Lipitor vs Crestor vs Zocor: how the top statins compare
Lipitor, Crestor and Zocor are the three most familiar statins — prescription cholesterol medicines that lower LDL (“bad”) cholesterol to reduce the risk of heart attack and stroke. They work the same way and all have low-cost generics; the practical differences are how strongly they lower LDL and which drug/food interactions to watch.
All three lower LDL cholesterol and cardiovascular risk. Rosuvastatin (Crestor) and atorvastatin (Lipitor) are “high-intensity” statins that drop LDL the most; simvastatin (Zocor) is “moderate-intensity” and has more drug interactions (and a restricted 80 mg dose because of muscle risk). These are prescription medicines — which one and what dose is a decision for your doctor based on your cholesterol target and overall heart risk, not something to choose or switch on your own.
| Crestor rosuvastatin | Lipitor atorvastatin | Zocor simvastatin | |
|---|---|---|---|
| Active ingredient | Rosuvastatin Calcium | Atorvastatin Calcium | Simvastatin |
| Our rating | 70/100 | Not yet rated | 70/100 |
| Pharmacy pays | ~$1.37 /30 | ~$0.92 /30 | ~$0.93 /30 |
| Intensity | High | High | Moderate |
| Typical LDL-C lowering | ~45–55%+ (dose-dependent) | ~40–50%+ (dose-dependent) | ~30–40% |
| Interactions | Fewer CYP interactions; some with certain antivirals/transplant drugs | Metabolized by CYP3A4 — caution with some antibiotics/antifungals; limit grapefruit | More CYP3A4 interactions; avoid grapefruit; 80 mg dose limited (muscle risk) |
| Good to know | The most potent per milligram; long-acting. Often chosen when big LDL drops are needed. | High-intensity and very widely prescribed, with cheap generics. | Moderate-intensity and older, with more interactions to watch; the 80 mg dose is restricted. |
Ratings are our independent FDA recall-safety score. General information, not medical advice.
Which should you choose?
Crestor (rosuvastatin)
The most potent per milligram; long-acting. Often chosen when big LDL drops are needed.
Lipitor (atorvastatin)
High-intensity and very widely prescribed, with cheap generics.
Zocor (simvastatin)
Moderate-intensity and older, with more interactions to watch; the 80 mg dose is restricted.
There isn't a single “best” statin — the right choice depends on how much LDL lowering you need and your other medicines. For larger LDL reductions, the high-intensity options (Crestor/rosuvastatin and Lipitor/atorvastatin) are typically used; simvastatin (Zocor) is moderate-intensity and interacts with more drugs (and grapefruit), with its highest 80 mg dose limited due to muscle-injury risk. Muscle aches are the most common complaint across statins and are usually manageable by adjusting dose or switching — tell your doctor rather than stopping on your own, since the heart-protection benefit is well established. This is general information, not medical advice; statins are prescription-only and individualized.
Frequently asked questions
Which statin is the strongest — Lipitor, Crestor or Zocor?
By LDL-lowering power per dose, rosuvastatin (Crestor) is generally the most potent, followed closely by atorvastatin (Lipitor); both are “high-intensity.” Simvastatin (Zocor) is “moderate-intensity.” But the goal is reaching your target LDL safely, not the biggest number — your doctor matches the statin and dose to your risk.
Which statin has the fewest interactions?
Rosuvastatin (Crestor) isn't heavily processed by the CYP3A4 enzyme, so it has fewer of the interactions that affect simvastatin (Zocor) and, to a lesser degree, atorvastatin (Lipitor) — including the grapefruit interaction. Always give your full medicine list to your prescriber and pharmacist.
Do statins cause muscle pain?
Muscle aches are the most commonly reported statin side effect, though serious muscle injury is rare. It can often be managed by changing the dose or switching statins. Tell your doctor about new muscle pain rather than stopping on your own — the heart-attack/stroke risk reduction is well established.
Can I switch between them myself?
No. Statins are prescription medicines and the doses aren't interchangeable milligram-for-milligram (e.g., 10 mg of rosuvastatin is much stronger than 10 mg of simvastatin). Any change should be made by your prescriber.