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What are the long-term side effects of rosuvastatin?

Rosuvastatin is a medication prescribed for long-term use. The side effects are typically mild and resolve if you stop taking the medication.
Taneia Surles, MPH
By | May 7, 2025 Medically reviewed by Samantha Marr, DNP, APN, AGPCNP-BC, CCRN
Spilled Rx bottle of white tablets: What are the long-term side effects of rosuvastatin?

Key takeaways

  • Rosuvastatin is a prescription medication used to lower blood cholesterol levels and reduce the risk of heart disease, heart attack, and stroke, which can be taken with little to no risk of long-term side effects.

  • Common side effects of rosuvastatin include unexplained muscle pain, tiredness, headache, nausea, or abdominal pain. However, these side effects are generally mild and resolve if you stop taking the medication.

  • In rare cases, serious side effects such as liver damage, kidney disease, and rhabdomyolysis may occur and can be life-threatening.

  • Report any unusual symptoms such as darkened urine, yellowing of the skin or eyes, loss of appetite, or extreme fatigue and weakness to your healthcare provider immediately, as well as disclose any medications or supplements you’re currently taking that could interact with rosuvastatin.

In this article:

Rosuvastatin calcium (brand name Crestor) is an HMG-CoA reductase inhibitor, or statin, used to treat high cholesterol levels by lowering bad cholesterol (LDL) and triglyceride (fat) levels, while raising good cholesterol (HDL) levels. This medication is taken daily and is typically prescribed indefinitely to people with high cholesterol to reduce the risk of heart attack or stroke. While rosuvastatin does not cause long-term side effects, it’s important to consult a healthcare provider to discuss possible risk factors and medications you’re currently taking that may interact with rosuvastatin. 

Common side effects of rosuvastatin

If you have high LDL cholesterol levels, your healthcare provider will likely recommend that you start taking a statin. Statins are medications that block HMG-CoA enzymes in the liver, lowering bad cholesterol and triglyceride levels while raising HDL. Statins are essential because they can significantly reduce the chance of major cardiovascular events like heart attacks and strokes, which can lead to death.

Many people take rosuvastatin daily, and the medication is known to be generally well-tolerated. However, as with any prescription medication, there can be side effects. 

Some of the most common side effects of rosuvastatin to take note of include the following:

  • Muscle aches and pains
  • Joint pain
  • Mild increase in blood glucose levels
  • Mild increase in liver enzymes (AST, ALT)
  • Brain fog or mild confusion
  • Insomnia
  • Reduced energy
  • Allergic reaction or hives
  • Headache
  • Dizziness
  • Nausea
  • Abdominal pain
  • Constipation

Craig D. Robison, MD, a board-certified cardiologist of Tri-City Cardiology of Mesa, Arizona, says that rosuvastatin’s most common side effects are muscle aches and pains. These symptoms occur in roughly 10% of people taking rosuvastatin and are the primary reason why people decide to stop taking rosuvastatin. In these instances, your healthcare provider may switch you to a different statin medication that doesn’t cause these side effects, or opt to try alternate-day dosing (every other day) instead of daily dosing.

As you take this medication, be sure to make regular visits to your healthcare provider. During these visits, you can discuss changes in your health or new symptoms and receive regular lab testing and exams to help mitigate or even prevent the development of side effects while taking statin medications.

Serious side effects

While it is extremely rare to experience severe side effects while taking rosuvastatin, it can happen, and it’s important to be aware of the signs to look out for. This is especially true if you’re just beginning treatment. While these side effects are relatively uncommon, they can worsen with time, so it’s crucial that they’re caught and treated early.

Serious side effects of rosuvastatin may include:

  • Myopathy (muscle damage and disease)
  • Liver damage or liver disease
  • Kidney dysfunction
  • Pancreatitis
  • Diabetes

The most serious side effect that can occur while taking rosuvastatin is rhabdomyolysis. About one to four of every 10,000 people taking rosuvastatin will experience rhabdomyolysis. This rare but severe muscle disease causes muscles to break down and disintegrate, releasing toxic components of the muscle fibers into the bloodstream. This can lead to kidney damage and, in extreme cases, kidney failure, which can result in death.

The Food and Drug Administration (FDA) reports that while the cardiovascular benefits of rosuvastatin outweigh the risks, people should consult their healthcare provider regarding the risk of contraindications. It’s also important to note that the risk of increased blood sugar levels is possible. That being said, please contact your healthcare provider if you experience loss of appetite, upper abdominal pain, unusual fatigue or weakness, dark urine, or yellowing of the skin or eyes (jaundice).

