Key takeaways
Rosuvastatin is a statin medication with common side effects such as muscle aches, headache, tiredness, and abdominal pain.
Long-term side effects of rosuvastatin include muscle pain, liver enzyme and kidney function changes, and elevated blood sugar.
Side effects of rosuvastatin are typically mild and temporary, but it’s important to regularly see your healthcare provider for monitoring and treatment adjustments as needed.
Rosuvastatin (generic for Crestor) is a prescription statin used to lower cholesterol and reduce the risk of cardiovascular events, such as heart attack and stroke. It’s also one of the most-filled prescriptions among SingleCare users. Because statin treatment is often long-term, patients may have questions about how rosuvastatin affects the body over time. This article covers common and serious side effects of rosuvastatin, possible long-term risks, factors that can increase the risk of side effects, and what to know about its safety with long-term use.
What are the long-term side effects of rosuvastatin?
Rosuvastatin is generally used long-term, and some side effects and health changes may develop or persist during treatment. According to its prescribing information, potential risks to consider with ongoing rosuvastatin use include:
- Muscle problems, including myopathy and, rarely, rhabdomyolysis
- Liver enzyme elevations and, rarely, liver injury
- Protein or blood in the urine
- Increases in hemoglobin A1c (HbA1c) and fasting blood glucose levels
Protein and blood in the urine have been reported more often with the 40 mg dose. These changes are generally temporary and have not been associated with worsening kidney function.
“The long-term side effects are less common than the short-term side effects,” says James Lyons, MD, clinical adviser at Epiphany Wellness. “For example, certain individuals [may] experience persistent muscle symptoms. In addition, there tends to be a slightly increased risk of developing Type 2 diabetes in those individuals who are already at risk, primarily due to the statin’s effect on blood sugar,” Dr. Lyons says.
Patients taking rosuvastatin should follow up regularly with their healthcare providers to monitor treatment. Lipid levels are typically checked periodically, while other tests, such as liver enzyme or blood glucose tests, may be recommended based on a patient’s health history, symptoms, and risk factors.
Common side effects of rosuvastatin
According to clinical trial results reported in the drug’s prescribing information, the most common side effects of rosuvastatin include headache (5.5% of subjects taking all doses), nausea (3.4%), muscle pain (myalgia, 2.8%), weakness (asthenia, 2.7%), and constipation (2.4%).
Other, less commonly reported side effects may include:
- Abdominal pain
- Dizziness
- Allergic reaction, including rash, itching, and swelling
Laboratory abnormalities reported with rosuvastatin include:
- Protein or blood in urine
- Elevated levels of creatine phosphokinase (CPK), a marker for muscle breakdown
- Elevated levels of glucose in blood
- Elevated liver enzyme tests
- Thyroid function abnormalities
Common rosuvastatin side effects are generally mild and may improve as the body adjusts to the medication. “[Statins] tend to cause relatively mild and short-lived side effects,” says Shernell Surratt-Gary, DO, in Scottsville, Kentucky. “These can include transient muscle soreness, joint discomfort, fatigue, and minor gastrointestinal issues within the initial week or two after beginning therapy. Some individuals will not experience any side effects,” she says.
Serious side effects of rosuvastatin
Rosuvastatin’s prescribing information includes warnings about serious muscle and liver problems. These include rhabdomyolysis, immune-mediated necrotizing myopathy (IMNM, a rare autoimmune condition that causes muscle damage), and, rarely, serious liver injury. Other warnings include protein or blood in the urine and increases in blood glucose and HbA1c, which may contribute to the development of Type 2 diabetes.
“While serious complications due to rosuvastatin use are extremely rare, they can occur,” Dr. Surratt-Gary says. “One serious complication is severe muscle deterioration known as rhabdomyolysis,” she shares. Rhabdomyolysis is when damaged muscle tissue releases protein and electrolytes into the bloodstream. This process can lead to potentially dangerous consequences, including nausea, vomiting, heart rhythm changes, seizures, kidney damage or acute kidney failure, permanent disability, or death. “Therefore, do not ignore persistent muscle weakness, extreme pain, or dark colored urine,” says Dr. Surratt-Gary.
Rosuvastatin side effects in females
The risk of some statin side effects may differ between females and males. Being female is a risk factor for statin intolerance, and women are more likely than men to stop or switch statins because of side effects. Studies have also suggested that women are more likely to receive lower-intensity statin treatment, have lower adherence to treatment, and report greater dissatisfaction with their cholesterol treatment.
Women may also be at greater risk of statin-associated muscle symptoms and new-onset diabetes. In one study, women had about a 1.5 times greater risk of myopathy than men. Another study found that women taking statins had a 1.5 times higher risk of developing Type 2 diabetes than women who were not taking statins. Older age may further increase the risk of statin intolerance and certain side effects.
