Statin Comparison: Find the Right Cholesterol Medicine

Statins are the most‑prescribed drugs for lowering bad cholesterol (LDL). They cut heart attack risk, but not all statins work the same way. If you’re starting therapy or thinking about switching, a quick side‑by‑side look helps you decide what fits your health profile.

Main Types of Statins

There are five statins you’ll see most often:

• Atorvastatin (Lipitor) – high‑intensity, drops LDL 35‑45% at 40‑80 mg.
• Rosuvastatin (Crestor) – also high‑intensity, similar LDL drop but works well at low doses (5‑10 mg).
• Simvastatin (Zocor) – moderate‑intensity, reduces LDL 25‑35% at 20‑40 mg.
• Pravastatin (Pravachol) – mild, good for people who need fewer drug interactions; LDL drop 20‑30% at 20‑40 mg.
• Lovastatin (Mevacor) – oldest, modest effect, LDL drop 20‑30% at 20‑40 mg.

All of them block the same enzyme (HMG‑CoA reductase), but potency, dosing, and how the body processes them differ.

Choosing the Best Statin for You

Start with your cardiovascular risk. If your doctor flags a high risk (previous heart attack, diabetes, or very high LDL), a high‑intensity statin like atorvastatin or rosuvastatin is usually first‑choice. For moderate risk, simvastatin or pravastatin often do the job with fewer side‑effects.

Side‑effects matter too. Muscle aches and a slight rise in liver enzymes happen with any statin, but they’re reported more often with higher doses. Rosuvastatin tends to cause fewer muscle complaints at low doses, while simvastatin can interact with certain antibiotics and antifungals.

Age and kidney function shape the decision. Older adults or those with chronic kidney disease may benefit from pravastatin because it’s cleared more gently. Pregnant women should avoid all statins entirely.

Cost is a practical factor. Generic atorvastatin and simvastatin are widely available and cheap, while rosuvastatin’s brand version can be pricier, though a generic entered the market recently.

Finally, talk to your doctor about personal factors—family history, other meds, diet, and lifestyle. Starting with a low dose, checking blood work after a few weeks, and adjusting upward is the safest path.

Bottom line: No single statin is best for everyone. Match the drug’s strength, side‑effect profile, and price to your health goals, and let your doctor guide the final pick.