Crestor -vs- Simvastatin

[RadioAstronomyObserver]

I'm on a 30 day trial offer from Crestor (20mg) to replace my Simvastatin (20mg).  I'm sure I know the answer to this question but hearing other opinions would be welcomed...  As I understand it, Crestor is a bit stronger than Simvastatn, or should I say, You can take a smaller dose of Crestor to equal Simvatstatin.  Other than the equivalent dose change is there any other differences - side effects I should be looking for?

[turretgunner]

My cardiologist changed me over from 40MG of Simvastatin to the same dosage of Crestor and I have been taking it for about a year now. So far, no problems and my LDL level has gone down even further since taking the Crestor.

[kenkeith]

Q: but that's another point, you say go with what is proven. Which is proven and which is truth?

.......Isn't something that is proven a fact and a fact is the truth? I don't want to fog the issue. :)

[RadioAstronomyObserver]

LOL!!  Same thing happened with one or two other threads of mine.  I don't mind at all and as a mater of fact, both of you have given quite a bit of information in more ways than one.

  You both confirm my observation that Crestor is, for lack of a better description, "more powerful" than Simvastatin, I believe 2/3 to2x(?).  Both the PCP and Cardiologist want me to go back to my original 40mg Simvastatin and since Crestor has a one month trial offer for people in similar financial situations as I'm in, we're going to try that at 20mg.  So, In essence, we're good to go as to the dose, it's just a matter of side effects which with research suggests most effects are similar to Simvastatin.

[ed34]

I bet you wished you hadn't asked now lol. Are you more confused than you were before asking?

[sonnys1]

I would start off at 2.5mg every other day. Check your numbers then titrate up accordingly.
Crestor is so powerful that you don't need a lot which lowers the risk of side effects.

[ed34]

but that's another point, you say go with what is proven. Which is proven and which is truth? when several studies conclude different things, how do you possibly know which is proven? they can't all be correct.
If you designed an electric car and gave 10 to each of 2 research companies to test them and publish the results. One said all 10 cars broke down and were a waste of money, the other said they were fantastic, which would the public believe, or be expected to believe? Its the same with many drugs, so no wonder the public are asking questions and becoming concerned.

[erijon]

Ed,

I can go point to point, quote to quote and link to link with you on this subject, but I won't as I respect your opinion.

Having said that, I spend many hours each week doing volunteer work where I am privileged to associate with some great cardiologists.. They share the latest studies and data with me and I spend hours on other cholesterol related forums on the Internet. Consider this statement supporting the Jupiter study from a recent publication;

"And this trial did not tell us the risks of lifelong, or even very long-term, Crestor therapy.

But what it did tell us, with a very high degree of statistical surety, was this: Giving Crestor to patients similar to the ones enrolled in this study can be expected to result in significantly and substantially improved cardiovascular outcomes, and in a relatively short period of time.

There are a lot of reasons that a lot of people are unhappy about these results. Chief among these are that Crestor is very expensive, and if the results of this study were taken to its logical extreme, we would be spending billions of dollars each year on Crestor.

The articles appearing this week in the Archives vary in quality from quite reasonable criticisms to absurdly polemical.

The main article largely consisted of a string of ad hominem attacks aimed at the presumed biases of the sponsor, the clinical investigators, and even the chair of the DSMB (a highly respected individual known for his rigid objectivity). While it may be legitimate to criticise the bias built-in to the study design (for instance, only the sponsor's statin was used in this trial), it remains true that, given that the JUPITER design is what it is, the resultant data - which can only be considered striking - must be evaluated on its own merits. Ironically, the chief author of this critical paper is himself a member of a fringe medical group known as The International Network of Cholesterol Skeptics (THINCS), whose stated mission is to "oppose" the notion that high cholesterol and animal fat play a role in cardiovascular disease. Members of THINCS also take an extraordinarily strong position opposing statins for any clinical use whatsoever. The irony, of course, is that this striking bias was not disclosed in an article whose main thrust was to criticise the disclosed biases of the JUPITER investigators."

By Richard N. Fogoros, M.D

Many complain about bias, but don't represent their own. FYI, the study in Greece was not funded in any way by any drug company. I do agree with you, what to believe. I will go with my personal experience and what can be proven. As soon as some one proves corruption in the studies, it will all just be conjecture to me.