Differences in statin side effect risk between women and men may be related to differences in kidney function, body composition, and drug metabolism. A 2020 analysis of FDA adverse-event reports also identified possible safety signals involving uterine fibroids, endometrial thickening, and cervical cancer among women taking rosuvastatin. However, the study found statistical associations only and did not establish that rosuvastatin caused these conditions, so more research is needed.
As for rosuvastatin and Crestor side effects in men specifically, one study found that rosuvastatin may decrease free testosterone levels in men with Type 2 diabetes after six months without affecting sexual function. Another study found that rosuvastatin had no significant effect on erectile dysfunction (ED), while atorvastatin was associated with worsening ED symptoms in that study.
Side effects of rosuvastatin in older adults
“Older adults are generally considered to be at a higher risk for experiencing muscle-related side effects from rosuvastatin use when compared to younger adults. This is largely due to age-related declines in muscle mass and renal function,” Dr. Lyons explains.
Though clinical studies of rosuvastatin did not show overall differences in safety or efficacy in adults 65 and older, advanced age is considered a risk factor for rosuvastatin-associated myopathy and rhabdomyolysis. However, recent evidence has not found higher rates of statin-associated muscle symptoms in adults over 75 compared with younger adults. Statins may also slightly increase the risk of Type 2 diabetes, particularly in people who already have risk factors. Healthcare providers may adjust treatment based on age and other health conditions.
The benefits and risks of statin treatment also depend on a person’s cardiovascular risk and age:
- The United States Preventive Services Task Force (USPSTF) recommends statins for certain adults ages 40 to 75 who have cardiovascular risk factors and an increased risk of CVD, but says there is not enough evidence to recommend for or against starting a statin for primary prevention in adults 76 and older.
- The 2026 American College of Cardiology (ACC) and American Heart Association (AHA) guidelines recommend considering statin therapy for primary prevention in adults ages 30 to 79 based on factors such as LDL cholesterol levels and estimated cardiovascular risk.
- For adults over 75 without established ASCVD, the American Geriatrics Society (AGS) and National Lipid Association conclude that available evidence suggests the cardiovascular benefits of statins generally outweigh potential risks such as muscle symptoms and new-onset Type 2 diabetes.
However, treatment decisions should be individualized because evidence in this age group remains more limited.
Rosuvastatin side effects by dose
In general, the risk of some side effects increases with higher doses of rosuvastatin. The usual adult dosage ranges from 5–40 mg daily. Rosuvastatin 5–10 mg is considered a moderate-intensity dose, while 20–40 mg is considered a high-intensity dose. According to the 2026 ACC/AHA guidelines, moderate-intensity statin therapy may be appropriate for people with a borderline (3% to less than 5%) 10-year ASCVD risk, while higher-risk patients may need moderate- or high-intensity therapy to lower LDL cholesterol (LDL-C).
Compare rosuvastatin (Crestor) side effects by dose |
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|---|---|---|
| Dose | Typical use | Notable side effect considerations |
| 5 mg (rosuvastatin calcium 5 mg tab) | Lower LDL-C by 30–49%; patients with kidney impairment (who require lower doses) or children with heterozygous familial hypercholesterolemia | Headache, nausea, muscle pain |
| 10 mg (rosuvastatin 10 mg tablets) | Lower LDL-C by 30–49%; patients with kidney impairment (who require lower doses) or children with heterozygous familial hypercholesterolemia | Headache, nausea, tiredness |
| 20 mg | Lower LDL-C by 50% or more; children 7 or older with homozygous familial hypercholesterolemia | Nausea, muscle pain, tiredness, constipation, joint pain |
| 40 mg | Lower LDL-C by 50% or more | Headache, constipation, muscle pain, joint pain, dizziness; higher risk of myopathy, with protein or blood in the urine reported more often at this dose |
Rosuvastatin drug interactions
Rosuvastatin has quite a few drug interactions that can increase the risk of myopathy and rhabdomyolysis, decrease the efficacy of the statin, or change the way certain drugs work. Examples of rosuvastatin’s drug interactions include:
- Gemfibrozil: Increases rosuvastatin levels and the risk of myopathy and rhabdomyolysis. The combination should generally be avoided. If they must be used together, rosuvastatin should be started at 5 mg and should not exceed 10 mg daily.
- Cyclosporine: Increases rosuvastatin levels and the risk of myopathy and rhabdomyolysis, and the combination should generally be avoided. If they must be used together, patients taking cyclosporine should not take more than 5 mg of rosuvastatin daily.
- Antiviral medications such as lopinavir-ritonavir and ledipasvir/sofosbuvir: Increase rosuvastatin levels and the risk of muscle-related side effects. Patients on certain antiviral medications shouldn’t take more than 10 mg of rosuvastatin daily.
- Colchicine: Increases the risk of myopathy and rhabdomyolysis.
- Antacids: Antacids containing aluminum and magnesium hydroxide can decrease the levels of rosuvastatin by 50%. Patients taking both should take Crestor at least two hours before the antacid.
