Rosuvastatin

What is rosuvastatin?

Rosuvastatin is a type of medication known as statin. It is used to lower cholesterol in people who have been diagnosed with high cholesterol, and can be prescribed as a preventative measure against heart and blood vessel disease, heart attacks and strokes.

How does rosuvastatin work?

Cholesterol, a substance produced by the liver, plays an important role in the functioning of all cells in the body. A high level of high-density lipoprotein (HDL), or “good” cholesterol, in the blood is good for you, whereas a high level of low-density lipoprotein (LDL), the “bad” cholesterol, can cause blockages in the arteries which may lead to a heart attack or stroke. The best way to limit the amount of LDL in your blood is to maintain a healthy weight, eat a balanced diet that is low in saturated fats, and exercise regularly. Alongside these measures, rosuvastatin helps to reduce the amount of LDL produced by the liver. It is prescribed to people at high risk of heart disease and stroke but must be accompanied by the appropriate lifestyle changes in order to work effectively.

How to switch high cholesterol medication?

Statins such as rosuvastatin are prescription medications, and should only be taken following consultation with a doctor. Your doctor will typically start by prescribing a low dose of rosuvastatin which may be gradually increased. They will also instruct you to follow a low-cholesterol diet and fitness plan.

How long do I need to take rosuvastatin for?

You will likely need to continue taking rosuvastatin for the rest of your life. Even if your cholesterol levels return to normal, rosuvastatin prevents them from increasing again. Never stop taking rosuvastatin without first consulting a doctor.

Active ingredients

The active ingredient in rosuvastatin is rosuvastatin as rosuvastatin calcium.

Inactive ingredients

The inactive ingredients in rosuvastatin are lactose, cellulose, microcrystalline (E460), magnesium oxide, magnesium stearate (E470b), crospovidone (E1202), hypromellose (E464), triacetin (E1518), titanium dioxide (E171), lactose monohydrate and iron oxide yellow.

Note different manufacturers and doses may contain different inactive ingredients.

Your doctor will decide your starting dose of rosuvastatin depending on your age, cholesterol level, personal risk of experiencing a heart attack or stroke and any factors that may make you more sensitive to side effects. The usual starting dose in adults is 5 to 10 mg taken once daily, which may be increased up to a maximum of 40 mg per day.

How to take rosuvastatin?

Always take rosuvastatin as instructed by a doctor. Swallow one tablet whole with a glass of water at around the same time each day. Try and build this into your daily routine - for example, take your dose each morning when you brush your teeth. If you experience nausea after taking rosuvastatin, you may wish to take it after a meal or a snack.

Rousuvastatin side effects

Like all medications, rosuvastatin can cause side effects in some patients. If you experience either of the following, stop taking this medication and consult a doctor immediately:

• If you experience either of the following, stop taking this medication and consult a doctor immediately:
• Signs of an allergic reaction, including swelling of the face, lips, tongue or throat, difficulty breathing, sudden wheezing, severe rash or itching, high fever
• Joint pain or inflammation
• Skin eruptions or inflammation, hives or sudden sensitivity to sunlight
• Sudden muscle aching, weakness, tenderness or pain
• Unusual bruising or bleeding
• Yellowing of the skin or eyes, itching, dark-coloured urine or pale-coloured stool
• Abdominal pain

Common or very common side effects

• Weakness (asthenia)
• Constipation or diarrhoea
• Dizziness
• Flatulence
• Abdominal discomfort
• Headache
• Muscle aches (myalgia)
• Nausea
• Sleep disorders
• Thrombocytopenia (low platelets, manifested by easily bruising)

Uncommon

• Hair loss (alopecia)
• Liver disorders
• Memory loss
• Pancreatitis (inflammation of the pancreas, manifested by upper abdominal pain)
• Numbness (paraesthesia)
• Sexual dysfunction
• Skin reactions
• Vomiting

Rare or very rare

• Muscle pain (myopathy)
• Peripheral neuropathy (sensory symptoms such as tingling or pins and needles)
• Tendon pain (tendinopathy) 
• Joint pain
• Gynaecomastia (breast tissue growth in men)
• Blood in the urine

Frequency not known

• Depression
• Diabetes mellitus (in those at risk)
• Interstitial lung disease
• Cough
• Shortness of breath
• Swelling 
• Protein in the urine
• Stevens-Johnson syndrome (a type of skin condition)

Contraindications

Do NOT take rosuvastatin if you are:

• Allergic to any of the ingredients in this medication
• Pregnant or planning pregnancy
• Breastfeeding
• Taking any medications that may interact with Rosuvastatin

Before taking rosuvastatin, tell your doctor and take special care if you:

• Have liver problems
• Have kidney problems
• Have thyroid problems
• Have ever had muscle problems e.g. myopathy or rhabdomyolysis
• Have a family history of muscle problems
• Drink a lot of alcohol or have a history of alcohol abuse
• Are of Asian ethnicity

Drug interactions

Before taking rosuvastatin, tell your doctor if you are taking or have recently taken any other medications, including those purchased over the counter without a prescription. In particular, tell your doctor if you are taking any of the following, as they may interfere with the way rosuvastatin works:

• Ciclosporin
• Warfarin or clopidogrel (blood thinners)
• Fibrates such as gemfibrozil and fenofibrate
• Any other medication used to lower cholesterol, such as ezetimibe
• Indigestion remedies such as antacids
• Erythromycin (an antibiotic)
• Fusidic acid (an antibiotic)
• An oral contraceptive
• Hormone replacement therapy
• Antiviral medications such as ritonavir with lopinavir and/or atazanavir or simeprevir, used in the treatment of HIV and hepatitis C infection.