Jon

[ed34]

Apparently the Americans and the Greeks disagree then.
Quote "A new study published in the Journal of the American College of Cardiology examined the results of 23 large clinical trials of statins for patterns of liver damage, measured by an increased concentration of the enzymes released when liver cells die."
Quote "The researchers found that high-dose statins caused 2.4 times as many cases of liver damage as low-dose statins, or 271 cases per 100,000 patients. When the researchers looked at individual statin drugs, they found that Zocor (simvastatin) was 1.6 more dangerous in high doses than low doses, and Lipitor (atorvastatin) was 4.0 times more dangerous."
Now more recent.....
Quote "The new study is consistent with prior studies, such as one in the "New England Journal of Medicine" that found a 5.5 higher risk of liver damage from maximum-dose Lipitor relative to a lower dose. Another "New England Journal of Medicine" study found that maximum-dose Lipitor was 4.5 times more likely to cause liver damage than a placebo."
another Quote "The study in the "Journal of the American College of Cardiology" also found that rates of cancer among those using statins went up as both LDL and total cholesterol levels decreased. Likewise, cancer risk increased along with the dose of statins being taken."

Now China is claiming that THEIR research has found no difference with cancer rates. What would you suggest we do to stop the confusion with conflicting research? Ignore the US research? ignore other nations research? how the heck are you supposed to believe? You say the Greeks and Chinese at the moment, but China is the new financial centre of the world and very influential, so it's convenient for drug companies to use them. I'm beginning to wonder if you can trust anything that comes out of a lab, obviously someone isn't able to use the equipment, so who is it? lol

[erijon]

Actually, two recent studies done in Greece and China have confirmed that statin therapy has been shown to not have effects on the liver as once though, in fact those with abnormal liver function prior to statin treatment showed improvement in their liver function.

From the Lancet dated 11/25;

"-- Long-term use of cholesterol-lowering statins does not increase the risk of liver disease in patients with abnormal liver function, and can actually improve liver function, according to a new study that challenges widespread belief.

The researchers also pointed out that this study is the first to show that statins provide a substantially greater cardiovascular benefit in patients with abnormal liver function than in those with normal liver function.

The study, published in the Nov. 24 online edition of The Lancet, included 437 patients with moderately abnormal liver tests believed to have non-alcoholic fatty liver disease. Statins were given to 227 patients, while the other 210 (the control group) received no treatment.

After three years of follow-up, the patients taking statins did not have a higher rate of liver problems than those in the control group. In addition, levels of alanine aminotransferase (ALT) -- a biomarker of liver problems -- decreased or normalized in the patients taking statins but worsened in the control group.

The investigators also found that patients with abnormal liver tests who took statins had a 39% to 68% reduced risk of cardiovascular events such as heart attack and stroke."

In fact, the folks doing the study have recommended that the mention of side effects on the liver be removed from the patient information leaflet.Overall, the risk of side effects from statins are 1 in 2,200 making statins one of the safest drugs available. Also, the risk of side effects to the nervous system is .025% of those on statins which compared to .021% in the placebo control group based on the Jupiter study. The overall incidence of side effects was 1 in 2221 in the statin group compared to 1 in 2223 in the placebo group.

Also, they are now prescribing statins before and after invasive surgical procedures as a  result of their anti-inflammatory properties which is why they are also being used now to treat pneumonia.

Larry, Crestor is more powerful that Simvastatin, however the dangerous side effects are really only a factor once your dosage exceeds 80mg.

Anyways, good luck with your decision,

Jon

[ed34]

Just to add, around 1 in 2000-5000 people on statins get nerve damage, but this number is too small to concern the drug companies. However, as millions and millions more people start to take statins, we will see an increase in this frequency. This also came from a statement in the American journal of cardiology.

[ed34]

I wish you luck with 20mg my friend and really hope you dont suffer any liver damage. Crestor is the most powerful statin to date, much stronger than Lipitor which is very strong. The starting dosage recommended for severe artery disease with crestor is 10mg, which lowers c-ldl by a whopping 46-52%. This is a lot, and most people don't need this much of a reduction, certainly that much of the powerful drug. You can get 5mg, but this is the lowest. It has been shown that 2.5mg lowers c-ldl by 40% and 1mg by 34%. Crestor studies showed that 1mg reduced c-ldl by the same level as 20-40mg of simvastatin. As the American Journal of cardiology stated, as levels of statins double, so does the frequency of  liver damage. It also states why take more than your body needs.
So, please be careful, I would hate to see you become seriously ill my friend. 20mg of crestor probably has the same strength as 400mg of simvastatin.