Statins Compared: Lipitor vs. Crestor vs. Zocor vs. Pravachol

Statins are the most-prescribed drug class for lowering LDL ("bad") cholesterol and cutting cardiovascular risk. Four of them — atorvastatin, rosuvastatin, simvastatin, and pravastatin — account for most prescriptions, and all four are now generic. This guide compares their potency, side-effect profiles from the FDA labels, and real 2026 cash prices.

The practical takeaway: which statin you take should be driven by how much LDL reduction you need and your interaction profile, not by cost — because as generics, they are all cheap. Prices below come from our catalog cross-checked against the CMS NADAC file; clinical facts trace to FDA DailyMed labeling.

Potency: not all statins are equal

Statins are grouped by how much they lower LDL at a given dose. Rosuvastatin and atorvastatin are "high-intensity" capable, meaning they can lower LDL by 50% or more. Simvastatin is moderate-intensity, and pravastatin is generally low-to-moderate. A high-intensity statin is standard after a heart attack or stroke; a lower-intensity one may be enough for primary prevention.

Price comparison (30-day cash)

Generic atorvastatin is about $8 a month and simvastatin about $5 — both a fraction of their brand equivalents. Generic rosuvastatin at roughly $12 is the priciest of the four but still cheap.

Side effects and interactions

According to FDA labeling, the statin class shares a similar safety profile: muscle aches are the most common complaint, and rare liver-enzyme elevations warrant monitoring. Simvastatin has more drug interactions (it is metabolized by CYP3A4) and a dose ceiling of 40 mg for most patients due to muscle-toxicity risk. Pravastatin and rosuvastatin have fewer CYP3A4 interactions, which can make them preferable for patients on multiple medications.

Which one should you ask about?

• Need a big LDL drop (post-event, high risk): high-intensity atorvastatin or rosuvastatin.
• On many other drugs: rosuvastatin or pravastatin have fewer interactions.
• Moderate goal, cost-sensitive: generic simvastatin is effective and cheapest.
• Muscle symptoms on one statin: your prescriber may rotate to another.

Because all four are inexpensive generics, the decision is clinical. Bring your LDL goal and medication list to your prescriber. It is also worth knowing that guidelines increasingly favor starting with an adequately dosed statin rather than under-dosing an expensive brand — since the generic costs the same at any strength, there is no financial reason to settle for a weaker dose than your risk warrants. If you have had trouble tolerating one statin, do not assume the whole class is off-limits; many patients who report side effects on one agent tolerate another, and rotating between these cheap generics costs nothing extra.

How statins are dosed and monitored

Statins are usually taken once daily, and per FDA labeling most can be taken at any time of day, though shorter-acting agents like simvastatin are traditionally dosed in the evening. Prescribers typically start at a dose matched to your risk and LDL goal, then recheck a lipid panel after several weeks to confirm the response. If you are not at goal, the options are to increase the dose, switch to a higher-intensity statin, or add a non-statin agent such as ezetimibe. Because all four statins here are inexpensive generics, none of these adjustments meaningfully changes your cost.

Routine liver-enzyme testing is no longer required for most patients under current labeling, but your prescriber may check enzymes at baseline. Report unexplained, persistent muscle pain or weakness, since rare muscle toxicity is the side effect that most often prompts a dose change or a switch between statins.

What statins cost over a year

Because statins are lifelong medications for most people who take them, the annual cost is what really matters. At generic prices, a year of atorvastatin runs roughly $100, simvastatin around $65, and rosuvastatin about $145 — before any coupon or 90-day-supply savings. The equivalent brand products would cost thousands of dollars a year for no added benefit. Choosing a 90-day supply through a low-cost channel can push the yearly total even lower, which is why the branded versions are almost never the rational choice once an AB-rated generic exists.

If you are ever quoted a brand price for one of these statins, that is usually a sign the pharmacy filled the branded product when a generic substitution was available. Ask the pharmacist directly whether the generic was dispensed, and if not, why. In most states a pharmacist can substitute an AB-rated generic unless the prescriber specifically wrote "dispense as written." A single question at the counter can be the difference between an $8 fill and a $250 one for the identical therapy.

How BetterBuyRx helps

BetterBuyRx shows the lowest verified cash price for each statin and strength across pharmacies, so once you and your prescriber pick a molecule you can fill it for the least. Compare atorvastatin, rosuvastatin, simvastatin, and pravastatin, or read our full cholesterol medication price guide.