Pravastatin vs. rosuvastatin comparison

In this article:

• Key differences
• Conditions treated
• Insurance coverage and cost
• Side effects
• Drug interactions
• Drug warnings

In this article

• Key differences
• Conditions treated
• Insurance coverage and cost
• Side effects
• Drug interactions
• Drug warnings

Pravastatin and rosuvastatin are generic medications approved by the Food and Drug Administration (FDA) to help lower high cholesterol. They are classified in a group of medicines called HMG-CoA reductase inhibitors, more commonly referred to as statins, because their active ingredients end in -statin. Other statins include Lipitor (atorvastatin), Lescol XL (fluvastatin), Livalo (pitavastatin), lovastatin, and Zocor (simvastatin). Statins work by blocking the action of an enzyme called HMG-CoA reductase, which in turn helps lower cholesterol levels. Statin therapy is typically the first choice of medication when treating high cholesterol. 

While pravastatin and rosuvastatin are both part of the statin group of drugs, they are not exactly the same. They have many similarities, as well as some differences, such as in their FDA-approved uses, dosages, and drug interactions. 

Pravastatin vs. rosuvastatin: Key differences

Pravastatin and rosuvastatin are both generic statins. The brand name for pravastatin is Pravachol, but the brand-name version is no longer marketed in the United States. The brand name of rosuvastatin is Crestor, which is still available. Pravastatin and rosuvastatin are typically taken once daily at any time of day, and can be taken with or without food. 

Compare pravastatin and rosuvastatin key differences
	Pravastatin	Rosuvastatin
Drug class	HMG-CoA reductase inhibitor; statin	HMG-CoA reductase inhibitor; statin
Brand/generic status	Generic	Generic
What is the brand name?	Pravachol (brand-name drug discontinued in the U.S.)	Crestor (brand-name drug is available in the U.S.)
What form(s) does the drug come in?	Oral tablet: 10, 20, 40, 80 mg	Oral tablet: 5, 10, 20, 40 mg
What is the standard dosage?	Adult dosage: Starts at 40 to 80 mg by mouth once daily Dosage for pediatric patients ages 8–13 years: 20 mg by mouth once daily Dosage for pediatric patients ages 14– 18 years: 40 mg by mouth once daily	Adult dosage: 5 to 40 mg by mouth once daily Pediatric dosage: Varies by age and diagnosis
How long is the typical treatment?	Long-term	Long-term
Who typically uses the medication?	Adults and pediatric patients 8 years and older	Adults and pediatric patients 7 years and older

 

Pravastatin vs. rosuvastatin: Conditions treated

While both drugs are used to lower cholesterol, they have some slight differences, which are outlined below. Pravastatin and rosuvastatin will help decrease your total cholesterol, LDL cholesterol, and triglycerides, and may also modestly increase your high-density lipoprotein cholesterol (HDL cholesterol, also known as your “good” cholesterol). Your prescribing healthcare provider may recommend using the medication along with lifestyle changes like diet and exercise.

Compare conditions treated by pravastatin and rosuvastatin
Pravastatin	Rosuvastatin
To lower the risk of myocardial infarction (heart attack), certain heart-related procedures, and heart-related death in adults with increased LDL cholesterol without coronary heart disease (CHD) To lower the risk of coronary death, heart attack, certain heart-related procedures, stroke, or transient ischemic attack (TIA, or mini stroke), and slow the progression of coronary atherosclerosis (blocked arteries) in adults with CHD To lower LDL cholesterol in adults with primary hyperlipidemia  To treat hypertriglyceridemia (high triglycerides) in adults To treat primary dysbetalipoproteinemia (a genetic condition) in adults  To lower LDL cholesterol in pediatric patients 8 years and older with heterozygous familial hypercholesterolemia (HeFH; a genetic condition that causes high LDL cholesterol)	To lower the risk of major adverse cardiovascular events (such as heart-related death, stroke, heart attack, or need for certain procedures) in adults who do not have CHD but have a higher risk for cardiovascular disease To lower LDL cholesterol and slow the progression of coronary atherosclerosis in adults To lower LDL cholesterol in adults with primary hyperlipidemia To treat hypertriglyceridemia in adults To treat primary dysbetalipoproteinemia in adults To lower LDL cholesterol in adults and children 8 years and older with HeFH To lower LDL cholesterol in adults and children 7 years and older with homozygous familial hypercholesterolemia (HoFH; a rare genetic condition that causes extremely high LDL cholesterol)

Pravastatin vs. rosuvastatin: Insurance coverage and cost comparison

Generic pravastatin and rosuvastatin are typically covered by insurance companies as well as Medicare prescription plans. You can contact your insurance provider for up-to-date information on coverage and costs. 

You can always use SingleCare to help you pay for your medicines. What’s more, you can  use the discount on your refills, too. 

If you are paying out of pocket, a three-month prescription (90 tablets) of pravastatin 40 mg would cost about $345. However, if you use a free SingleCare coupon, you could pay as low as $13 for a three-month supply at your local participating pharmacy. 

