Medications
Rosuvastatin - Crestor
CRESTOR is an HMG Co-A reductase inhibitor indicated for:
• patients with primary hyperlipidemia and mixed dyslipidemia as an adjunct to diet to reduce elevated total-C, LDL-C, ApoB, nonHDL-C, and TG levels and to increase HDL-C
• patients with hypertriglyceridemia as an adjunct to diet
• patients with primary dysbetalipoproteinemia (Type III hyperlipoproteinemia) as an adjunct to diet
• patients with homozygous familial hypercholesterolemia (HoFH) to reduce LDL-C, total-C, and ApoB
• slowing the progression of atherosclerosis as part of a treatment strategy to lower total-C and LDL-C as an adjunct to diet
• pediatric patients 10 to 17 years of age with heterozygous familial hypercholesterolemia (HeFH) to reduce elevated total-C, LDL-C and ApoB after failing an adequate trial of diet therapy
• risk reduction of MI, stroke, and arterial revascularization procedures in patients without clinically evident CHD, but with multiple risk factors
Limitations of use:
• CRESTOR has not been studied in Fredrickson Type I and V dyslipidemias.
Most frequent adverse reactions (rate ≥ 2%) are headache, myalgia, abdominal pain, asthenia, and nausea.
• Cyclosporine: Combination increases rosuvastatin exposure. Limit CRESTOR dose to 5 mg once daily.
• Gemfibrozil: Combination should be avoided. If used together, limit CRESTOR dose to 10 mg once daily.
• Lopinavir/Ritonavir or atazanavir/ritonavir: Combination increases rosuvastatin exposure. Limit CRESTOR dose to 10 mg once daily.
• Coumarin anticoagulants: Combination prolongs INR. Achieve stable INR prior to starting CRESTOR. Monitor INR frequently until stable upon initiation or alteration of CRESTOR therapy.
• Concomitant lipid-lowering therapies: Use with fibrates and niacin products may increase the risk of skeletal muscle effects.
• Skeletal muscle effects (e.g., myopathy and rhabdomyolysis): Risks increase with use of 40 mg dose, advanced age (≥65), hypothyroidism, renal impairment, and combination use with cyclosporine, lopinavir/ritonavir, atazanavir/ritonavir, or certain other lipid-lowering drugs. Advise patients to promptly report unexplained muscle pain, tenderness, or weakness and discontinue CRESTOR if signs or symptoms appear
• Liver enzyme abnormalities and monitoring: Persistent elevations in hepatic transaminases can occur. Monitor liver enzymes before and during treatment
