Pravastatin vs Rosuvastatin

[tominboise]

I had my annual physical yesterday with a fast and blood draw. To set the baseline, I am a 65yo Male in decent shape, exercise (walk, ride mountain bike, run stair sets, lift weights) and have been on Pravastatin for about 15 years (20mg tab). My history going back 5 years.




The doctor has suggested going to Rosuvastatin to get the Chol down. I don't really want to and am not sure if I should just ignore his suggestion or take it. I lost a fair amount of what I call "pop" in my legs when I went on the Pravastatin. I am active and don't want worse side effects. Of course, I don't want open heart bypass surgery either.
Family history - Mother had heart attack and bypass at about age 65. She was a smoker. Father never had heart issues. One sister, age 75, that has had a mild heart attack a few years ago; One sister, age 70, who has super low cholesterol and other numbers as she is very strict on her diet, doesn't eat sugar, etc.

So, I know it comes down to genetics and random luck, but any thoughts either way?

 

[scrabbler1]

I don't know about Pravastatin, but earlier this year my doctor switched me from Simvastatin (which I had been taking for the last 10 years) to Rosuvastatin and I had a sharp drop in Cholesterol.

 

[Koolau]

I had my annual physical yesterday with a fast and blood draw. To set the baseline, I am a 65yo Male in decent shape, exercise (walk, ride mountain bike, run stair sets, lift weights) and have been on Pravastatin for about 15 years (20mg tab). My history going back 5 years.


View attachment 60108

The doctor has suggested going to Rosuvastatin to get the Chol down. I don't really want to and am not sure if I should just ignore his suggestion or take it. I lost a fair amount of what I call "pop" in my legs when I went on the Pravastatin. I am active and don't want worse side effects. Of course, I don't want open heart bypass surgery either.
Family history - Mother had heart attack and bypass at about age 65. She was a smoker. Father never had heart issues. One sister, age 75, that has had a mild heart attack a few years ago; One sister, age 70, who has super low cholesterol and other numbers as she is very strict on her diet, doesn't eat sugar, etc.

So, I know it comes down to genetics and random luck, but any thoughts either way?

I always say it when this discussion comes up: You (or someone) is paying your doctor a lot of money to advise you on your health. If you're not going to take her advice, you likely should save the money. I understand that all meds have side effects (otherwise - they have NO beneficial effects). I'd suggest w*rking with your doc to find a drug that w*rks and has limited side effects for you.

It takes a while to play the drug roulette sometimes, but hopefully worth the effort. End of sermon.

All the best to you as you and your doctor address your health.

 

[joesxm3]

I would switch to Rosuvastatin, 10mg or 5mg.

Your numbers seem high (to me) for being on a statin. I wonder if you might be like me where my high cholesterol is due to a defect in my absorption pathway rather than from the liver synthesizing too much.

You might ask to try 10mg ezetimibe which blocks cholesterol absorption in the intestine.

Modern lipidology seems to prefer combination therapy of ezetimibe plus a statin over high dose statin, mainly due to avoiding side effects.

Boston Heart Diagnostics has a Cholesterol Balance Test that can identify if Ezetimibe might help you, but you can also just try it an see. This test suggested I would respond to Ezetimibe.

My LDL-C was 170. With 10mg Rosuvastatin it dropped to 107. I refused 20mg Rosuvastatin and asked to add 10mg Ezetimibe and had a unusually large response, dropping to 27 (normal people would drop about 30 points). I cut back to 5mg Rosuvastatin and last blood draw was LDL-C 36.

So my advice (no medical credentials) is to switch to Rosuvastatin, but not more than 10mg. See what happens. If not low enough add 10mg Ezetimibe and see how you respond to the combination therapy.

Regarding your leg comment, are you taking Coenzyme Q10? Statins deplete that which muscles need.

 

[tominboise]

I would switch to Rosuvastatin, 10mg or 5mg.

