Statin Dose Equivalence

Statin Intensity Comparison

The American College of Cardiology/American Heart Association guidelines classify rosuvastatin 10 mg as a moderate-intensity statin that reduces LDL-C by approximately 30-49% 1, 2
Simvastatin 20-40 mg is also classified as moderate-intensity statin therapy with similar LDL-C reduction of 30-49% 2, 3
The intensity classification is based on the percentage reduction in LDL-C from baseline, with moderate-intensity statins reducing LDL-C by 30-49% 2

Rosuvastatin 10 mg and simvastatin 40 mg are both considered moderate-intensity statins with comparable LDL-C lowering effects, according to the ACC/AHA guidelines 1, 2
Simvastatin 40 mg is the highest practical dose that can be considered equivalent to rosuvastatin 10 mg, as simvastatin 80 mg is no longer recommended due to increased myopathy risk 2, 4

The FDA no longer recommends initiating or titrating to simvastatin 80 mg due to increased risk of myopathy and rhabdomyolysis 2, 4
Simvastatin has more drug interactions than rosuvastatin, which may affect the practical equivalence in certain patient populations 5
If a patient requires the LDL-C lowering effect of rosuvastatin 10 mg but cannot take it, simvastatin 40 mg would be the appropriate alternative, though it may have a slightly lower efficacy 2

Monitoring lipid levels after switching between statins is important, as individual patient response to statins can vary 2

Avoid using simvastatin 80 mg as an equivalent to rosuvastatin 10 mg despite potentially similar LDL-C lowering effects, as the FDA has warned against initiating this dose due to myopathy risk 2, 4
Don't overlook potential drug interactions when switching between statins, particularly with simvastatin which has more significant interactions with medications 5