Ro-statin (Tablets) Instructions for Use
Marketing Authorization Holder
Atoll LLC (Russia)
Manufactured By
Ozon, LLC (Russia)
ATC Code
C10AA07 (Rosuvastatin)
Active Substance
Rosuvastatin (Rec.INN WHO registered)
Dosage Forms
| Ro-statin | Film-coated tablets, 5 mg: 5, 6, 7, 10, 14, 15, 18, 20, 21, 24, 25, 28, 30, 35, 36, 40, 42, 45, 50, 54, 60, 63, 70, 80, 90 or 100 pcs. | |
| Film-coated tablets, 10 mg: 5, 6, 7, 10, 14, 15, 18, 20, 21, 24, 25, 28, 30, 35, 36, 40, 42, 45, 50, 54, 60, 63, 70, 80, 90 or 100 pcs. | ||
| Film-coated tablets, 20 mg: 5, 6, 7, 10, 14, 15, 18, 20, 21, 24, 25, 28, 30, 35, 36, 40, 42, 45, 50, 54, 60, 63, 70, 80, 90 or 100 pcs. | ||
| Film-coated tablets, 40 mg: 5, 6, 7, 10, 14, 15, 18, 20, 21, 24, 25, 28, 30, 35, 36, 40, 42, 45, 50, 54, 60, 63, 70, 80, 90 or 100 pcs. |
Dosage Form, Packaging, and Composition
Capsules hard gelatin, size #2, light gray body and cap, opaque; capsule contents – a mixture of powder and granules or microgranulated powder, white or white with a yellowish tint, compaction of the capsule contents into lumps shaped like the capsule is allowed, easily destroyed when pressed.
| 1 tab. | |
| Rosuvastatin calcium | 5.21 mg, |
| Equivalent to rosuvastatin content | 5 mg |
Excipients: lactose monohydrate (milk sugar) – 144.824 mg, microcrystalline cellulose – 25.344 mg, croscarmellose sodium – 9.311 mg, povidone (povidone K25) – 5.431 mg, colloidal silicon dioxide – 1.94 mg, magnesium stearate – 0.97 mg.
Capsule body composition iron oxide black dye – 0.05%, titanium dioxide – 2%, gelatin – up to 100%.
Capsule cap composition iron oxide yellow dye – 0.1%, titanium dioxide – 2%, gelatin – up to 100%.
5 pcs. – contour cell packaging (1) – cardboard packs.
5 pcs. – contour cell packaging (2) – cardboard packs.
5 pcs. – contour cell packaging (3) – cardboard packs.
5 pcs. – contour cell packaging (4) – cardboard packs.
5 pcs. – contour cell packaging (5) – cardboard packs.
5 pcs. – contour cell packaging (6) – cardboard packs.
5 pcs. – contour cell packaging (9) – cardboard packs.
5 pcs. – contour cell packaging (10) – cardboard packs.
6 pcs. – contour cell packaging (1) – cardboard packs.
6 pcs. – contour cell packaging (2) – cardboard packs.
6 pcs. – contour cell packaging (3) – cardboard packs.
6 pcs. – contour cell packaging (4) – cardboard packs.
6 pcs. – contour cell packaging (5) – cardboard packs.
6 pcs. – contour cell packaging (6) – cardboard packs.
6 pcs. – contour cell packaging (9) – cardboard packs.
6 pcs. – contour cell packaging (10) – cardboard packs.
7 pcs. – contour cell packaging (1) – cardboard packs.
7 pcs. – contour cell packaging (2) – cardboard packs.
7 pcs. – contour cell packaging (3) – cardboard packs.
7 pcs. – contour cell packaging (4) – cardboard packs.
7 pcs. – contour cell packaging (5) – cardboard packs.
7 pcs. – contour cell packaging (6) – cardboard packs.
7 pcs. – contour cell packaging (9) – cardboard packs.
7 pcs. – contour cell packaging (10) – cardboard packs.
