Is Crestor affected by genetics?

Yes — the active ingredient is metabolized by a gene known to vary between individuals.

Relevant genes: ABCG2, SLCO1B1

Crestor is affected by pharmacogenetics through the ABCG2 and SLCO1B1 genes. Your genotype for these genes can change how your body processes Crestor, which can affect both how well it works and how well you tolerate it. The strongest evidence level on this page is Strong, based on CPIC or FDA guidelines.

What's in Crestor

rosuvastatin affected by ABCG2, SLCO1B1

Affected by ABCG2, SLCO1B1 · CPIC · Strong evidence

Read the full rosuvastatin genetics guide →

Rosuvastatin phenotype recommendations

Published guidance from CPIC on how rosuvastatin should be dosed or substituted based on your SLCO1B1, ABCG2 phenotype.

Phenotype	What it means	Recommendation	Evidence
Increased Function SLCO1B1	Your genetics suggest normal handling of rosuvastatin, so standard dosing can be used.	CPIC Prescribe desired starting dose and adjust doses of rosuvastatin based on disease-specific and population-specific guidelines.	Strong
Normal Function SLCO1B1	Your genetics suggest normal handling of rosuvastatin, so standard dosing can be used.	CPIC Prescribe desired starting dose and adjust doses of rosuvastatin based on disease-specific and population-specific guidelines.	Strong
Decreased Function SLCO1B1	Your genetics suggest higher rosuvastatin levels in the body, so extra care may be needed at higher doses.	CPIC Prescribe desired starting dose and adjust doses of rosuvastatin based on disease-specific and population-specific guidelines. Prescriber should be aware of possible increased risk for myopathy especially for doses >20 mg.	Strong
Possible Decreased Function SLCO1B1	Your genetics suggest higher rosuvastatin levels in the body, so extra care may be needed at higher doses.	CPIC Prescribe desired starting dose and adjust doses of rosuvastatin based on disease-specific and population-specific guidelines. Prescriber should be aware of possible increased risk for myopathy especially for doses >20 mg.	Strong
Poor Function SLCO1B1	Your genetics suggest much higher rosuvastatin levels in the body, so a lower dose is usually recommended, and combination treatment may be considered if needed.	CPIC Prescribe ≤20 mg as a starting dose and adjust doses of rosuvastatin based on disease-specific and population-specific guidelines. If dose >20 mg is needed for desired efficacy, consider combination therapy (i.e., rosuvastatin plus nonstatin guideline-directed medical therapy).	Strong
Possible Poor Function SLCO1B1	Your genetics suggest much higher rosuvastatin levels in the body, so a lower dose is usually recommended, and combination treatment may be considered if needed.	CPIC Prescribe ≤20 mg as a starting dose and adjust doses of rosuvastatin based on disease-specific and population-specific guidelines. If dose >20 mg is needed for desired efficacy, consider combination therapy (i.e., rosuvastatin plus nonstatin guideline-directed medical therapy).	Strong
Indeterminate SLCO1B1	The impact of your genotype on response to this drug is unknown.	CPIC Initiate therapy with recommended starting dose.	—
Not available SLCO1B1	The impact of your genotype on response to this drug is unknown.	CPIC Initiate therapy with recommended starting dose.	—
Normal Function ABCG2	Your genetics suggest you should respond typically to this statin with standard dosing.	CPIC Prescribe desired starting dose and adjust doses of rosuvastatin based on disease-specific and population-specific guidelines.	Strong
Decreased Function ABCG2	Your genetics may slightly increase rosuvastatin levels, but standard dosing is usually appropriate.	CPIC Prescribe desired starting dose and adjust doses of rosuvastatin based on disease-specific and population-specific guidelines.	Strong
Poor Function ABCG2	Your genetics suggest you may need a lower starting dose or an alternative to reduce risk of side effects and get the desired cholesterol-lowering effect.	CPIC Prescribe ≤20 mg as a starting dose and adjust doses of rosuvastatin based on disease-specific and population-specific guidelines. If dose >20 mg is needed for desired efficacy, consider an alternative statin or combination therapy (i.e., rosuvastatin plus nonstatin guideline-directed medical therapy).	Strong
Indeterminate ABCG2	The impact of your genotype on response to this drug is unknown.	CPIC Initiate therapy with recommended starting dose.	—
Not available ABCG2	The impact of your genotype on response to this drug is unknown.	CPIC Initiate therapy with recommended starting dose.	—

Source: CPIC

The gene behind the guidance

SLCO1B1 Solute Carrier Organic Anion Transporter 1B1

SLCO1B1 is the transporter that moves statins into liver cells where they work. A common variant (called *5) reduces transporter function and leaves more statin circulating in the bloodstream and muscle tissue. That's directly linked to statin-associated muscle pain and, rarely, more serious muscle damage.

People with reduced SLCO1B1 function are at higher risk of statin myopathy, especially on simvastatin and high-dose atorvastatin. Dose reduction or switching statin usually resolves it.

See all drugs affected by SLCO1B1 →

Browse the full drug-class: Statins.

Related medications

Find out how your genetics affect Crestor

This page describes the general pharmacogenetics. A Gene2Rx report analyzes your own DNA to tell you which metabolizer group you fall into, across every medication.

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Informational only — not medical advice. Pharmacogenetic guidance describes population-level patterns; your individual response depends on many factors. Never start, stop, or change a medication without talking to your prescribing clinician.