rosuvastatin

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 :1001.1 (as calcium salt)

%Protein binding :90

%Excreted unchanged in urine : 5

Volume of distribution (L/kg) :134 litres

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

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20–60 5–20 mg daily

10 to 20 : 5–20 mg daily

<10 : 5–20 mg daily

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

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

HD :Not dialysed. Dose as in GFR <10 mL/min

HDF/high flux :Unknown dialysability. Dose as in GFR <10 mL/min

CAV/VVHD :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

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Route

Oral

Rate of Administration

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Comments

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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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