Rosuvastatin - Usage, Precautions, Side Effects, and Drug Interactions

What Is Rosuvastatin, and Why Is It Used?

Rosuvastatin is a prescription drug used along with a proper diet to lower the risk of stroke, cardiac diseases, and the chances of heart surgery in people who have heart diseases or have been diagnosed with them. It is available in the form of tablets and is supposed to be taken by mouth. It helps to decrease the bad cholesterol, which is low-density lipoproteins, and elevate the good cholesterol, which is high-density lipoproteins. Rosuvastatin can also be used in children and teenagers between 8 to 17 years old suffering from familial heterozygous hypercholesterolemia (a hereditary condition in which the cholesterol cannot be removed from the body normally). Rosuvastatin belongs to the class of medications known as HMG-CoA reductase inhibitors (statins).

How Does Rosuvastatin Work to Lower Cholesterol?

Rosuvastatin works by slowing the cholesterol production in the body to decrease the amount of cholesterol that builds up on the walls of the arteries and blocks the blood flow to the heart, brain, and other body parts. When cholesterol accumulates on the walls of the arteries, the blood flow and oxygen supply to the heart, brain, and other integral organs of the body decrease. Rosuvastatin directly acts on the liver and stimulates the uptake of low-density lipoproteins or bad cholesterol. As a result, the overall plasma LDL and VLDL (very low-density lipoproteins) levels decrease. Therefore, Rosuvastatin has been known to reduce the risk of cardiac disorders, angina, congestive cardiac failure, and strokes.

What Important Warnings and Precautions Should Be Taken Before Using Rosuvastatin?

• Severe Muscle Problems - Rosuvastatin can cause severe muscle problems or myopathy. The symptoms of muscle problems include pain, tenderness, and weakness of the muscles. Myelopathy can progress to rhabdomyolysis, leading to muscle breakdown, renal disorders, and even death. The patient must consult his doctor immediately if he has unusual pain, weakness, tiredness, and fever.

• Liver Problems - Rosuvastatin can increase the levels of liver enzymes which can be a sign of damage. The doctors must check the levels of liver enzymes before administering Rosuvastatin to make sure that the liver enzymes are under controlled levels.

Precautions:

Before taking Rosuvastatin, the patient must inform the doctor if he or she:

1. Is allergic to Rosuvastatin, its contents, or other medications.

2. Takes prescription, over-the-counter drugs, vitamins, and other herbal supplements.

3. Takes antacids containing aluminum or magnesium hydroxide. The patient must take these drugs two hours before taking Rosuvastatin.

4. Is suffering from liver disease. The doctor might order a liver test to check whether the liver is working alright or not. However, the patient may be advised to discontinue the medication if his liver is not functioning properly.

5. Drinks alcohol, is more than 65 years old and has seizures, muscle aches, low blood pressure, and thyroid diseases.

6. Is pregnant or planning to conceive. The patient must use effective birth control measures to prevent pregnancy while taking Rosuvastatin or inform the doctor if they are already pregnant.

7. Is a lactating mother or planning to breastfeed the baby.

8. Is planning to undergo surgery.

How Should Rosuvastatin Be Used?

Rosuvastatin is mostly available in the form of capsules or tablets. The drug can be taken by mouth, mixed with water, or taken through a feeding tube. It is usually taken once daily with or without meals. However, the patient must take Rosuvastatin at the same time every day. The patient must follow the instructions written on the prescription label carefully and consult the doctor if he is unclear with the instructions. Take the drug as per the doctor's prescribed dosage schedule, and do not take more or less of it. Sometimes, the doctor might initially start with the low dose and increase the dose gradually. Swallow the capsule without chewing or crushing them. If the patient finds it difficult to swallow the capsule, he must open it and sprinkle the contents into one teaspoonful of apple sauce. Drink the entire mixture at once, and do not save the remaining portion for later use.

What Are the Different Drug Dosage Forms and Strengths?