A three-month supply of rosuvastatin 10 mg, without insurance, would cost about $375. However, with a free SingleCare coupon, you could pay about $21 for a 90-day supply at your local participating pharmacy.

Compare pravastatin vs. rosuvastatin cost and coverage
	Pravastatin	Rosuvastatin
Typically covered by insurance?	Yes	Yes
Typically covered by Medicare Part D?	Yes	Yes
Quantity	90, 40 mg tablets	90, 10 mg tablets
SingleCare cost*	$13 for a 3-month supply	$21 for a 3-month supply

*Price at the time of publication. Drug prices fluctuate and vary by location.

Pravastatin vs. rosuvastatin side effects

The following lists outline some of the more common side effects of rosuvastatin and pravastatin, but is not a full list of every possible side effect. Consult your healthcare provider or pharmacist for more information and a full list of side effects.

Compare pravastatin vs. rosuvastatin side effects
Pravastatin	Rosuvastatin
Muscle aches and pains	Muscle aches and pains
Headache	Headache
Nausea	Nausea
Diarrhea	Weakness
Vomiting	Constipation
Upper respiratory tract infection

Allergic reactions are rare. If you have symptoms such as hives, difficulty breathing or swallowing, or swelling of the face, lips, tongue, or throat, get emergency medical help right away. 

Source: Pravastatin (DailyMed), Crestor (DailyMed)

Pravastatin and rosuvastatin drug interactions

Before taking pravastatin or rosuvastatin, tell your healthcare provider about all the medications you take, including prescription drugs, over-the-counter medications, and vitamins or supplements. While taking a statin, do not start any other new medication unless you check with your healthcare provider first. 

The table below outlines some of the interactions that may occur between pravastatin or rosuvastatin and other medications. Some drugs can make the statin less effective. For example, bile acid sequestrants can make pravastatin less effective, while antacids can make rosuvastatin less effective. Some drugs can make you more likely to experience myopathy (muscle weakness and pain) and rhabdomyolysis (a serious condition where muscle breakdown releases harmful substances into the bloodstream, which may cause kidney damage) when combined with a statin. Gemfibrozil and colchicine are two examples of such drugs.

However, this is not a full list of every possible interaction. Consult your healthcare provider for more information about drug interactions and how they may affect you. 

Compare pravastatin vs. rosuvastatin drug interactions
Drug	Drug class	Interacts with pravastatin?	Interacts with rosuvastatin?
Fenofibrate  Gemfibrozil	Fibrates	Yes	Yes
Cyclosporine	Immunosuppressant	Yes	Yes
Clarithromycin  Erythromycin	Macrolide antibiotics	Yes	Yes
Colchicine	Anti-gout medicine	Yes	Yes
Cholestyramine  Colestipol	Bile acid sequestrants	Yes	No
Febuxostat	Anti-gout medicine	No	Yes
Maalox Mylanta	Aluminum and magnesium antacids	No	Yes
Warfarin	Blood thinner	Yes	Yes

 

Pravastatin and rosuvastatin drug warnings

Pravastatin and rosuvastatin have some warnings and considerations to be aware of. These drugs are not safe or appropriate for everyone. You should not take pravastatin or rosuvastatin if you are allergic to any ingredient in the medication. Also, you should not take these medicines if you are in acute liver failure or have decompensated cirrhosis (a severe stage of liver disease). If you are pregnant, planning to become pregnant, or breastfeeding, you should not take pravastatin or rosuvastatin. 

Before taking pravastatin or rosuvastatin, be sure to tell your healthcare provider about your medical and family history and any conditions you currently have. This can help your provider determine the safest and most appropriate treatment for you. Be sure to mention if you have or have had any unexplained muscle aches or weakness, kidney or liver problems, or thyroid problems. Also, discuss alcohol consumption with your healthcare provider. 

Serious adverse events that may occur from either drug include:

• Muscle problems: Tell your healthcare provider if you have muscle pain, tenderness, or weakness, especially if you also have a fever or feel unusually tired. Muscle problems can be serious in some people, and in rare cases, may cause kidney damage that can lead to death. 
• Liver problems: Tell your healthcare provider if you have unusual tiredness or weakness, appetite loss, upper stomach pain, dark urine, or yellowing of the skin and whites of the eyes. Your healthcare provider will monitor your liver enzymes during treatment. 
• Protein or blood in the urine: Tell your healthcare provider if you have blood in your urine.
• Increased blood sugar levels: Statins may increase your blood sugar levels. Your healthcare provider will tell you if you should monitor your blood sugar. 

Pravastatin and rosuvastatin are both commonly prescribed to manage your cholesterol levels. Your healthcare provider, such as your primary care provider or cardiologist can decide which medicine is best for you, based on considerations such as your medical history, family history, and risk factors. If cost is a factor in choosing your statin, remember that a SingleCare prescription discount card can help you save on your prescription and refills.