10 pcs. – contour cell packaging (1) – cardboard packs.
10 pcs. – contour cell packaging (2) – cardboard packs.
10 pcs. – contour cell packaging (3) – cardboard packs.
10 pcs. – contour cell packaging (4) – cardboard packs.
10 pcs. – contour cell packaging (5) – cardboard packs.
10 pcs. – contour cell packaging (6) – cardboard packs.
10 pcs. – contour cell packaging (9) – cardboard packs.
10 pcs. – contour cell packaging (10) – cardboard packs.
10 pcs. – polyethylene terephthalate jars (1) – cardboard packs.
60 pcs. – polyethylene terephthalate jars (1) – cardboard packs.
70 pcs. – polyethylene terephthalate jars (1) – cardboard packs.
80 pcs. – polyethylene terephthalate jars (1) – cardboard packs.
90 pcs. – polyethylene terephthalate jars (1) – cardboard packs.
100 pcs. – polyethylene terephthalate jars (1) – cardboard packs.
Capsules hard gelatin, size #2, light gray body, yellow cap with a light beige tint, opaque; capsule contents – a mixture of powder and granules or microgranulated powder, white or white with a yellowish tint, compaction of the capsule contents into lumps shaped like the capsule is allowed, easily destroyed when pressed.
| 1 tab. | |
| Rosuvastatin calcium | 10.42 mg, |
| Equivalent to rosuvastatin content | 10 mg |
Excipients: lactose monohydrate (milk sugar) – 140.658 mg, microcrystalline cellulose – 24.612 mg, croscarmellose sodium – 9.154 mg, povidone (povidone K25) – 5.274 mg, colloidal silicon dioxide – 1.94 mg, magnesium stearate – 1.94 mg.
Capsule body composition iron oxide black dye – 0.05%, titanium dioxide – 2%, gelatin – up to 100%.
Capsule cap composition iron oxide yellow dye – 0.1%, titanium dioxide – 2%, gelatin – up to 100%.
5 pcs. – contour cell packaging (1) – cardboard packs.
5 pcs. – contour cell packaging (2) – cardboard packs.
5 pcs. – contour cell packaging (3) – cardboard packs.
5 pcs. – contour cell packaging (4) – cardboard packs.
5 pcs. – contour cell packaging (5) – cardboard packs.
5 pcs. – contour cell packaging (6) – cardboard packs.
5 pcs. – contour cell packaging (9) – cardboard packs.
5 pcs. – contour cell packaging (10) – cardboard packs.
6 pcs. – contour cell packaging (1) – cardboard packs.
6 pcs. – contour cell packaging (2) – cardboard packs.
6 pcs. – contour cell packaging (3) – cardboard packs.
6 pcs. – contour cell packaging (4) – cardboard packs.
6 pcs. – contour cell packaging (5) – cardboard packs.
6 pcs. – contour cell packaging (6) – cardboard packs.
6 pcs. – contour cell packaging (9) – cardboard packs.
6 pcs. – contour cell packaging (10) – cardboard packs.
7 pcs. – contour cell packaging (1) – cardboard packs.
7 pcs. – contour cell packaging (2) – cardboard packs.
7 pcs. – contour cell packaging (3) – cardboard packs.
7 pcs. – contour cell packaging (4) – cardboard packs.
7 pcs. – contour cell packaging (5) – cardboard packs.
7 pcs. – contour cell packaging (6) – cardboard packs.
7 pcs. – contour cell packaging (9) – cardboard packs.
7 pcs. – contour cell packaging (10) – cardboard packs.
10 pcs. – contour cell packaging (1) – cardboard packs.
10 pcs. – contour cell packaging (2) – cardboard packs.
10 pcs. – contour cell packaging (3) – cardboard packs.
10 pcs. – contour cell packaging (4) – cardboard packs.
10 pcs. – contour cell packaging (5) – cardboard packs.
10 pcs. – contour cell packaging (6) – cardboard packs.
10 pcs. – contour cell packaging (9) – cardboard packs.
