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Crestor Appetite & Cravings Changes: What the Evidence Actually Shows

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At a glance

  • Drug / rosuvastatin (Crestor), HMG-CoA reductase inhibitor (statin)
  • Appetite change as a labeled reaction / not described [1]
  • Nausea, pooled 12-week trials / 3.4% on Crestor vs 3.1% on placebo [1]
  • Constipation, same trials / 2.4% vs 2.4% [1]
  • Diabetes reported in JUPITER / 2.8% vs 2.3%; mean HbA1c 0.1% higher on Crestor [1]
  • Dosing / 5 to 40 mg once daily, any time of day, with or without food [1]

Does the Crestor label list appetite loss or cravings?

In the label's pooled placebo-controlled trials of up to 12 weeks (382 people on placebo, 744 on Crestor 5 to 40 mg), the reported rates were headache 5.5% versus 5.0%, nausea 3.4% versus 3.1%, myalgia 2.8% versus 1.3%, asthenia 2.7% versus 2.6% and constipation 2.4% versus 2.4% [1].

Decreased appetite, increased appetite and food cravings do not appear among these tabulated reactions [1]. The postmarketing reactions the label gives as examples include thrombocytopenia, hepatitis, jaundice, peripheral neuropathy, rare cognitive impairment, myasthenia gravis, interstitial lung disease, gynecomastia and DRESS; appetite change is not among them [1].

What the large rosuvastatin trials recorded

JUPITER assigned 17,802 adults to rosuvastatin 20 mg or placebo and ran for a median of 1.9 years [3]. The label's adverse reaction figures from that trial (8,901 people per arm, mean 2 years) are myalgia 7.6% versus 6.6%, arthralgia 3.8% versus 3.2%, constipation 3.3% versus 3.0% and nausea 2.4% versus 2.3%, with diabetes mellitus reported in 2.8% versus 2.3% [1].

HOPE-3 randomized 12,705 intermediate-risk adults to rosuvastatin 10 mg or placebo for a median of 5.6 years. Its abstract reports no excess of diabetes or cancers on rosuvastatin, but an excess of cataract surgery (3.8% versus 3.1%, P=0.02) and muscle symptoms (5.8% versus 4.7%, P=0.005) [2].

METEOR randomized 984 adults to rosuvastatin 40 mg or placebo for 2 years [4]. The label's adverse reaction figures from it (700 people on 40 mg versus 281 on placebo, mean 1.7 years) include myalgia 12.7% versus 12.1% and increased CPK 2.6% versus 0.7% [1].

Nausea and constipation rates

Nausea was reported in 3.4% of people taking Crestor versus 3.1% taking placebo in pooled trials of up to 12 weeks, and in 2.4% versus 2.3% in JUPITER [1]. Constipation was identical in the two arms of the 12-week trials, 2.4% versus 2.4% [1].

Blood sugar

The label reports that HbA1c and fasting glucose can rise on Crestor, in some cases past the diabetes threshold [1]. In JUPITER, mean HbA1c was 0.1% higher on rosuvastatin than on placebo and diabetes was reported in 2.8% versus 2.3% [1].

Does the dose or the time of day matter?

Crestor is taken at 5 to 40 mg once daily at any time of day, with or without food, and exposure (AUC) does not differ between morning and evening dosing [1]. The label's short-term adverse reaction rates pool the whole 5 to 40 mg range [1].

Frequently asked questions

Does Crestor cause loss of appetite?
Appetite loss is not described as a side effect in the Crestor prescribing information [1]. The label quantifies nausea at 3.4% on Crestor 5 to 40 mg versus 3.1% on placebo and constipation at 2.4% in both groups, in pooled trials of up to 12 weeks [1].
Can rosuvastatin cause food cravings?
Nothing in the Crestor label describes food cravings [1]. The label does report that HbA1c and fasting glucose can rise, and JUPITER reported diabetes in 2.8% versus 2.3% on placebo [1]. Those numbers describe blood sugar, not appetite.
How common is nausea on Crestor?
Nausea rates on Crestor sit close to placebo: 3.4% versus 3.1% in pooled trials of up to 12 weeks and 2.4% versus 2.3% in JUPITER [1].
Does the time of day affect how Crestor is taken?
The label allows 5 to 40 mg once daily at any time of day with or without food, and exposure is the same with morning and evening dosing [1]. Its short-term adverse reaction rates are pooled across the 5 to 40 mg range [1].

References

  1. DailyMed - CRESTOR- rosuvastatin tablet, film coated. DailyMed - CRESTOR- rosuvastatin tablet, film coated
  2. Yusuf S, Bosch J, Dagenais G, Zhu J, Xavier D, Liu L, et al. Cholesterol Lowering in Intermediate-Risk Persons without Cardiovascular Disease. N Engl J Med. 2016;374(21):2021-31. Cholesterol Lowering in Intermediate-Risk Persons without Cardiovascular Disease
  3. Ridker PM, Danielson E, Fonseca FA, Genest J, Gotto AM, Kastelein JJ, et al. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008;359(21):2195-207. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein
  4. Crouse JR, Raichlen JS, Riley WA, Evans GW, Palmer MK, O'Leary DH, et al. Effect of rosuvastatin on progression of carotid intima-media thickness in low-risk individuals with subclinical atherosclerosis: the METEOR Trial. JAMA. 2007;297(12):1344-53. Effect of rosuvastatin on progression of carotid intima-media thickness in low-risk individuals with subclinical atherosclerosis: the METEOR Trial
Evidence overview for rosuvastatin: Crestor Appetite & Cravings Changes: What the Evidence Actually Shows