Atorvastatin vs Rosuvastatin: what is the difference?

How they differ

Both are statins that block HMG-CoA reductase, the rate-limiting enzyme in the body's own cholesterol assembly line, and rosuvastatin is the more potent per unit weight. The larger practical difference is how each is cleared: atorvastatin is broken down by the liver enzyme CYP3A4, which is the enzyme grapefruit juice and many other medicines interfere with, and rosuvastatin is largely not, so it has fewer interactions. Rosuvastatin is also more water-loving, which keeps more of it in the liver where it is meant to act. Atorvastatin became the best-selling medicine of all time as Lipitor; rosuvastatin followed as Crestor. Atorvastatin is the heavier at 558.6 against 481.5, and rosuvastatin carries a sulfonamide group that atorvastatin does not.

Side by side

Common questions

What is the difference between Atorvastatin and Rosuvastatin?

Both are statins that block HMG-CoA reductase, the rate-limiting enzyme in the body's own cholesterol assembly line, and rosuvastatin is the more potent per unit weight. The larger practical difference is how each is cleared: atorvastatin is broken down by the liver enzyme CYP3A4, which is the enzyme grapefruit juice and many other medicines interfere with, and rosuvastatin is largely not, so it has fewer interactions. Rosuvastatin is also more water-loving, which keeps more of it in the liver where it is meant to act.

Is Atorvastatin bigger than Rosuvastatin?

Atorvastatin is the heavier molecule, 558.6 g/mol against 481.5 g/mol for Rosuvastatin. Atorvastatin is C33H35FN2O5 and Rosuvastatin is C22H28FN3O6S.