Class: HMG-CoA Reductase Inhibitor
Dosage Forms. Tablet: 5 mg, 10 mg, 20 mg, 40 mg
Common FDA Label Indication, Dosing, and Titration.
1. Hyperlipidemia: Adults, 10-20 mg po daily, may titrate to 40 mg po daily; Children 10-17 y, 5-20 mg po daily, may titrate to 20 mg po daily
2. Disorder of cardiovascular system, primary prophylaxis, familial hypercholesterolemia, homozygous, hypertriglyceridemia, mixed lipidemia: 10-20 mg po daily, may titrate to 40 mg po daily
1. Acute coronary syndrome: 40 mg po daily
MOA. HMG-CoA reductase inhibitors competitively inhibit conversion of HMG-CoA to mevalonate, an early rate-limiting step in cholesterol synthesis. A compensatory increase in LDL receptors, which bind and remove circulating LDL-cholesterol, results. Production of LDL-cholesterol can also decrease because of decreased production of VLDL-cholesterol or increased VLDL removal by LDL receptors.
Drug Characteristics: Rosuvastatin
Medication Safety Issues: Rosuvastatin
Drug Interactions: Rosuvastatin
Adverse Reactions: Rosuvastatin
Efficacy Monitoring Parameters. Total cholesterol, LDL-cholesterol, and triglycerides levels; HDL-cholesterol levels.
Toxicity Monitoring Parameters. Signs/symptoms of rhabdomyolysis (myalgias, dark urine, arthralgias, fatigue) or hepatotoxicity; LFTs should be performed at baseline, 12 wk after initiation of therapy, and every 6 mo thereafter; serum creatine kinase should be measured in patients experiencing muscle pain and in those receiving other drugs associated with myopathy.
Key Patient Counseling Points. Contact prescriber immediately if pregnancy occurs while taking rosuvastatin. Do not drink alcohol. Rosuvastatin does not take the place of diet and exercise to lower cholesterol levels.
Clinical Pearls. Lipid level assessment should be done within 4 wk following dose initiation or titration. Consider holding rosuvastatin 4-7 d before major surgery as patient is at higher risk for occurrence of rhabdomyolysis. May increase risk of diabetes.