- Warfarin: Rosuvastatin increases the time it takes for blood to clot in people taking warfarin. People taking both warfarin and rosuvastatin will require careful monitoring.
You may have heard that people taking certain statins should avoid grapefruit juice because it can increase levels of the drug in the blood. However, this interaction applies to only certain statins. Rosuvastatin does not have a significant interaction with grapefruit juice.
For a full interaction list, read our article on rosuvastatin interactions to avoid.
Always discuss your full list of medications, supplements, and over-the-counter medications with your healthcare provider so they can make recommendations that are safe and effective for you.
Who should not take rosuvastatin?
People who have acute liver failure or decompensated cirrhosis, or who are allergic to rosuvastatin or any of its ingredients, shouldn’t take the drug. Healthcare providers may also weigh the risks and benefits of rosuvastatin treatment and adjust the dosage in people with kidney problems or other factors that increase the risk of side effects.
In 2021, the FDA requested a change to statin prescribing labels regarding their use during pregnancy. Statins such as Crestor were previously contraindicated during pregnancy. The FDA removed that blanket contraindication because some patients at very high risk of cardiovascular events may benefit from continued treatment. However, the FDA still recommends discontinuing statins in most pregnant patients and discussing the risks and benefits with a healthcare provider. Breastfeeding is not recommended for patients who need to continue taking a statin.
Though rosuvastatin can increase the risk of new-onset Type 2 diabetes, people who already have diabetes may still take the drug. “Individuals with pre-existing diabetes do not need to discontinue statin use based on concerns regarding blood sugar control. Instead, they should continue to monitor their glucose levels regularly,” says Dr. Lyons.
How to reduce the risk of rosuvastatin side effects
According to the healthcare providers we interviewed, ways to reduce the risk of rosuvastatin side effects include:
- Take the drug exactly as directed by your clinician, including taking rosuvastatin at about the same time every day.
- Review your full list of prescription and non-prescription drugs or supplements that you currently take with your healthcare provider to screen for any interactions.
- Limit your intake of alcoholic beverages.
- Report any new or worsening muscle aches or tenderness immediately to your healthcare provider.
- Regularly follow up with your healthcare provider for monitoring.
Besides female sex and older age, other factors that may increase the risk of statin-associated muscle symptoms include kidney or liver disease, uncontrolled hypothyroidism, vitamin D deficiency, low body weight or BMI, Asian ancestry, major surgery, excessive alcohol use, and strenuous physical activity.
If you are taking rosuvastatin and suspect side effects, don’t stop taking it on your own. Consult with your healthcare provider to evaluate and adjust your treatment accordingly.
Bottom line: Is rosuvastatin safe?
Rosuvastatin is a safe drug when prescribed by a licensed healthcare provider and taken as directed. Common side effects are typically mild and temporary. Long-term effects may include persistent muscle problems, changes in liver enzymes or kidney function, and elevated blood sugar levels. Discussing your full medical history, in addition to a full review of your medications and supplements, is one way to minimize the risk of side effects when taking rosuvastatin. Those experiencing side effects should consult with their healthcare provider for monitoring, dose adjustments, or to discuss alternative treatments. Healthcare providers will consider your full health history and cardiovascular risk profile to weigh the benefits and risks of starting, continuing, or adjusting your rosuvastatin therapy.
Expert takeaway
“Rosuvastatin is one of the most prescribed statin drugs, and in my experience, people tend to tolerate it well,” says Karen Berger, MD, member of the SingleCare Medical Review Board. “It’s important to communicate any concerns with your healthcare provider.”
Frequently asked questions
How long does rosuvastatin stay in your system?
Rosuvastatin stays in your system for about three to four days after your last dose, but this timeline can vary based on factors such as kidney function, liver function, age, and genetics.
Is Crestor safe long-term?
Yes, Crestor is generally safe long-term when prescribed by a licensed healthcare professional and taken as directed.
Does rosuvastatin cause weight gain?
Weight gain is not listed as a side effect of rosuvastatin, but there may be indirect ways the medication may contribute to weight gain in certain patients.
The SingleCare prices in this article are the most accurate at the time of publishing in ZIP code 23666 as of Oct. 15, 2026. Prices vary by pharmacy. Visit our coupon page for updated drug prices at pharmacies near you.
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- Rosuvastatin decreases testosterone levels but not sexual function in men with type 2 diabetes, Diabetes Research and Clinical Practice (2016)
- The effect of rosuvastatin and atorvastatin on erectile dysfunction in hypercholesterolaemic patients, Polish Heart Journal Kardiologia Polska (2014)
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- Statin use for the primary prevention of cardiovascular disease in adults: Preventive medication, USPSTF (2022)
- 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of dyslipidemia: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines, JACC Journals (2026)
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Featured experts
- James Lyons, MD, clinical adviser at Epiphany Wellness
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