Your numbers seem high (to me) for being on a statin. I wonder if you might be like me where my high cholesterol is due to a defect in my absorption pathway rather than from the liver synthesizing too much.

You might ask to try 10mg ezetimibe which blocks cholesterol absorption in the intestine.

Modern lipidology seems to prefer combination therapy of ezetimibe plus a statin over high dose statin, mainly due to avoiding side effects.

Boston Heart Diagnostics has a Cholesterol Balance Test that can identify if Ezetimibe might help you, but you can also just try it an see. This test suggested I would respond to Ezetimibe.

My LDL-C was 170. With 10mg Rosuvastatin it dropped to 107. I refused 20mg Rosuvastatin and asked to add 10mg Ezetimibe and had a unusually large response, dropping to 27 (normal people would drop about 30 points). I cut back to 5mg Rosuvastatin and last blood draw was LDL-C 36.

So my advice (no medical credentials) is to switch to Rosuvastatin, but not more than 10mg. See what happens. If not low enough add 10mg Ezetimibe and see how you respond to the combination therapy.

Regarding your leg comment, are you taking Coenzyme Q10? Statins deplete that which muscles need.

Good advice, thank you. I am taking COQ10 daily and have been for a long time. I will do some research and talk with my doc about Ezetimibe and Rosuvastatin, dosage amounts, etc

 

[Irishgirlyc58]

I just switched from 20 mg Pravastatin to 5 mg Rosuvastatin about a month ago. Statins tend to upset my GI system so I'm trying this. It seems fine-some minor muscle twitches but those seem to have gone away. If this one bothers my stomach like the others I'm going to ask for Repatha. The pharmacist told me that she had a horrible experience with muscle cramps and started taking Repatha and her numbers are great.

Your numbers on Pravastatin look like my numbers before medication when my doctor told me that my cholesterol numbers were making him nervous!

 

[joesxm3]

Good advice, thank you. I am taking COQ10 daily and have been for a long time. I will do some research and talk with my doc about Ezetimibe and Rosuvastatin, dosage amounts, etc

Depending on how deep you want to go on the research, you should look for interviews with Dr. Thomas Dayspring on You Tube.

I hope one of these will get you near his more recent comments on combination therapy.

This is the third part of a very deep interview

 

[mountainsoft]

My wife was on Atorvastatin for a while but had issues with muscle cramps. She switched to Rosuvastatin and hasn't had any issues since then.

My cardiologist just started me on Rosuvastatin. I specifically asked for it as my wife had better results with it and he commented it was a good one. I've only been on it 3-4 days so far, but it's hard to believe that tiny little 5mg pill would have any affect on my 225 pound body. But, we'll see what happens when I get blood work in a couple months.

My last lipid test was Jan 2024. At that time my cholesterol was 193, HDL was 53 (best I've ever been), and LDL was 129. Hopefully the Rosuvastatin will improve those numbers.

 

[TripleLindy]

I started taking Rosuvastatin 5mg earlier this year. No side effects for me at all and I’m very active. Lots of golf (walking the course), pickleball, yard work, playing with grandkids, etc.

As far as taking doc’s advice, I also resisted, but more so because of mixed messages. He’d tell me that he didn’t want to manage to a number and that if all other tests, like calcium, were ok, then he didn’t want me on a statin just to manage cholesterol number. All other tests were stellar (full cardiac work up) yet he still prescribed the statin. I finally decided to give it a go.

 

[tominboise]

I messaged with my Dr and we decided to try 5mg Rosuvastatin for 6 weeks and do a Lipid panel. If that works, great. If not, we will try adding Ezetimbe and see what happens.

So I will try the new medicine through the holidays, which should be the toughest test.

 

[Surewhitey]

DWs kidneys reacted badly to 10mg Rosuvastatin. To the point of 3rd stage kidney disease. She took herself off it & they went back to normal.

I'm on 10mg also with no side effects for ~6 years now. My success has a lot to do with carb intake and weight. 175-180 lbs is a good place for me. Here's my 10 yr journey...

