HMG-CoA reductase inhibitor (statin)·#6 most prescribed in Canada

Crestorrosuvastatin calcium

Also known as: Rosuvastatin (multiple Canadian generics)

Crestor (rosuvastatin) lowers LDL cholesterol and reduces heart attack risk. Learn about dosing, side effects, and BC PharmaCare coverage at Pill4Me Chilliwack.

Prescriptions (Canada 2024)

5,900,000 prescriptions

Drug class

HMG-CoA reductase inhibitor (statin)

DIN (Canada)

02247162, 02247163 +2 more

What is Crestor?

Crestor is used to lower LDL (bad) cholesterol and triglycerides, and to raise HDL (good) cholesterol. It is used to reduce the risk of heart attack, stroke, and other serious cardiovascular events in patients at risk, including those with diabetes or family history of heart disease.

How it works

Rosuvastatin blocks an enzyme in your liver called HMG-CoA reductase, which your liver needs to make cholesterol. When this enzyme is blocked, the liver makes less cholesterol and removes more LDL cholesterol from the bloodstream. Most of the effect happens in the liver and does not directly affect dietary cholesterol.

Forms & strengths

Tablets: 5 mg, 10 mg, 20 mg, 40 mg. Generic rosuvastatin is available in the same strengths at lower cost.

How to take it

Usually taken once daily at any consistent time of day, with or without food. Unlike some other statins, rosuvastatin does not need to be taken at night. Dose ranges from 5 mg to 40 mg depending on your cholesterol goals and risk profile. Asian patients may require lower starting doses. Take at the same time each day for consistent results.

Side effects

Common side effects

Muscle aches, pain, or weakness (most common reason patients stop statins)
Headache
Nausea or stomach upset
Constipation or diarrhea
Joint pain
Mild blood sugar elevation (clinical significance usually outweighed by cardiovascular benefit)

Serious side effects — seek care immediately

Rhabdomyolysis (severe muscle breakdown) — severe muscle pain with dark (cola-coloured) urine requires emergency care
Liver toxicity — rarely causes significant liver damage; routine monitoring is no longer recommended unless symptoms develop
Immune-mediated necrotizing myopathy (IMNM) — a rare autoimmune muscle condition that may persist even after stopping the statin
New-onset diabetes — small increase in risk, but cardiovascular benefits far outweigh this in most patients

Important warnings

Report any unexplained muscle pain, tenderness, or weakness to your pharmacist or doctor promptly — especially if accompanied by fever or dark urine

Avoid large amounts of grapefruit juice — rosuvastatin has less of an interaction than some other statins (atorvastatin, simvastatin), but large amounts may still increase drug levels

Do not take during pregnancy or while breastfeeding — stop the medication and contact your doctor if you become pregnant

Inform all healthcare providers (including dentist) that you are on a statin before any procedure

Asian patients (Chinese, Japanese, Korean, Vietnamese, Filipino) may have higher blood levels at the same dose and often start at 5 mg

Who should not take it

Active liver disease or unexplained persistent elevations in liver enzymes
Pregnancy — statins can harm a developing baby; use effective contraception
Breastfeeding
Severe kidney impairment (dose adjustment required for moderate kidney disease)
Concomitant use with cyclosporine — use with extreme caution or avoid

Drug interactions

Cyclosporine markedly increases rosuvastatin levels — this combination requires dose restriction to 5 mg maximum. Gemfibrozil (a cholesterol medication) significantly increases levels and rhabdomyolysis risk — combination should be avoided. Warfarin: rosuvastatin can modestly increase INR — monitor more closely when starting or changing doses. Antacids containing aluminum and magnesium (taken at the same time) reduce absorption — separate by 2 hours.

BC PharmaCare coverage

Crestor (rosuvastatin) may be covered under BC PharmaCare depending on your plan. Covered under Fair PharmaCare for eligible BC residents. Generic rosuvastatin is preferred under the Low Cost Alternative (LCA) program — your pharmacist can switch you to the covered generic automatically at no extra cost. Coverage amounts vary — Fair PharmaCare covers 70–100% after your annual deductible depending on your income. Call us at 604-705-3644 and we'll check your specific coverage in minutes. BC PharmaCare covers the generic version at 100% of the approved price. If you choose the brand name instead of the generic, you pay the difference in cost out of pocket. Your pharmacist can dispense the generic automatically unless your doctor has specified 'no substitution' on the prescription. Coverage information is a general guide only. Your actual coverage depends on your PharmaCare plan and eligibility. We check coverage for free — call 604-705-3644 or ask at the counter.

Coverage details change — confirm with your Pill4Me pharmacist or visit BC PharmaCare.

Frequently asked questions

Do I need to take Crestor at night?

No. Unlike some older statins (lovastatin, simvastatin), rosuvastatin has a long half-life and works just as well taken at any time of day — morning or evening. The most important thing is to take it consistently at the same time each day.

Should I be worried about grapefruit with Crestor?

Rosuvastatin has much less of a grapefruit interaction than atorvastatin or simvastatin. Occasional grapefruit consumption is generally not a concern. However, drinking large amounts of grapefruit juice daily (more than one large glass) may modestly increase rosuvastatin levels. It is generally safe to enjoy grapefruit occasionally without worrying.

Can I stop my statin if my cholesterol levels are back to normal?

Not without talking to your doctor first. Statins treat the underlying cause (your liver producing too much cholesterol) rather than the symptom (high LDL reading). When you stop, cholesterol typically returns to its previous level within weeks. Most people need to stay on statins long-term, especially if prescribed for cardiovascular risk reduction rather than just a high number.

What should I do if I develop muscle pain on Crestor?

Report any unexplained muscle pain, soreness, or weakness to your pharmacist or doctor. Mild aches are common and often temporary. Severe muscle pain — especially with weakness or dark urine — requires immediate medical attention (this could indicate rhabdomyolysis). Your doctor may check a blood test (CK level) and may adjust your dose or switch you to a different statin.

What is the difference between Crestor and generic rosuvastatin?

Generic rosuvastatin contains the same active ingredient (rosuvastatin calcium) at the same dose as Crestor. Health Canada requires generics to be bioequivalent — meaning they work the same way in your body. Generic rosuvastatin is significantly less expensive under BC PharmaCare and is the preferred option for most patients.

Related medications

Lipitor (atorvastatin calcium)Eliquis (apixaban)

Questions about Crestor?

Our Chilliwack pharmacists can review your medications, check for interactions, and answer any questions — at no charge.

Call 604-705-3644 Transfer my prescription →

Medical disclaimer: This page is for general educational purposes only and does not constitute medical advice. Always consult your pharmacist or prescriber before making any changes to your medications. BC PharmaCare coverage criteria are subject to change.