10 pcs. – contour cell packaging (10) – cardboard packs.
10 pcs. – polyethylene terephthalate jars (1) – cardboard packs.
60 pcs. – polyethylene terephthalate jars (1) – cardboard packs.
70 pcs. – polyethylene terephthalate jars (1) – cardboard packs.
80 pcs. – polyethylene terephthalate jars (1) – cardboard packs.
90 pcs. – polyethylene terephthalate jars (1) – cardboard packs.
100 pcs. – polyethylene terephthalate jars (1) – cardboard packs.
Capsules hard gelatin, size #2, light gray body, light yellow cap with a beige tint, opaque; capsule contents – a mixture of powder and granules or microgranulated powder, white or white with a yellowish tint, compaction of the capsule contents into lumps shaped like the capsule is allowed, easily destroyed when pressed.
| 1 tab. | |
| Rosuvastatin calcium | 20.83 mg, |
| Equivalent to rosuvastatin content | 20 mg |
Excipients: lactose monohydrate (milk sugar) – 132.329 mg, microcrystalline cellulose – 23.157 mg, croscarmellose sodium – 8.842 mg, povidone (povidone K25) – 4.962 mg, colloidal silicon dioxide – 1.94 mg, magnesium stearate – 1.94 mg.
Capsule body composition iron oxide black dye – 0.05%, titanium dioxide – 2%, gelatin – up to 100%.
Capsule cap composition iron oxide yellow dye – 0.1763%, titanium dioxide – 0.9744%, gelatin – up to 100%.
5 pcs. – contour cell packaging (1) – cardboard packs.
5 pcs. – contour cell packaging (2) – cardboard packs.
5 pcs. – contour cell packaging (3) – cardboard packs.
5 pcs. – contour cell packaging (4) – cardboard packs.
5 pcs. – contour cell packaging (5) – cardboard packs.
5 pcs. – contour cell packaging (6) – cardboard packs.
5 pcs. – contour cell packaging (9) – cardboard packs.
5 pcs. – contour cell packaging (10) – cardboard packs.
6 pcs. – contour cell packaging (1) – cardboard packs.
6 pcs. – contour cell packaging (2) – cardboard packs.
6 pcs. – contour cell packaging (3) – cardboard packs.
6 pcs. – contour cell packaging (4) – cardboard packs.
6 pcs. – contour cell packaging (5) – cardboard packs.
6 pcs. – contour cell packaging (6) – cardboard packs.
6 pcs. – contour cell packaging (9) – cardboard packs.
6 pcs. – contour cell packaging (10) – cardboard packs.
7 pcs. – contour cell packaging (1) – cardboard packs.
7 pcs. – contour cell packaging (2) – cardboard packs.
7 pcs. – contour cell packaging (3) – cardboard packs.
7 pcs. – contour cell packaging (4) – cardboard packs.
7 pcs. – contour cell packaging (5) – cardboard packs.
7 pcs. – contour cell packaging (6) – cardboard packs.
7 pcs. – contour cell packaging (9) – cardboard packs.
7 pcs. – contour cell packaging (10) – cardboard packs.
10 pcs. – contour cell packaging (1) – cardboard packs.
10 pcs. – contour cell packaging (2) – cardboard packs.
10 pcs. – contour cell packaging (3) – cardboard packs.
10 pcs. – contour cell packaging (4) – cardboard packs.
10 pcs. – contour cell packaging (5) – cardboard packs.
10 pcs. – contour cell packaging (6) – cardboard packs.
10 pcs. – contour cell packaging (9) – cardboard packs.
10 pcs. – contour cell packaging (10) – cardboard packs.
10 pcs. – polyethylene terephthalate jars (1) – cardboard packs.
60 pcs. – polyethylene terephthalate jars (1) – cardboard packs.
70 pcs. – polyethylene terephthalate jars (1) – cardboard packs.
80 pcs. – polyethylene terephthalate jars (1) – cardboard packs.