 

[joesxm3]

I messaged with my Dr and we decided to try 5mg Rosuvastatin for 6 weeks and do a Lipid panel. If that works, great. If not, we will try adding Ezetimbe and see what happens.

So I will try the new medicine through the holidays, which should be the toughest test.

Sounds like your doctor is up to date on the latest thinking. I am happy that he agreed to the suggestion.

 

[freedom2022]

I take 5mg Rosuvastatin daily. I don't feel any side effect physically. Any side effects that I should be aware of?

 

[mountainsoft]

When do you take your Rosuvastatin? My prescription says to take it nightly, but everything I've read said it can be taken any time of day. I take mine in the morning with my other meds, as it's just more convenient.

 

[joesxm3]

You need to Rosuvastatin 2 hours away from magnesium or antacids because they interfere with absorption.

 

[mountainsoft]

You need to Rosuvastatin 2 hours away from magnesium or antacids because they interfere with absorption.

Don't take either, so I'm good there...

 

[TripleLindy]

Since this thread seems to have run its course, I have another question regarding Rosuvastatin.

I’m on a 5mg dose and the pills were super small, round pills in my first prescription. I recently had the prescription refilled and the pills are now a little larger and oval shaped, with SG on one side and 116 on the other. Google shows that the manufacturer is ScieGen.

I started having bouts of nausea and think it began with the refill. I didn’t have any side effects at all with the other pill. I don’t know who that manufacturer was since I don’t any more of them.

Anyone else have any issues with the SG 116 version of this med?

 

[Koolau]

Since this thread seems to have run its course, I have another question regarding Rosuvastatin.

I’m on a 5mg dose and the pills were super small, round pills in my first prescription. I recently had the prescription refilled and the pills are now a little larger and oval shaped, with SG on one side and 116 on the other. Google shows that the manufacturer is ScieGen.

I started having bouts of nausea and think it began with the refill. I didn’t have any side effects at all with the other pill. I don’t know who that manufacturer was since I don’t any more of them.

Anyone else have any issues with the SG 116 version of this med?

Have you checked back with the prescribing doctor. Hopefully s/he will know about this side effect and offer advice.


The usual advice is to take meds with food, but that might be contraindicated which is why I'd suggest a call to the doctor with specific discussion of symptoms and the source of the pill, etc. Worth a quick call - or if you have a portal, it's even better.


Best luck!

 

[TripleLindy]

Have you checked back with the prescribing doctor. Hopefully s/he will know about this side effect and offer advice.


The usual advice is to take meds with food, but that might be contraindicated which is why I'd suggest a call to the doctor with specific discussion of symptoms and the source of the pill, etc. Worth a quick call - or if you have a portal, it's even better.


Best luck!

Thanks. A Google search revealed that nausea was the most commonly reported side effect of the ScieGen drug. I called the pharmacy and they have the pill I was originally given, so they’re refilling the prescription with that one.

 

[Koolau]

Thanks. A Google search revealed that nausea was the most commonly reported side effect of the ScieGen drug. I called the pharmacy and they have the pill I was originally given, so they’re refilling the prescription with that one.

Fantastic! Glad you thought to call them first.

 

[Dalton]

For what it's wort to the OP, I switched from Pravastatin to Rosuvastatin in '18. My complaint was muscle aches and cramping. I was trying to increase my fitness on my mountain bike (and 2018 was my 3rd year back on the bike), and in retrospect I was usually overdoing the intensity, so it wasn't ever clear if the Pravastatin was causing any of my issues or not, but my cardiologist suggested trying Rosuvastatin. I've been happy with it, I still ride my bike, and my legs are pretty much always sore, but I still ride pretty hard and have more than doubled the volume, and I'm faster and stronger than I ever have been. I don't have any reason to believe that any of the statins were the cause of pain and my lipid panel and liver numbers are all good.