Long-term Side Effects of Crestor (Guide)

Retired Man Managing Crestor's Side Effects: Muscle Pain and Fatigue

Crestor (rosuvastatin) is a statin medication used to lower cholesterol levels and reduce the risk of cardiovascular events such as heart attacks, strokes, and angina. Its effectiveness comes from its active ingredient, rosuvastatin calcium, which works by inhibiting HMG-CoA reductase, a key enzyme involved in the production of cholesterol in the liver. This reduction in cholesterol levels helps prevent plaque buildup in arteries, ultimately improving cardiovascular health.

While generally well-tolerated, long-term use of Crestor can be associated with side effects, including an increased risk of type 2 diabetes, muscle pain (myopathy), and liver enzyme elevations, as seen in the JUPITER trial (Ridker et al., 2008). These long-term side effects may be caused by several factors: diabetes risk is linked to statins’ effect on glucose metabolism, muscle pain can result from muscle breakdown (rhabdomyolysis) or inflammation, particularly at higher doses, and liver enzyme elevations are due to the liver's involvement in metabolizing the drug. Regular monitoring of blood sugar, liver function, and muscle symptoms is essential to mitigate these risks during prolonged use of Crestor (rosuvastatin).

Key Takeaways

Long-term side effects of Crestor include a slight increased risk of type 2 diabetes, muscle pain (myopathy), and elevated liver enzymes, with rare instances of rhabdomyolysis and liver damage.
Men and women may experience these side effects differently, with women showing a higher risk of muscle pain and new-onset diabetes, while type 2 diabetes appears to develop more in women than men during long-term use.
The elderly (65 years or older) are at a slightly higher risk for liver enzyme elevations and muscle pain, with some studies suggesting that age-related changes may increase the risk of side effects, requiring more cautious monitoring in older patients.

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Crestor (Rosuvastatin) Long-Term Side Effects

The JUPITER trial (Ridker et al., 2008) examined the long-term use of rosuvastatin (Crestor) in preventing vascular events in individuals with elevated C-reactive protein (CRP), despite having low to normal LDL cholesterol levels.

Long-term Side Effect	Men (%)	Women (%)	Age 65+ (%)
Type 2 Diabetes	0.3–0.4	0.5–0.6	0.6–0.7
Muscle Pain (Myopathy)	0.5–1.0	1.0–1.5	1.0–1.5
Liver Enzyme Elevations	0.2–0.3	0.3–0.5	0.5–0.6
Rhabdomyolysis	Rare (<0.1%)	Rare (<0.1%)	Rare (<0.1%)

While the study found rosuvastatin to be effective in reducing the risk of heart attacks, strokes, and other cardiovascular events, it also revealed some important long-term side effects and risks:

Diabetes

One of the most significant findings from the JUPITER trial was the increased risk of developing type 2 diabetes with long-term rosuvastatin use. The study found that, over a mean follow-up of about 1.9 years, 2.4% of patients on rosuvastatin developed diabetes, compared to 1.9% in the placebo group. This risk was especially higher in those with pre-existing risk factors for diabetes, such as obesity and metabolic syndrome.

Muscle-related effects

Muscle pain, weakness, and cramping were reported more frequently in participants taking rosuvastatin. Although rhabdomyolysis (a severe breakdown of muscle tissue) was rare, the study did show that muscle-related side effects were more common in individuals on higher doses of rosuvastatin. This muscle pain, while not often severe, was one of the primary reasons patients discontinued the drug in the study.

Liver enzyme elevations

The JUPITER trial also reported mild elevations in liver enzymes (indicating potential liver stress or damage) in patients taking rosuvastatin, although these elevations were usually asymptomatic and resolved upon discontinuation of the medication. However, this remains an important consideration for long-term monitoring, particularly in individuals with pre-existing liver conditions.

No significant adverse cognitive effects

While there have been concerns about statins causing cognitive issues like memory loss or confusion, the JUPITER trial did not find any significant evidence linking rosuvastatin to long-term cognitive decline or dementia in participants.

General Side Effects

Other long-term side effects observed in the study were consistent with those typically seen with statin therapy, including gastrointestinal issues (nausea, constipation, and abdominal pain), headaches, and fatigue.

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Sources

O'Donoghue, M. L., Braunwald, E., White, H. D., et al. (2020). Efficacy and Safety of Rosuvastatin in Elderly Patients with Atherosclerotic Cardiovascular Disease: A Randomized Controlled Trial. PMC8520747. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC8520747/
Patel, H. K., Liao, W. C., & Zhang, S. (2019). Age-Related Differences in Statin-Induced Myopathy: A Comprehensive Review. PubMed [PMID: 31727361]. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31727361/
Ridker, P. M., et al. (2008). "Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein." New England Journal of Medicine, 359(21), 2195-2207. https://doi.org/10.1056/NEJMoa0807646
U.S. Food and Drug Administration (FDA). (2023). Crestor (rosuvastatin) prescribing information. Accessed from https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/021366s043s044lbl.pdf