Crestor Disease Interactions
There are 5 disease interactions with Crestor (rosuvastatin).
HMG-CoA reductase inhibitors (applies to Crestor) rhabdomyolysis
Major Potential Hazard, Moderate plausibility. Applicable conditions: Myopathy, Myoneural Disorder, Hypothyroidism, Renal Dysfunction
Severe myopathy, including rhabdomyolysis with acute renal failure secondary to myoglobinuria, has been reported rarely with the use of HMG-CoA reductase inhibitors. The myopathy may be dose-related and is characterized by muscle aches and/or weakness in conjunction with increases in creatine phosphokinase (CPK) values exceeding 10 times the upper limit of normal. Therapy with HMG-CoA reductase inhibitors should be administered cautiously in patients with preexisting myopathy, in those with predisposing factors for myopathy or with a history of myoneural disorder, since it may delay the recognition or confound the diagnosis of a drug-induced musculoskeletal effect. Patients should be advised to report promptly any unusual muscle pain, tenderness or weakness, particularly if accompanied by malaise or fever. Periodic CPK determinations may be considered in some patients, although the value of such monitoring is uncertain. HMG-CoA reductase inhibitor therapy should be withdrawn if markedly elevated CPK levels occur or if drug-related myopathy is diagnosed or suspected.
References
- Hartung H-P, Toyka K, Schalke BB, Schmidt B "Pravastatin-associated inflammatory myopathy." N Engl J Med 327 (1992): 649-50
- Pierce LR, Gross TP, Wysowski DK "Myopathy and rhabdomyolysis associated with lovastatin-gemfibrozil combination therapy." JAMA 264 (1990): 71-5
- Walker JF "Simvastatin: the clinical profile." Am J Med 87 (1989): s44-6
- Simons LA "Simvastatin in severe primary hypercholesterolemia: efficacy, safety, and tolerability in 595 patients over 18 weeks. The Principal Investigators." Clin Cardiol 16 (1993): 317-22
- McGovern ME, Mellies MJ "Long-term experience with pravastatin in clinical research trials." Clin Ther 15 (1993): 57-64
- Witztum JL, Reaven P "Lovastatin, nicotinic acid, and rhabdomyolysis." Ann Intern Med 109 (1988): 597-8
- "Lovastatin 5-year safety and efficacy study. Lovastatin Study Groups I through IV." Arch Intern Med 153 (1993): 1079-87
- Corpier CL, Suki WN, Jones PH, et al. "Rhabdomyolysis and renal injury with lovastatin use. Report of two cases in cardiac transplant recipients." JAMA 260 (1988): 239-41
- Alivizatos PA, East C, Farmer JA, Grundy SM, Jones PH "Rhabdomyolysis in patients receiving lovastatin after cardiac transplantation." N Engl J Med 318 (1988): 47-8
- Munson J, Illingworth DR, Hosenpud J, Norman DJ "Myolysis and acute renal failure in a heart-transplant recipient receiving lovastatin." N Engl J Med 318 (1988): 46-7
- Mueller BA, Wallace CS "Lovastatin-induced rhabdomyolysis in the absence of concomitant drugs." Ann Pharmacother 26 (1992): 190-2
- Bilheimer DW "Long-term clinical tolerance of lovastatin and simvastatin." Cardiology 77 (1990): 58-65
- "Product Information. Mevacor (lovastatin)." Merck & Company Inc (2002):
- "Product Information. Pravachol (pravastatin)." Bristol-Myers Squibb (2001):
- "Product Information. Zocor (simvastatin)." Merck & Company Inc (2001):
- Abadia R, Agnus D, Chariot P, Charpentier C, Gherardi RK, Danan C "Simvastatin-induced rhabdomyolysis followed by a MELAS syndrome." Am J Med 94 (1993): 109-10
- McDonagh J, Winocour P, Walker DJ "Musculoskeletal manifestations during simvastatin therapy." Br J Rheumatol 32 (1993): 647-8
- Fattu JM, Troendle AJ, Levy RI "A quarter century of drug treatment of dyslipoproteinemia, with a focus on the new HMG-CoA reductase inhibitor fluvastatin." Circulation 87 (1993): i45-53
- "Product Information. Lescol (fluvastatin)." Novartis Pharmaceuticals (2001):
- Fernandezzatarain G, Villatoro J, Calvo C, Garcia H, Navarro V "Rhabdomyolysis and acute renal failure associated with lovastatin." Nephron 66 (1994): 483-4
