Rosuvastatin — Cholesterol Medication Guide | KiwiMeds
✅ Reviewed by a Registered Pharmacist NZ | Last updated: May 2026 | This information is for educational purposes only and does not replace advice from your doctor or pharmacist.
What is rosuvastatin?
Rosuvastatin (brand name Crestor) is a potent statin used to lower LDL (“bad”) cholesterol and reduce cardiovascular risk. It is one of the most effective statins for lowering LDL and is widely prescribed in New Zealand alongside atorvastatin.
What is it used for? (NZ context)
Rosuvastatin is prescribed to lower LDL cholesterol, reduce cardiovascular risk, and treat familial hypercholesterolaemia (inherited high cholesterol). It is funded by Pharmac in New Zealand.
How does it work?
Rosuvastatin inhibits HMG-CoA reductase, the key enzyme in cholesterol synthesis in the liver. This causes the liver to take up more LDL from the blood via LDL receptors, reducing circulating LDL levels. Rosuvastatin is the most potent statin currently available.
How to take it
Rosuvastatin can be taken at any time of day, with or without food (unlike simvastatin, which is specifically best taken in the evening). The usual starting dose is 5–10mg, with a maximum of 40mg daily. Unlike simvastatin, rosuvastatin is not significantly affected by grapefruit juice.
Common side effects
- Muscle aches (myalgia)
- Headache
- Stomach pain
- Nausea
- Weakness
Serious side effects to watch for
Rhabdomyolysis (severe muscle breakdown) is rare but serious. Seek medical attention for unexplained severe muscle pain or dark urine. Liver enzyme elevation is uncommon but possible. Asian patients (Chinese, Japanese, Filipino, Korean, Vietnamese, Indian) are advised to start at lower doses (5mg) due to higher blood levels.
Important drug interactions
Unlike simvastatin, rosuvastatin is not significantly affected by grapefruit. However, interactions still exist: warfarin — rosuvastatin increases INR; dose adjustments may be needed. Antacids (aluminium/magnesium hydroxide) — reduce rosuvastatin absorption if taken simultaneously; separate doses by 2 hours. Ciclosporin significantly increases rosuvastatin levels.
NZ-specific information
Pharmac funding: Rosuvastatin 5mg, 10mg, and 20mg tablets are funded by Pharmac. The brand Crestor and generic rosuvastatin are both available in NZ.
Frequently asked questions
Is rosuvastatin stronger than atorvastatin?
Rosuvastatin and atorvastatin are both high-intensity statins. At equivalent doses, rosuvastatin produces slightly greater LDL reduction. However, both are highly effective. Choice between them depends on individual factors including tolerability and existing medications.
Do I need to avoid grapefruit with rosuvastatin?
No — unlike simvastatin and lovastatin, rosuvastatin is not significantly affected by grapefruit juice. You can eat grapefruit normally.
Can I stop rosuvastatin if I feel fine?
Rosuvastatin works in the background to prevent future heart attacks and strokes — you won’t feel its benefit day-to-day. Stopping increases your cardiovascular risk significantly. Do not stop without discussing with your doctor.
💬 Talk to your pharmacist or doctor for personalised advice about rosuvastatin.
Reviewed by a Registered Pharmacist NZ | BPharm, Pharmacy Council of New Zealand
References & Further Information
The following New Zealand and international resources were used to inform this page: