CLINICAL USE


HMG CoA reductase inhibitor:Hyperlipidaemia

DOSE IN NORMAL RENAL FUNCTION

5–40 mg daily Asians, people at increased risk of myopathy, and in combination with fibrates: 5–20 mg daily

PHARMACOKINETICS

  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :1001.1 (as calcium salt)
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :90
  • %Excreted unchanged in urine &nbsp &nbsp : 5

  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp :134 litres

  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :19/Increased

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

    20–60 5–20 mg daily
  • 10 to 20 &nbsp &nbsp : 5–20 mg daily
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : 5–20 mg daily

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Unlikely dialysability. Dose as in GFR <10 mL/min.

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in GFR <10 mL/min
  • HDF/high flux &nbsp :Unknown dialysability. Dose as in GFR <10 mL/min
  • CAV/VVHD &nbsp &nbsp &nbsp:Unknown dialysability. Dose as in GFR 10 to 20 mL/min

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs
  • Antibacterials: erythromycin reduces concentration of rosuvastatin; increased risk of myopathy with daptomycin
  • Anticoagulants: effect of coumarins and phenindione enhanced
  • Ciclosporin: increased risk of myopathy – avoid concomitant useLipid-lowering agents: increased risk of myopathy with fibrates, gemfibrozil (avoid) and nicotinic acid

    ADMINISTRATION

    Reconstition

    –

    Route

    Oral

    Rate of Administration

    –

    Comments

    –

    OTHER INFORMATION

    In renal impairment, doses above 20 mg should not be used due to risk of myopathyDo not use doses greater than 20 mg in Asian patientsAlways start at a dose of 5 mg The 40 mg dose should only be used under specialist supervisionIncreased risk of proteinuria with doses above 40 mgCase studies from Glasgow have shown that statins in combination with fusidic acid have an increased risk of causing myopathy in diabetic patients.
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