90 pcs. – polyethylene terephthalate jars (1) – cardboard packs.
100 pcs. – polyethylene terephthalate jars (1) – cardboard packs.
Capsules hard gelatin, size #0, brown body, dark brown cap, opaque; capsule contents – a mixture of powder and granules or microgranulated powder, white or white with a yellowish tint, compaction of the capsule contents into lumps shaped like the capsule is allowed, easily destroyed when pressed.
| 1 tab. | |
| Rosuvastatin calcium | 41.66 mg, |
| Equivalent to rosuvastatin content | 40 mg |
Excipients: lactose monohydrate (milk sugar) – 264.658 mg, microcrystalline cellulose – 46.314 mg, croscarmellose sodium – 17.684 mg, povidone (povidone K25) – 4.924 mg, colloidal silicon dioxide – 3.88 mg, magnesium stearate – 3.88 mg.
Capsule body composition iron oxide black dye – 0.17%, iron oxide red dye – 0.25%, iron oxide yellow dye – 0.85%, titanium dioxide – 1.3333%, gelatin – up to 100%.
Capsule cap composition iron oxide black dye – 0.53%, iron oxide red dye – 0.93%, iron oxide yellow dye – 0.2%, titanium dioxide – 0.3333%, gelatin – up to 100%.
5 pcs. – contour cell packaging (1) – cardboard packs.
5 pcs. – contour cell packaging (2) – cardboard packs.
5 pcs. – contour cell packaging (3) – cardboard packs.
5 pcs. – contour cell packaging (4) – cardboard packs.
5 pcs. – contour cell packaging (5) – cardboard packs.
5 pcs. – contour cell packaging (6) – cardboard packs.
5 pcs. – contour cell packaging (9) – cardboard packs.
5 pcs. – contour cell packaging (10) – cardboard packs.
6 pcs. – contour cell packaging (1) – cardboard packs.
6 pcs. – contour cell packaging (2) – cardboard packs.
6 pcs. – contour cell packaging (3) – cardboard packs.
6 pcs. – contour cell packaging (4) – cardboard packs.
6 pcs. – contour cell packaging (5) – cardboard packs.
6 pcs. – contour cell packaging (6) – cardboard packs.
6 pcs. – contour cell packaging (9) – cardboard packs.
6 pcs. – contour cell packaging (10) – cardboard packs.
7 pcs. – contour cell packaging (1) – cardboard packs.
7 pcs. – contour cell packaging (2) – cardboard packs.
7 pcs. – contour cell packaging (3) – cardboard packs.
7 pcs. – contour cell packaging (4) – cardboard packs.
7 pcs. – contour cell packaging (5) – cardboard packs.
7 pcs. – contour cell packaging (6) – cardboard packs.
7 pcs. – contour cell packaging (9) – cardboard packs.
7 pcs. – contour cell packaging (10) – cardboard packs.
10 pcs. – contour cell packaging (1) – cardboard packs.
10 pcs. – contour cell packaging (2) – cardboard packs.
10 pcs. – contour cell packaging (3) – cardboard packs.
10 pcs. – contour cell packaging (4) – cardboard packs.
10 pcs. – contour cell packaging (5) – cardboard packs.
10 pcs. – contour cell packaging (6) – cardboard packs.
10 pcs. – contour cell packaging (9) – cardboard packs.
10 pcs. – contour cell packaging (10) – cardboard packs.
10 pcs. – polyethylene terephthalate jars (1) – cardboard packs.
60 pcs. – polyethylene terephthalate jars (1) – cardboard packs.
70 pcs. – polyethylene terephthalate jars (1) – cardboard packs.
80 pcs. – polyethylene terephthalate jars (1) – cardboard packs.
90 pcs. – polyethylene terephthalate jars (1) – cardboard packs.
100 pcs. – polyethylene terephthalate jars (1) – cardboard packs.
