Rosuvastatin

What is Rosuvastatin?

Rosuvastatin is a type of medication known as a 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, 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 start by prescribing a low dose of Rosuvastatin which may be gradually increased, and instruct you to follow a low-cholesterol diet and fitness plan.

How long do I need to take Rosuvastatin for?

You will probably 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 monohydrate, calcium hydrogen phosphate anhydrous, microcrystalline cellulose, crospovidone (type B), magnesium stearate, hypromellose (15cP) (E464), titanium dioxide (E171), sunset yellow FCF (E110), allura red AC aluminium lake (E129), indigo carmine aluminium lake (E132), and triacetin.

Your doctor will decide your starting dose of Rosuvastatin depending on you age, cholesterol level, personal risk of experiencing a heart attack or stroke and any other factors that may make you more sensitive to side effects. The usual starting dose in adults in 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. 

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:

• Difficulty breathing

• Swelling of the face, lips, tongue or throat, which may cause difficulty swallowing

• Severe itching of the skin, with or without raised, red lumps

• Unusual aches or pains in your muscles which go on for longer than usual. 

The following common side effects may affect up to 1 in every 10 patients:

• Headache

• Stomach pain

• Constipation

• Nausea

• Muscle pain

• Feeling weak

• Dizziness

• An increase in the level of protein found in the urine

• Diabetes, which is more likely if you have high levels of sugar or fat in your blood, are overweight, or have high blood pressure

Uncommon side effects, which may affect up to 1 in every 100 patients, include:

• Rash, itching or skin irritation

• An increase in levels of protein in the urine

Rare side effects, affecting up to 1 in every 1000 people, include:

• Severe allergic reaction

• Muscle damage in adults

• Inflammation of the pancreas, characterised by severe stomach pain

• Increase in liver enzymes in the blood

• Decrease of platelets in the blood

Very rarely (up to 1 in every 10 000 cases), the following side effects may occur:

• Jaundice (yellowing of the skin and whites of the eyes)

• Hepatitis (inflammation of the liver)

• Traces of blood in the urine

• Damage to the nerves in the legs or arms

• Joint pain

• Memory loss

• Breast enlargement in men (gynaecomastia)

The following side effects have been reported, although their frequency is unknown:

• Diarrhoea

• Stevens-Johnson syndrome with symptoms such as serious blistering of the skin, mouth, eyes and genitals

• Cough

• Shortness of breath

• Oedema (swelling)

• Sleep disturbance, insomnia or nightmares

• Sexual difficulties

• Depression

• Breathing problems, including persistent cough and/or shortness of breath

• Fever

• Tendon injury

• Prolonged muscle weakness

Contraindications

Do NOT take Rosuvastatin if:

• You are allergic to any of the ingredients in this medication (see below ‘Ingredients’)

• You are pregnant, planning on becoming pregnant, or breastfeeding

• You have liver disease

• You have severe kidney problems

• You have repeated or unexplained muscle aches or pains

Additionally, do NOT take Rosuvastatin 40 mg if:

• You have moderate kidney problems

• Your thyroid gland is not working properly

• You have had any repeated or unexplained muscle aches or pains, a personal or family history of muscle problems, or a previous history of muscle problems when taking cholesterol-lowering medications

• You regularly drink large amounts of alcohol

• You are of Asian origin (Japanese, Chinese, Filipino, Vietnamese, Korean and Indian)

Before taking Rosuvastatin, inform your doctor and take particular care if:

• You have severe respiratory failure

• You have ever had muscle problems when taking other statins

• You drink a lot of alcohol or have a history of alcohol abuse

• You have a history of liver disease or problems with your liver

• You have any kidney or thyroid problems

• You have a personal or family history of muscle disorder

• You are older than 70 years of age

• You are of Asian origin. Your doctor will need to choose the right starting dose for you.

• You are lactose intolerant, as this medication contains lactose

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 (an immunosuppressant)

• 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). If you need to take fusidic acid to treat bacterial infection, you will need to temporarily stop taking Rosuvastatin. When taken in combination with Rosuvastatin, fusidic acid can in rare case lead to muscle weakness, tenderness or pain.

• An oral contraceptive

• Hormone replacement therapy

• Antiviral medications such as ritonavir with lopinavir and/or atazanavir or simeprevir, used in 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 3 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 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 pain, 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 cheaper. 

Rosuvastatin vs other Statins

There are 5 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 which 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 and processed meats, butter, ghee, lard, cream and ice cream, cheese, cakes and biscuits, chocolate, coconut oil and cream, and palm oil. Instead, choose lean cuts of meat and include plenty of fruits and vegetables and wholegrains in your diet. Food which 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 24 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 an 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?

It is possible that Rosuvastatin can slightly increase the the level of hormones released by some contraceptive pills in women, which may 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 with any affecting the absorption of the medication. 

Sources

Patient Information Leaflet

NHS > Rosuvastatin

American Heart Association > Cholesterol Medications