu-like symptoms.
Some of the common but not serious side effects of Lipitor are diarrhea, constipation, gas, headache, joint pain, forgetfulness and confusion. Serious but rare side effects include muscle pain or tenderness or weakness, lack of energy , fever, chest pain, nausea, unusual tiredness, weakness, bleeding or bruising, loss of appetite, stomach pain, flu-like symptoms, dark urine and yellowing eyes or skin.
Drug Interactions
When on Crestor, patients need to disclose the use of any of the following: anticoagulants such as warfarin; cimetidine, or Tagamet; cyclosporine, or Neoral and Sandimmune; ketoconazole, or Nizoral; other medications for high cholesterol, such as clofibrate, fenofibrate, gemfibrozil, and niacin; HIV protease inhibitors, including atazanavir, taken with ritonavir, lopinavir and ritonavir; and spironolactone.
Lipitor also interacts with certain drugs; patients need to tell their doctors if they’re using any of the following: antifungal medications such as itraconazole and ketoconazole; cimetidine, or Tagamet; clarithromycin, or Biaxin; colchicine, or Colcrys; digoxin, or Lanoxin; diltiazem, or Cardizem, Cartia, Taztia or Tiazac; erythromycin, or E.E.S., E-Mycin or Erythrocin); efavirenz; oral contraceptives; other cholesterol-lowering medications such as fenofibrate, gemfibrozil, and niacin; HIV protease inhibitors such as darunavir, fosamprenavir, lopinavir, nelfinavir, saquinavir, ritonavir and tipranavir; medications that suppress the immune system, such as cyclosporine; rifampin, or Rifadin and Rimactane; spironolactone, or Aldactone; and telaprevir, or Incivek.
References
- Comparison of lipid-modifying efficacy of rosuvastatin versus atorvastatin in patients with acute coronary syndrome -NIH
- Comparison of the efficacy and safety of rosuvastatin 10 mg and atorvastatin 20 mg in high-risk patients with hypercholesterolemia – NIH
- Crestor Oral Uses and How to Use – HealthCentral
- Rosuvastatin – MedlinePlus
- Wikipedia: Rosuvastatin
- Crestor Information – eMC
- Lipitor Information – eMC
- Wikipedia: Lipitor
- Atorvastatin – MedlinePlus
- Lipitor Oral Uses and How to Use – HealthCentral