Clinical-Pharmacological Group
Hypolipidemic agent
Pharmacotherapeutic Group
Hypolipidemic agent – HMG-CoA reductase inhibitor
Pharmacological Action
Hypolipidemic agent from the group of statins, an HMG-CoA reductase inhibitor. Through the principle of competitive antagonism, the statin molecule binds to the part of the coenzyme A receptor where this enzyme attaches. Another part of the statin molecule inhibits the process of converting hydroxymethylglutarate into mevalonate, an intermediate product in the synthesis of the cholesterol molecule.
Inhibition of HMG-CoA reductase activity leads to a series of sequential reactions, resulting in a decrease in intracellular cholesterol content and a compensatory increase in LDL receptor activity and, accordingly, an acceleration of LDL cholesterol (Ch) catabolism.
The hypolipidemic effect of statins is associated with a decrease in total Ch levels due to LDL-Ch. The reduction in LDL levels is dose-dependent and is not linear but exponential in nature.
Statins do not affect the activity of lipoprotein and hepatic lipases, do not have a significant effect on the synthesis and catabolism of free fatty acids, so their effect on TG levels is secondary and mediated through their main effects of reducing LDL-Ch levels. The moderate reduction in TG levels during statin treatment is apparently associated with the expression of remnant (apo E) receptors on the surface of hepatocytes, involved in the catabolism of IDL, which contain approximately 30% TG.
In addition to the hypolipidemic effect, statins have a positive effect on endothelial dysfunction (a preclinical sign of early atherosclerosis), on the vascular wall, the state of atheroma, improve the rheological properties of blood, and have antioxidant and antiproliferative properties.
The therapeutic effect appears within 1 week after the start of therapy and after 2 weeks of treatment is 90% of the maximum possible effect, which is usually achieved by the 4th week and thereafter remains constant.
Pharmacokinetics
After oral administration, the Cmax of rosuvastatin in blood plasma is reached in approximately 5 hours. Bioavailability is approximately 20%.
Rosuvastatin accumulates in the liver. Vd is approximately 134 L. Binding to plasma proteins (mainly albumin) is approximately 90%.
It is biotransformed to a small extent (about 10%), being a non-profile substrate for cytochrome P450 system isoenzymes. The main isoenzyme involved in the metabolism of rosuvastatin is CYP2C9. Isoenzymes CYP2C19, CYP3A4, and CYP2D6 are involved in the metabolism to a lesser extent.
The main identified metabolites of rosuvastatin are N-desmethyl and lactone metabolites. N-desmethyl is approximately 50% less active than Rosuvastatin; lactone metabolites are pharmacologically inactive.
About 90% of the rosuvastatin dose is excreted unchanged in the feces. The remainder is excreted in the urine. Plasma T1/2 is approximately 19 hours. T1/2 does not change with increasing dose. The mean plasma clearance value is approximately 50 L/h (coefficient of variation 21.7%).
As with other HMG-CoA reductase inhibitors, the membrane cholesterol transporter is involved in the hepatic uptake of rosuvastatin, playing an important role in the hepatic elimination of rosuvastatin.
The systemic exposure of rosuvastatin increases proportionally with the dose.
In patients with severe renal failure (CrCl <30 ml/min), the plasma concentration of rosuvastatin is 3 times higher, and the concentration of N-desmethyl is 9 times higher than in healthy volunteers. The plasma concentration of rosuvastatin in patients on hemodialysis was approximately 50% higher than in healthy volunteers.
In patients with hepatic insufficiency, with a severity of 8 and 9 on the Child-Pugh scale, an increase in T1/2 of at least 2 times was noted.
Indications
Hypercholesterolemia (type IIa, including familial heterozygous hypercholesterolemia) or mixed hypercholesterolemia (type IIb) as an adjunct to diet, when diet and other non-pharmacological treatments (e.g., exercise, weight loss) are insufficient.
Familial homozygous hypercholesterolemia as an adjunct to diet and other cholesterol-lowering therapy or in cases where such therapy is not suitable for the patient.
