This document compares several statin medications and provides information on dosing, food interactions, and myopathy risk. It notes that atorvastatin and rosuvastatin can be taken without regard to food. Fluvastatin, pitavastatin, and pravastatin also have no food effect and very low risk of myopathy. In contrast, lovastatin and simvastatin should be taken with food to reduce myopathy risk, which is moderate for these statins. The table provides a concise overview of statin properties for clinical decision making.

1. Dose Timing
Take with
Food?
Grapefruit
Statin Medication Myopathy Risk
Low
Intensity
<30% LDL ↓
High
Intensity
≥50% LDL ↓
Moderate
Intensity
30–49% LDL ↓
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Atorvastatin
Lipitor®
10-20 mg 40-80 mg Any With or
without
Avoid Low
Rosuvastatin
Crestor®, Ezallor®
5-10 mg 20-40 mg Any
With or
without
No effect Low
Fluvastatin
Lescol®
40 mg BID
20-40 mg PM
(unless BID)
With or
without
No effect Very low
Fluvastatin ER
Lescol XL®
80 mg XL Any
With or
without
No effect Very low
Pitavastatin
Livalo®, Zypitamag®
1-4 mg* Any
With or
without
No effect Very low
Pravastatin
Pravachol®
40-80 mg
10-20 mg Any
With or
without
No effect Very low
Lovastatin
Mevacor®
40-80 mg
20 mg PM
(unless BID)
With food Avoid Moderate
Simvastatin
Zocor®, FloLipid®
20-40 mg^
10 mg PM
With or
without
Avoid Moderate
Lovastatin ER
Altoprev®
40-80 mg
20 mg Bedtime Not specified
†
Avoid Moderate
Statins Comparison
*Some sources reference pitavastatin 1 mg as low intensity.
^Simvastatin 80 mg may be considered moderate or high intensity; however, this dose is not recommended due to ↑ risk of myopathy/rhabdomyolysis.
† The manufacturer’s prescribing information does not specify whether or not each dose has to be taken with food.
Statin dose intensities reference: 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol