• Adjunctive management of primary hypercholesterolemia and mixed dyslipidemias.
• Adjunctive management of hypertriglyceridemia.
• Adjunctive management of primary dysbetalipoproteinemia.
• Homozygous familial hypercholesterolemia.
• Slows the progression of atherosclerosis as adjunct to diet.
• Adjunctive therapy to diet and exercise for the reduction of LDL cholesterol in children 8–17 yrs with heterozygous familial hypercholesterolemia if after diet therapy fails the following still exist: LDL cholesterol remains >190 mg/dL or remains >160 mg/dL [with family history of premature cardiovascular disease or 2 risk factors for cardiovascular disease])
• Primary prevention of cardiovascular disease (reduces risk of stroke, myocardial infarction, and revascularization) in patients without clinically evident coronary heart disease but with an increased risk of cardiovascular disease because of age (50 yr for men; 60 yr for women), hsCRP 2 mg/L, and the presence of 1 risk factor for cardiovascular disease (hypertension, low HDL-C, smoking, or premature family history of coronary heart disease).

Contraindicated in:

• Hypersensitivity
• Active liver disease or unexplained persistent elevations in AST & ALT
• OB: Pregnancy (may cause fetal harm)
• Lactation: May cause serious adverse reactions in infant.

Use Cautiously in:

• History of liver disease
• Alcoholism
• Renal impairment
• Patients with Asian ancestry (may have ↑ blood levels and ↑ risk of rhabdomyolysis)
• Concurrent use of gemfibrozil, azole antifungals, protease inhibitors, niacin, cyclosporine, amiodarone, or verapamil (higher risk of myopathy/rhabdomyolysis)
• Women of reproductive potential (use effective contraception)
• Pedi: Children <7 yr (safety not established).

CNS: amnesia, confusion, memory loss, weakness.

GI: abdominal pain, constipation, drug-induced hepatitis, ↑ liver function tests, nausea.

Derm: rash.

Endo: hyperglycemia.

Hemat: thrombocytopenia.

Metab: RHABDOMYOLYSIS, immune-mediated necrotizing myopathy, myalgia.

Drug-Drug:

• Antacids↓ absorption (administer 2 hr after rosuvastatin).
• ↑risk of myopathy when used with cyclosporine, lopinavir/ritonavir, atazanavir/ritonavir, simeprevir, colchicine, fibrates or large doses of niacin; concurrent use of gemfibrozil should be avoided, if possible; use ↓ doses with cyclosporine, lopinavir/ritonavir, and atazanavir/ritonavir.
• ↑levels of norgestrel and ethinyl estradiol.
• May ↑ risk of bleeding with warfarin; monitor INR.

(Generic available)

• Tablets: 5 mg; 10 mg; 20 mg; 40 mg;

• PO (Adults): 10 mg once daily initially (range 5–20 mg initially) (20 mg initial dose may be considered for patients with LDL-C >190 mg/dL or homozygous familial hypercholesterolemia); dose may be adjusted at 2–4 wk intervals, some patients may require up to 40 mg/day, however this dose is associated with ↑ risk of rhabdomyolysis; Patients with Asian ancestry — initial dose should be 5 mg; Concurrent cyclosporine therapy — Dose should not exceed 5 mg/day; Concurrent lopinavir/ritonavir, atazanavir/ritonavir, or simeprevir therapy — Dose should not exceed 10 mg/day; Concurrent gemfibrozil therapy — Dose should not exceed 10 mg/day (avoid if possible).
• PO (Children 10–17 yr): Heterozygous familial hypercholesterolemia — 5–20 mg once daily.
• PO (Children 8–<10yr): Heterozygous familial hypercholesterolemia — 5–10 mg once daily.
• PO (Children 7–17 yr): Homozygous familial hypercholesterolemia — 20 mg once daily.

Crestor

• Inhibits 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, an enzyme which is responsible for catalyzing an early step in the synthesis of cholesterol.

• Lowering of total and LDL cholesterol and triglycerides. Slightly increases HDL cholesterol.
• Slows the progression of coronary atherosclerosis.

Therapeutic Classification: lipid-lowering agents

Pharmacologic Classification: hmg coa reductase inhibitors (statins)

Absorption: 20% absorbed following oral administration.

Distribution: Unknown.

Metabolism/Excretion: 10% metabolized, 90% excreted unchanged in feces.

Half-life: 19 hr.

(effect on lipids)

• Instruct patient to take medication as directed, not to skip doses or double up on missed doses. Take missed doses as soon as remembered but not within 12 hr of next dose. Medication helps control but does not cure elevated serum cholesterol levels.
• Advise patient that this medication should be used in conjunction with diet restrictions (fat, cholesterol, carbohydrates, alcohol), exercise, and cessation of smoking.
• Instruct patient to notify health care professional if unexplained muscle pain, tenderness, or weakness occurs, especially if accompanied by fever or malaise.
• Advise patient to take magnesium or aluminum-containing antacids, if needed, at least 2 hr after rosuvastatin.
• Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications.
• Advise patient to notify health care professional of medication regimen before treatment or surgery.
• Instruct female patient to inform health care professional if pregnancy is planned or suspected or if breastfeeding.
• Emphasize the importance of follow-up exams to determine effectiveness and to monitor for side effects.

roe-SOO-va-sta-tin