ICD codes
| ICD-10 code | Indication |
| E78.0 | Pure hypercholesterolemia |
| E78.2 | Mixed hyperlipidemia |
| ICD-11 code | Indication |
| 5C80.00 | Primary hypercholesterolemia |
| 5C80.2 | Mixed hyperlipidemia |
| EB90.21 | Tuberous xanthoma |
| EB90.22 | Eruptive xanthoma |
Dosage Regimen
| The method of application and dosage regimen for a specific drug depend on its form of release and other factors. The optimal dosage regimen is determined by the doctor. It is necessary to strictly adhere to the compliance of the dosage form of a specific drug with the indications for use and dosage regimen. |
It is taken orally. The recommended initial dose is 10 mg once daily. If necessary, the dose can be increased to 20 mg after 4 weeks. An increase in dose to 40 mg is possible only in patients with severe hypercholesterolemia and a high risk of cardiovascular complications (especially in patients with familial hypercholesterolemia) with insufficient efficacy at a dose of 20 mg and under medical supervision.
Adverse Reactions
Nervous system disorders: frequent – headache, dizziness, asthenic syndrome; possible – anxiety, depression, insomnia, neuralgia, paresthesia.
Digestive system disorders: frequent – constipation, nausea, abdominal pain; possible – reversible transient dose-dependent increase in hepatic transaminase activity, dyspepsia (including diarrhea, flatulence, vomiting), gastritis, gastroenteritis.
Respiratory system disorders: frequent – pharyngitis; possible – rhinitis, sinusitis, bronchial asthma, bronchitis, cough, dyspnea, pneumonia.
Cardiovascular system disorders: possible – angina pectoris, increased blood pressure, palpitations, vasodilation.
Musculoskeletal system disorders: frequent – myalgia; possible – arthralgia, arthritis, muscle hypertonia, back pain, pathological limb fracture (without injury); rare – myopathy, rhabdomyolysis (concomitant with renal impairment, while taking rosuvastatin at a dose of 40 mg); frequency unknown – occurrence or exacerbation of myasthenia.
Urinary system disorders: tubular proteinuria (in less than 1% of cases – for doses of 10 and 20 mg, 3% of cases – for a dose of 40 mg); possible – peripheral edema (of the hands, legs, ankles, shins), lower abdominal pain, urinary tract infections.
Eye disorders: frequency unknown – ocular myasthenia.
Allergic reactions: possible – skin rash, skin itching; rare – angioedema.
Laboratory parameters: transient dose-dependent increase in CPK activity (if CPK activity increases more than 5 times compared to the upper limit of normal, therapy should be temporarily discontinued).
Other: frequent – asthenic syndrome; possible – accidental injury, anemia, chest pain, diabetes mellitus, ecchymosis, influenza-like syndrome, periodontal abscess.
Contraindications
Active liver disease (including persistent increase in hepatic transaminase activity or any increase in transaminase activity more than 3 times the upper limit of normal), severe renal impairment (creatinine clearance <30 ml/min), myopathy, concurrent use of cyclosporine, pregnancy, lactation (breastfeeding), women of reproductive potential not using adequate contraception, children and adolescents under 18 years of age, hypersensitivity to rosuvastatin.
Use in Pregnancy and Lactation
Contraindicated during pregnancy and lactation.
Do not use in women of reproductive potential not using reliable methods of contraception.
Use in Hepatic Impairment
Contraindicated in active liver disease (including persistent increase in hepatic transaminase activity or any increase in transaminase activity more than 3 times the upper limit of normal).
Use in Renal Impairment
Contraindicated in severe renal impairment (creatinine clearance <30 ml/min).
Pediatric Use
Contraindicated in children and adolescents under 18 years of age (because efficacy and safety have not been established).