Rosuvastatin and alcohol

You should avoid drinking excessive amounts of alcohol while taking this medication. Limit the amount of alcohol you drink to below the recommended maximum of 14 units per week.

Rosuvastatin and pregnancy

Rosuvastatin is not recommended for use during pregnancy. If you are trying to get pregnant, you will need to stop taking rosuvastatin three months before trying for a baby. If you become pregnant or think you might be pregnant while taking rosuvastatin, stop taking it immediately and contact your doctor.

How to cope with the side effects of rosuvastatin?

Up to 1 in 10 people may experience mild side effects of rosuvastatin. In general, these are nothing to worry about and there are some measures you can take to manage them. If you experience any nausea or stomach discomfort, try to stick to simple, small meals that are not too rich or spicy, and try to eat slowly. Nausea can be reduced by taking rosuvastatin after a snack, rather than on an empty stomach. Any constipation you might experience can be gradually relieved by including more high-fibre foods in your diet, such as fresh fruits, vegetables and cereals, by staying well hydrated and exercising regularly. If you are experiencing regular headaches, dizziness or fatigue, try to rest until the feeling has passed, drink plenty of fluids and ask a pharmacist to recommend a painkiller. If these side effects persist, you can consult your doctor for help.

Rosuvastatin vs. Crestor

Crestor is a brand name for the generic drug rosuvastatin. They both contain the active ingredient rosuvastatin and work in the same way, although the generic version may be less expensive. The inactive ingredients and appearance can vary between different generic versions of the same medication, so some people prefer branded medication instead.

Rosuvastatin vs other statins

There are five types of statins available on prescription in the UK. Your doctor will decide which is best for you depending on your cholesterol level, medical history and personal requirements. Simvastatin, fluvastatin and pravastatin are low-intensity statins that are sufficient for lowering cholesterol in most patients. Patients with very high cholesterol levels may be prescribed a high-intensity statin instead, such as atorvastatin (Lipitor) and rosuvastatin (Crestor).

Lifestyle changes to help lower cholesterol

The best way to lower your cholesterol levels is to make some changes to your diet. According to the UK government, saturated fats should equate to no more than 11% of your nutritional intake, meaning no more than 20 g per day for women and 30 g per day for men. To cut down on saturated fats, avoid fatty cuts of meat, processed meats, butter, cream, ice cream, cheese, cakes, biscuits, chocolate, coconut oil, and palm oil. Instead, choose lean cuts of meat and include plenty of fruits and vegetables and whole grains in your diet. Foods that are rich in omega-3 fatty acids, such as oily fish and avocados, can have a lowering effect on your triglyceride levels, so try and include these in your diet as well. Limit your alcohol intake to below the recommended maximum of 14 units per week and, if you haven’t already done so, quit smoking. 
 
In addition to eating a healthy and balanced diet, you should try and build exercise into your routine, even if this is just a daily walk. Aerobic exercise such as swimming, cycling and running helps to keep the heart and arteries healthy and will improve your overall strength and wellbeing.

Is rosuvastatin a cure?

While statins such as rosuvastatin are not a cure for high cholesterol, they are the most effective treatment for high cholesterol and the only cholesterol-lowering drug that has been linked directly to a reduction in the risk of heart attack or stroke. When taking in combination with a low-cholesterol diet and regular exercise, they effectively lower cholesterol in most patients.

Is rosuvastatin safe?

Rosuvastatin is considered to be a safe and effective treatment for high cholesterol. Statins in general tend to have very few side effects, and your doctor will be able to recommend which is right for you.

How long does rosuvastatin take to work?

You will not be able to tell if rosuvastatin is working, but a doctor will arrange a check-up with you to monitor your cholesterol levels. Rosuvastatin starts working immediately but can take up to a month to take full effect.

Can I crush rosuvastatin?

Rosuvastatin should not be crushed or split but should be swallowed whole with a glass of water.

What should I do if I miss a dose of rosuvastatin?

If you miss a dose of rosuvastatin, don’t worry. Just skip the dose and take your next dose at the normal time. Never take a double dose to make up for a missed one.

Is rosuvastatin a blood thinner?

Rosuvastatin is not a blood thinner. It is a type of statin that works by lowering the level of “bad” cholesterol in the blood and increasing the level of “good” cholesterol.

Will rosuvastatin affect my fertility?

There is no evidence to suggest that rosuvastatin affects fertility in men or women. However, if you are trying to get pregnant, you should inform your doctor before taking rosuvastatin, as they may wish to prescribe an alternative treatment.

Will rosuvastatin affect my contraception?

Rosuvastatin will not affect the efficacy of your contraception. It is possible that rosuvastatin may slightly increase the level of hormones released by some contraceptive pills in women, which might increase your chances of experiencing side effects. If you experience unusual side effects of your contraceptive medication while taking rosuvastatin, speak to your doctor for advice.

Is there any food or drink I need to avoid while taking rosuvastatin?

Unlike other statins, rosuvastatin can be taken in combination with grapefruit juice without any effect on the absorption of the medication.