The different dosage forms of Rosuvastatin have been described below:

• Dosage for Hyperlipidemia, Hypertriglyceridemia, and Type 3 Hyperlipoproteinemia:

  • Adult Dosage - 18 to 64 years of age: 5 mg to 40 mg.

  • Child Dosage - 0 to 17 years of age - The drug has not been studied in children and should not be used in people below 18 years.

• Older Adults - 65 years of age or above: The kidneys of older adults do not work as well as they should. As a result, a higher amount of the drug stays in the body for prolonged periods which increases the risk of side effects.

• Dosage for Hyperlipidemia:

  • Adult Dosage - 18 to 64 years of age: 5 mg to 40 mg once daily.

  • Child Dosage - 10 to 17 years: 5 mg to 20 mg once daily.

  • Child Dosage - 8 to 9 years: 5 mg to 10 mg once daily.

  • Child Dosage - 0 to 7 years: This medication should not be used in children below eight years.

What Are Some of the Side Effects of Rosuvastatin?

The common side effects of Rosuvastatin are listed below:

• Constipation.

• Stomachache.

• Dizziness.

• Difficulty in falling asleep.

• Depression.

• Pain in the joints.

• Headache.

• Memory loss.

• Confusion.

The serious side effects of Rosuvastatin are listed below:

• Muscle pain and weakness.

• Fever.

• Tiredness.

• Chest pain.

• Decreased urine output.

• Dark red urine.

• Yellowing of the skin and the eyes.

• Pain in the upper part of the abdomen.

• Weakness.

• Unusual bleeding.

• Loss of appetite.

• Rashes.

• Hives.

• Respiratory difficulties.

• Swelling of the face, nose, throat, and hands.

• Hoarseness.

The post-marketing side effects of Rosuvastatin are listed below:

• Numbness or tingling sensation in the extremities.

• Depression.

• Sleep disorders.

• Hepatic failure (liver failure).

• Thrombocytopenia (low levels of blood platelets).

• Enlargement of breast tissues in males.

Which Drugs Can Interact With Rosuvastatin?

Rosuvastatin can interact with vitamins, minerals, and herbs. Drug interaction is when the substance changes how the drug works, which can be harmful or prevent the drug from working properly. The drugs that can interact with Rosuvastatin are listed below:

1. Antacids - Antacids containing aluminum or magnesium reduce the amount of Rosuvastatin in the blood, making the drug less effective. As a result, the drug fails to treat the patient’s condition. Therefore, these drugs must be taken two hours before taking Rosuvastatin.

2. Anticoagulants - Blood thinners or anticoagulants are used to thin the blood. These drugs can increase the international normalized ratio, which is a measure of the rate of blood clot formation.

3. Cholesterol Drugs - When other drugs used to treat high cholesterol are taken with Rosuvastatin, the level of the drug increases in the blood resulting in muscle problems. The examples of such drugs are listed below:

   1. Niacin.

   2. Gemfibrozil.

   3. Fenofibrate.

4. HIV (Human Immunodeficiency Virus) Drugs - When anti-HIV drugs are taken with Rosuvastatin, the risk of muscle pain, weakness, and tenderness increases. Examples of the drugs are listed below:

   1. Atazanavir.

   2. Nelfinavir.

   3. Lopinavir.

   4. Ritonavir.

5. Other Drugs - The other drugs that interfere with the working of Rosuvastatin are listed below:

   1. Elbasvir (hepatitis C drugs).

   2. Cyclosporins (immunosuppressants).

   3. Colchicines (gout drugs).

   4. Darolutamide and Regorafenib (anti-cancer drugs).

Conclusion:

Rosuvastatin is commonly used to treat cholesterol-related problems in adults and children. Though other drugs are available to treat similar problems, Rosuvastatin is commonly used because of its safety and efficacy. However, this drug should not be considered the only treatment for weight loss. It is used with diet and weight loss exercises to maintain the body’s cholesterol levels. This drug is a boon for the ones who plan to undergo surgery for cardiac disorders because it prevents diseases like stroke, angina, and congestive heart failure. Hence, the patient must consult the doctor before taking Rosuvastatin to know its therapeutic uses.