Also, be sure to discuss any medications you’re currently taking with your healthcare provider before beginning rosuvastatin, as certain prescription medications, over-the-counter medications, and supplements may interact negatively and potentially cause adverse effects.

Medications that should not be taken with rosuvastatin include:

  • Gemfibrozil
  • Cyclosporine
  • Coumarin anticoagulants
  • Lopinavir/ritonavir or atazanavir/ritonavir
  • Lipid-lowering therapies
  • Colchicine
  • Antivirals such as Paxlovid
  • Blood thinners

What are the long-term side effects of rosuvastatin?

Rosuvastatin is a long-term medication, meaning that once it’s prescribed, people will usually take it daily for the rest of their lives to manage cholesterol levels. However, despite the statin being a long-term medication, there are few, if any, long-term side effects.

“There are no standard long-term side effects, and if side effects do occur, they generally will happen at the beginning when the medication is started,” says Charles German, MD, Director of Preventive Cardiology at MedStar Heart & Vascular Institute in Washington, D.C. “We have had statins since the 1980s and have decades worth of information to show that these medications are both safe and effective in the long-term.”

Dr. Robison adds that most side effects with rosuvastatin are reversible upon discontinuation of the medication. “There have not been any serious side effects from long-term use that have been identified,” he says.

However, as most side effects of rosuvastatin occur relatively soon after beginning treatment, it’s important that you let your healthcare provider know of any unusual symptoms you may experience after beginning rosuvastatin, such as dark urine, which can be a sign of kidney problems.

It’s also important to note that the risk of serious side effects can increase when taking higher doses of rosuvastatin. However, you can lower your risk and eventually get a lower dose of the medication by reducing your cholesterol levels. If you have high cholesterol, try to prioritize eating heart-healthy foods, avoiding saturated and trans fats, and instead choosing foods with lean protein and soluble fiber. Regular exercise can also help cholesterol levels, as physical movement raises HDL levels and helps promote weight loss, thus lowering dangerous cholesterol and potentially the dose of rosuvastatin.

Additionally, it is recommended that you seek to lower your cholesterol by quitting smoking and reducing or eliminating alcohol consumption.

Factors such as age, gender, family history, blood pressure, and other health conditions, such as thyroid disease, renal disease, or diabetes, can all play a role in determining whether or not a statin is the best option to lower your cholesterol levels. You should consult your healthcare provider to determine whether or not starting a statin is necessary for you.

What is the best statin to take with the least side effects?

There are currently seven different statin medications that the FDA has approved for lowering cholesterol. “Generally, rosuvastatin and atorvastatin are the most potent and effective,” Dr. German says. Both medications come with their unique side effects, and your healthcare provider should make the ultimate decision as to which statin is best for you to take.

Atorvastatin (brand name Lipitor) is associated with an increased risk of muscle pain and memory loss. It also has more known adverse drug interactions than rosuvastatin. Rosuvastatin, on the other hand, comes with an increased risk of liver problems and kidney disease.

As both prescription drugs are known to help prevent heart disease and adverse events such as heart attack or stroke, it’s best to consult with a healthcare provider to determine the best medication for you.

People who are pregnant, breastfeeding, have liver failure, or have known allergies to rosuvastatin are advised not to take this medication. Additionally, people of Asian descent or who have thyroid, liver, kidney, or muscle problems should discuss the best drug to tackle their risk of cardiovascular disease with a healthcare provider before starting rosuvastatin.

Aside from statins, other medications may also help lower your cholesterol levels. “Other cholesterol-lowering medications such as ezetimibe, bempedoic acid, or PCSK9 inhibitors have fewer side effects than rosuvastatin and other statin medications,” Dr. Robison explains. However, please note these medications may not lower cholesterol as well as a statin would, and may not be as helpful in preventing severe cardiac episodes. Also, some of these medications, specifically the PCSK9 inhibitors, are not as affordable as statins.

Statins are most frequently recommended for people between 40 and 75. However, recent studies show that they can also provide cardiovascular benefits to older adults.

The bottom line

Rosuvastatin is a medication prescribed to lower cholesterol and reduce the risk of serious cardiac events. Although the risk of long-term side effects when taking rosuvastatin is rare, you should always consult with your healthcare provider when beginning a new medication and report any unusual symptoms or side effects.

If rosuvastatin is not the best choice for your health, other statin medications, such as atorvastatin, may be better. Non-statin options, including PCSK9 inhibitors, ezetimibe, and bempedoic acid, are also available for those needing to lower their cholesterol levels. Lifestyle modifications, such as a healthy diet, regular exercise, and weight loss, are also important for improving your health, regardless of your choice of medication.

If you have questions or concerns about taking rosuvastatin, please consult a healthcare provider to determine the best medication for your needs and lifestyle.