Special Precautions
Use with caution in the presence of risk factors for rhabdomyolysis (including renal failure, hypothyroidism, personal or family history of hereditary muscular diseases and previous history of muscle toxicity with other HMG-CoA reductase inhibitors or fibrates), in chronic alcoholism, in patients over 65 years of age, with a history of liver disease, sepsis, arterial hypotension, during major surgical procedures, trauma, severe metabolic, endocrine or electrolyte disturbances, in uncontrolled epilepsy, in persons of Asian origin (Chinese, Japanese).
Therapy should be discontinued if the CPK level is significantly increased (more than 5 times the upper limit of normal) or if muscle symptoms are severe and cause daily discomfort (even if the CPK level is 5 times less than the upper limit of normal).
When using rosuvastatin at a dose of 40 mg, it is recommended to monitor renal function parameters.
In most cases, proteinuria decreases or disappears during therapy and does not indicate the occurrence of acute or progression of existing kidney disease.
An increase in the incidence of myositis and myopathy has been reported in patients taking other HMG-CoA reductase inhibitors in combination with fibric acid derivatives (including gemfibrozil), cyclosporine, nicotinic acid, azole antifungals, protease inhibitors and macrolide antibiotics. Gemfibrozil increases the risk of myopathy when co-administered with some HMG-CoA reductase inhibitors. Therefore, concomitant administration of rosuvastatin and gemfibrozil is not recommended. The risk-benefit ratio should be carefully considered when using rosuvastatin concomitantly with fibrates or niacin.
It is recommended to determine liver function parameters before starting therapy and 3 months after starting therapy. Rosuvastatin should be discontinued or the dose reduced if the serum transaminase activity level exceeds 3 times the upper limit of normal.
In patients with hypercholesterolemia due to hypothyroidism or nephrotic syndrome, therapy for the underlying diseases should be carried out before starting treatment with rosuvastatin.
Effect on ability to drive vehicles and operate machinery
When engaging in potentially hazardous activities, patients should take into account that dizziness may occur during therapy.
Drug Interactions
With simultaneous use of rosuvastatin and cyclosporine, the AUC of rosuvastatin was on average 7 times higher than the value observed in healthy volunteers, while the plasma concentration of cyclosporine did not change.
Initiation of rosuvastatin therapy or an increase in the drug dose in patients simultaneously receiving vitamin K antagonists (e.g., warfarin) may lead to an increase in prothrombin time and INR, and discontinuation of rosuvastatin or a dose reduction may lead to a decrease in INR (in such cases, monitoring of INR is recommended).
Concomitant use of rosuvastatin and gemfibrozil leads to a 2-fold increase in Cmax in plasma and AUC of rosuvastatin.
Concomitant use of rosuvastatin and antacids containing aluminum and magnesium hydroxide leads to a decrease in the plasma concentration of rosuvastatin by approximately 50%. This effect is less pronounced if antacids are taken 2 hours after taking rosuvastatin (clinical significance is unknown).
Concomitant use of rosuvastatin and erythromycin leads to a decrease in the AUC of rosuvastatin by 20% and Cmax of rosuvastatin by 30% (probably as a result of increased intestinal motility caused by taking erythromycin).
Concomitant use of rosuvastatin and oral contraceptives increases the AUC of ethinyl estradiol and the AUC of norgestrel by 26% and 34%, respectively. Such interaction cannot be excluded with simultaneous use of rosuvastatin and hormone replacement therapy.
Gemfibrozil, other fibrates and hypolipidemic doses of nicotinic acid (≥1 g/day) increased the risk of myopathy when used concomitantly with other HMG-CoA reductase inhibitors, possibly because they can cause myopathy when used as monotherapy.
Concomitant use of rosuvastatin and itraconazole (a CYP3A4 inhibitor) increases the AUC of rosuvastatin by 28% (clinically insignificant).
Storage Conditions
Store at 2°C (36°F) to 25°C (77°F). Keep in original packaging, protected from light. Keep out of reach of children.
Dispensing Status
Rx Only
Important Safety Information
This information is for educational purposes only and does not replace professional medical advice. Always consult your doctor before use. Dosage and side effects may vary. Use only as prescribed.
Medical Disclaimer
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