BMA Concise Guide to Medicine & Drugs

Rosuvastatin

Brand name Crestor

Used in the following combined preparations None

QUICK REFERENCE

Drug group Lipid-lowering drug

Overdose danger rating Low

Dependence rating Low

Prescription needed Yes

Available as generic No

GENERAL INFORMATION

Rosuvastatin is a “statin” lipid-lowering drug that is used in the treatment of hypercholesterolaemia (high blood cholesterol levels). It is more potent than other statins so can achieve lower cholesterol levels than the other statins. It is prescribed to people who have not responded to other forms of therapy, such as a special diet or less potent statins, and are at risk of developing, or have existing, coronary artery disease or stroke. Cholesterol is a lipid (fat) that is produced naturally in the body and is necessary for the production of many other body chemicals. Rosuvastatin works by inhibiting an enzyme involved in the manufacture of cholesterol in the liver.

Adverse effects of rosuvastatin are usually mild and wear off with time. However, any unexplained aches or pains or muscle weakness should be reported to your doctor immediately. People of Asian origin are given lower starting doses because the drug behaves more potently in them.

INFORMATION FOR USERS

Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.

How taken/used Tablets.

Frequency and timing of doses Once daily at night.

Adult dosage range 5–40mg (5–20mg for patients of Asian origin); 10mg (initial dose), increased to 20mg after 4 weeks, if necessary; a maximum dose of 40mg may be given for severe hypercholesterolaemia.

Onset of effect 2–4 weeks.

Duration of action 24 hours.

Diet advice A low-fat diet is usually recommended.

Storage Keep in original container at room temperature, out of the reach of children.

Missed dose Do not take the missed dose. Take the next scheduled dose as usual.

Stopping the drug Do not stop taking the drug without consulting your doctor. Symptoms may recur.

Exceeding the dose An occasional unintentional extra dose is unlikely to be a cause for concern. However, if you notice any unusual symptoms, or if a large overdose has been taken, notify your doctor.

POSSIBLE ADVERSE EFFECTS

Common adverse effects of rosuvastatin include abdominal pain, constipation or diarrhoea, nausea, flatulence, headache, and sleep disturbance. Most are mild and transient, but discuss with your doctor if they are severe. If you develop a rash, jaundice, or muscle tenderness, pain, or weakness, stop taking the drug and consult your doctor at once.

INTERACTIONS

Ciclosporin increases blood levels of rosuvastatin

Warfarin Rosuvastatin may enhance the effects of warfarin. The level of anticoagulation (INR) should be monitored.

Erythromycin reduces the effectiveness of rosuvastatin.

Oestrogens Rosuvastatin increases blood levels of some of these drugs.

Gemfibrozil and other lipid-lowering drugs There is an increased risk of adverse effects when these drugs are taken with rosuvastatin.

Antacids may reduce the effectiveness of rosuvastatin.

Anti-HIV drugs may increase the risk of muscle damage when taken with rosuvastatin.

SPECIAL PRECAUTIONS

Be sure to tell your doctor if:

· You have liver or kidney problems.

· You have a personal or family history of muscle problems.

· You have porphyria.

· You are of Asian origin.

· You are taking other medicines.

Pregnancy Not recommended. May affect fetal development. Discuss with your doctor if you are pregnant or intend to become pregnant.

Breast-feeding Not recommended. Safety not established. Discuss with your doctor.

Infants and children Not recommended.

Over 60 Reduced initial dose. Discuss with your doctor.

Driving and hazardous work No special problems.

Alcohol Avoid excessive amounts. Alcohol may increase the risk of developing liver problems with this drug.

PROLONGED USE

Prolonged treatment can adversely affect liver function.

Monitoring Periodic blood tests to test for muscle toxicity and assess liver function are recommended.