Rosuvastatin is an oral drug for lowering blood cholesterol levels. It belongs to a class of drugs called HMG-CoA reductase inhibitors more commonly referred to as statins. Other drugs in this class include simvastatin Zocor lovastatin Mevacor pravastatin Pravachol atorvastatin Lipitor and fluvastatin Lescol. These drugs reduce cholesterol levels by inhibiting HMG-CoA reductase an enzyme that produces cholesterol in the liver. Rosuvastatin and other statins lower blood total cholesterol as well as blood LDL cholesterol levels. LDL cholesterol is the bad type of cholesterol that increases the risk of coronary artery disease atherosclerosis and heart attacks. Lowering LDL cholesterol levels slows the progression of coronary artery disease and may even reverse it. Statins also increase HDL cholesterol the good type of cholesterol and reduce triglycerides.

Scientists have discovered that in addition to atherosclerosis inflammation of the coronary arteries may also contribute to the development of heart attacks. The presence of inflammation can be determined by measuring a chemical in the blood called highly sensitive C-reactive protein Hs-CRP. Moreover Hs-CRP can be used to predict the occurrence of heart attacks strokes and death. Hs-CRP is in fact a better predictor of the risk for heart attacks than LDL cholesterol. Scientists have found that statins reduce the level of Hs-CRP in the body presumably by reducing inflammation in the coronary arteries and this may be another mechanism through which statins prevent heart attacks strokes and death. More research needs to be conducted however to confirm the importance of inflammation and the mechanisms through which statins work. Rosuvastatin was approved by the FDA in August 2003.

The starting dose for most adults is 5 mg once daily. The maximum dose is 40 mg daily and this dose should be reserved for patients who do not adequately respond to a 20 mg dose.

The most common side effects of rosuvastatin are headache nausea vomiting diarrhea and muscle pain. The most serious side effects are liver failure muscle breakdown rhabdomyolysis and kidney failure. Liver failure caused by statins is very rare. More often statins cause increases in liver tests due to injury to the liver. The test levels usually return to normal with continued therapy but if the level is over three times the upper limit of normal or baseline practitioners usually stop the statin. Periodic measurement of liver tests is recommended for all statins. For rosuvastatin these tests should be obtained before therapy is started twelve weeks after therapy is started when the dose is increased if there is a medical concern and periodically during prolonged treatment. Rhabdomyolysis is a very rare but serious side effect of statin therapy. When used alone the frequency of rhabdomyolysis due to statins is less than one percent. Rhabdomyolysis is a process in which there is severe injury to muscles leading to severe pain and the release of muscle protein myoglobin into the blood. Myoglobin may cause kidney failure. To prevent the occurrence of rhabdomyolysis patients taking statins who develop unexplained muscle pain weakness or tenderness should report the symptoms to their provider. Rosuvastatin may cause reversible increases in the amount of protein excreted by the kidneys and in some patients kidney failure has occurred as a result. This effect depends on the dose and occurs more often at the 40 mg dose.

When administered with cyclosporine the blood level of rosuvastatin increases seven fold and this could increase the side effects of rosuvastatin.

Rosuvastatin increases the action of the blood thinner warfarin and could increase the risk of bleeding from warfarin. Antacids reduce the absorption of rosuvastatin and should be administered two hours after rosuvastatin. The use of rosuvastatin with nicotinic acid gemfibrozil or other drugs that may cause liver or muscle injury may increase the incidence of the muscle injury.

Rosuvastatin is used for the reduction of blood total cholesterol HDL cholesterol and triglyceride levels and to increase HDL cholesterol levels.

Store at room temperature between 2-25°C 36-77°F.