Atorvastatin and rosuvastatin are both used to treat hyperlipidemia.
Atorvastatin
Atorvastatin is more lipophilic, making it easier to enter cells, which can lead to elevated liver enzymes and muscle enzymes. However, atorvastatin is safer than rosuvastatin in terms of renal function safety.
Rosuvastatin
Rosuvastatin is a hydrophilic drug and has a lower chance of entering cells compared to atorvastatin. Therefore, the incidence of elevated liver enzymes caused by rosuvastatin is relatively lower, but it can still cause liver function damage, elevated liver enzymes, muscle soreness, and increased myoglobin.
Rosuvastatin is slightly less safe than atorvastatin for patients with renal insufficiency, and its lipid-lowering effect is slightly stronger than atorvastatin.
Patients with mild to moderate renal impairment do not need dose adjustment, while rosuvastatin is contraindicated at all doses in patients with severe renal impairment (eGFR < 10 ml/1.73m²/min).