Crestor (rosuvastatin calcium) is a prescription medication classified as a statin, specifically designed to manage elevated cholesterol levels and associated cardiovascular risks. It functions by inhibiting the HMG-CoA reductase enzyme in the liver, a critical step in cholesterol production, thereby effectively lowering low-density lipoprotein (LDL) and triglycerides while raising high-density lipoprotein (HDL). This medication is indicated for use in appropriate adult patient populations as part of a comprehensive treatment plan that includes dietary modification and exercise. Clinical evidence supports its role in reducing the risk of major cardiovascular events in select high-risk individuals.

Features

• Active pharmaceutical ingredient: Rosuvastatin calcium
• Available in multiple tablet strengths: 5 mg, 10 mg, 20 mg, and 40 mg
• Formulated for oral administration, once daily
• Manufactured under stringent quality control standards
• Requires a prescription from a licensed healthcare provider

Benefits

• Significantly reduces levels of LDL (bad) cholesterol
• Lowers triglyceride concentrations in the bloodstream
• Increases levels of HDL (good) cholesterol
• Reduces the risk of heart attack, stroke, and arterial revascularization procedures in high-risk patients
• Helps slow the progression of atherosclerosis
• Contributes to overall cardiovascular risk reduction when combined with lifestyle changes

Common use

Crestor is primarily prescribed for the treatment of hypercholesterolemia (high cholesterol) and mixed dyslipidemia. It is used in adult patients who have not achieved target lipid levels through diet and exercise alone. Additionally, it is indicated to reduce the risk of myocardial infarction and stroke in individuals without clinically evident coronary heart disease but with an increased risk based on age, hsCRP levels, and the presence of at least one additional cardiovascular risk factor. It may also be used in conjunction with other lipid-lowering therapies in certain complex dyslipidemias, as determined by a healthcare professional.

Dosage and direction

The recommended starting dose is typically 10 mg or 20 mg taken orally once daily, with or without food. Dosage should be individualized based on the patient’s LDL-C goals, the recommended baseline therapy, and potential for side effects. The 40 mg dose is reserved for patients who do not achieve their LDL-C goal with 20 mg and should only be used after careful assessment. Administration time can be any time of day, though consistency is advised. Dosage adjustments may be necessary for patients taking certain concomitant medications or those with predisposing factors for myopathy. Patients should swallow tablets whole and not crush or chew them.

Precautions

Before initiating Crestor therapy, physicians should perform a lipid panel and liver enzyme tests. Use with caution in patients who consume substantial quantities of alcohol or have a history of liver disease. Patients should be advised to report unexplained muscle pain, tenderness, or weakness immediately, particularly if accompanied by malaise or fever. Blood glucose levels should be monitored as statins can cause increases in HbA1c and fasting serum glucose. Caution is advised in patients with risk factors for hemorrhagic stroke. Crestor is not recommended during pregnancy or breastfeeding. Renal function should be assessed in patients with predisposing factors for renal impairment.

Contraindications

Crestor is contraindicated in patients with a known hypersensitivity to rosuvastatin calcium or any component of the formulation. It is contraindicated in patients with active liver disease or unexplained persistent elevations of hepatic transaminases. Use is contraindicated during pregnancy and in nursing mothers due to potential fetal harm and excretion in human milk. Concomitant use with cyclosporine is contraindicated. The 40 mg dose is contraindicated in patients of Asian ancestry, those with predisposing factors for myopathy/rhabdomyolysis, and patients with severe renal impairment (CrCl <30 mL/min/1.73m²).

Possible side effect

Common adverse reactions (≥2%) include headache, myalgia, abdominal pain, nausea, and constipation. Less frequent but clinically significant side effects may include: myopathy and rhabdomyolysis with renal dysfunction, hepatic enzyme elevations, memory loss and confusion, increased HbA1c and fasting serum glucose levels, and nightmares. Rare cases of immune-mediated necrotizing myopathy, an autoimmune myopathy, have been reported. Allergic reactions including rash, pruritus, urticaria, and very rarely, angioedema may occur. Patients should be monitored for symptoms of diabetes and hemorrhagic stroke.

Drug interaction

Crestor demonstrates several clinically important drug interactions. Concomitant use with cyclosporine is contraindicated. Gemfibrozil significantly increases rosuvastatin exposure and should be avoided. Other fibrates and niacin may increase the risk of myopathy. Antacids containing aluminum and magnesium hydroxide decrease rosuvastatin absorption; administration should be separated by at least 2 hours. Warfarin: Rosuvastatin may potentiate anticoagulant effect; monitor INR closely. Protease inhibitors and certain combination HIV treatments may increase rosuvastatin concentrations. Oral contraceptives containing ethinyl estradiol and norgestrel may have increased AUC. Careful consideration and potential dose adjustment are required when co-administering with these agents.

Missed dose

If a dose is missed, the patient should take it as soon as remembered, unless it is nearly time for the next scheduled dose. In that case, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not take two doses of Crestor at the same time to make up for a missed dose. Consistency in daily administration is important for maintaining stable lipid-lowering effects. If multiple doses are missed, patients should contact their healthcare provider for guidance rather than attempting to compensate with larger subsequent doses.

Overdose

There is no specific antidote for rosuvastatin overdose. In the event of suspected overdose, symptomatic and supportive measures should be instituted. Liver function and CK levels should be monitored. The patient should receive appropriate supportive treatment based on clinical presentation. Due to extensive hepatic metabolism, hemodialysis is unlikely to significantly enhance clearance. Cases of overdose have been reported with doses up to 640 mg; these were not associated with adverse experiences. However, given the potential for serious effects such as rhabdomyolysis and hepatic injury, any suspected overdose requires immediate medical attention and monitoring.

Storage

Store Crestor tablets at room temperature between 20°C to 25°C (68°F to 77°F) with excursions permitted between 15°C to 30°C (59°F to 86°F). Keep in the original container with the lid tightly closed to protect from moisture and light. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Properly discard any unused medication that is no longer needed or has expired. Do not flush medications down the toilet or pour them into a drain unless instructed to do so by specific disposal instructions.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Crestor is a prescription medication that should only be used under the supervision of a qualified healthcare professional. Patients should not initiate, discontinue, or change dosage without consulting their physician. The complete prescribing information contains additional important information including boxed warnings. Individual results may vary, and not all patients will experience the same benefits or side effects. Healthcare providers should assess the risks and benefits for each individual patient before prescribing.

Reviews

Clinical trials and post-marketing surveillance demonstrate Crestor’s efficacy in lipid management and cardiovascular risk reduction. In the JUPITER trial, rosuvastatin 20 mg significantly reduced major cardiovascular events in patients with elevated hsCRP. Many physicians report satisfactory LDL-C reduction in their patient populations, with most patients tolerating the medication well. Some reviews note the importance of monitoring for muscular symptoms, particularly at higher doses. Patient satisfaction often correlates with achieving lipid targets and the convenience of once-daily dosing. Real-world evidence continues to support the favorable benefit-risk profile established in clinical trials when used appropriately in indicated populations.