- Jokubaitis LA "Updated clinical safety experience with fluvastatin." Am J Cardiol 73 (1994): d18-24
- Lees AM, Lees RS "Rhabdomyolysis from the coadministration of lovastatin and the antifungal agent itraconazole." N Engl J Med 333 (1995): 664-5
- Ahmand S "Lovastatin-induced myopathy in a hypothyroid patient." J Fam Pract 41 (1995): 227-8
- Cook TJ, Miettinen T, Haghfelt T, Pyorala K, Thorgeirsso, Kjekshus J, Berg K, Faergeman O, Musliner TA, Olsson AG, Pedersen TR "Safety and tolerability of cholesterol lowering with simvastatin during 5 years in the scandinavian simvastatin survival study." Arch Intern Med 156 (1996): 2085-92
- Black DM, Bakker-Arkema RG, Isaacsohn JL, Keilson LM, Miller VT, Brown WV, Davidson MH, Davignon J, Goldstein RJ, Shurzinske LJ, Weiss SR "Efficacy and safety of a new HMG-CoA reductase inhibitor, atorvastatin, in patients with hypertriglyceridemia." JAMA 275 (1996): 128-33
- "Product Information. Lipitor (atorvastatin)." Parke-Davis (2001):
- Dubufvereijken PWG, Spooren PFMJ, Vandoormaal JJ, Vanpuijenbroek EP "Possible increased risk of rhabdomyolysis during concomitant use of simvastatin and gemfibrozil." J Intern Med 240 (1996): 403-4
- "Product Information. Baycol (cerivastatin)." Bayer (2001):
- Fisher KA, Grunden JW "Lovastatin-induced rhabdomyolysis possibly associated with clarithromycin and azithromycin." Ann Pharmacother 31 (1997): 859-63
- Iliadis EA, Rosenson RS "Long-term safety of pravastatin-gemfibrozil therapy in mixed hyperlipidemia." Clin Cardiol 22 (1999): 25-8
- van Puijenbroek EP, Du Buf-Vereijken PW, Spooren PF, van Doormaal JJ "Possible increased risk of rhabdomyolysis during concomitant use of simvastatin and gemfibrozil." J Intern Med 240 (1996): 403-4
- Alvarez JM, Goldstein J, Rawdanowiz TJ "Rhadbdomyolysis after coronary artery bypass grafting in a patient receiving simvastatin." J Thorac Cardiovasc Surg 116 (1998): 654-5
- Kindred LH, Pogson GW, Carper BG "Rhabdomyolysis and renal failure associated with cerivastatin-gemfibrozil combination therapy." Am J Cardiol 83 (1999): 1146
- "Product Information. Crestor (rosuvastatin)." AstraZeneca Pharma Inc (2003):
- "Product Information. Livalo (pitavastatin)." Kowa Pharmaceuticals America (formerly ProEthic) (2010):
HMG-CoA reductase inhibitors (applies to Crestor) cognitive impairment
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: CNS Disorder
Cognitive impairment (e.g., memory loss, forgetfulness, amnesia, memory impairment, confusion) have been observed in patients receiving statins. The reports are usually not serious, and reversible upon statin discontinuation. Caution is recommended when using these agents in patients with cognitive impairment.
References
- "Product Information. Mevacor (lovastatin)." Merck & Company Inc (2002):
- "Product Information. Pravachol (pravastatin)." Bristol-Myers Squibb (2001):
- "Product Information. Zocor (simvastatin)." Merck & Company Inc (2001):
- "Product Information. Lescol (fluvastatin)." Novartis Pharmaceuticals (2001):
- "Product Information. Lipitor (atorvastatin)." Parke-Davis (2001):
- "Product Information. Crestor (rosuvastatin)." AstraZeneca Pharma Inc (2003):
HMG-CoA reductase inhibitors (applies to Crestor) diabetes
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Diabetes Mellitus
Increases in HbA1c and fasting serum glucose levels have been reported with the use of certain HMG-CoA reductase inhibitors. Caution should be exercised when using these agents in diabetic patients and close monitoring is recommended.
References
- "Product Information. Mevacor (lovastatin)." Merck & Company Inc (2002):
- "Product Information. Pravachol (pravastatin)." Bristol-Myers Squibb (2001):
- "Product Information. Zocor (simvastatin)." Merck & Company Inc (2001):
- "Product Information. Lescol (fluvastatin)." Novartis Pharmaceuticals (2001):
- "Product Information. Lipitor (atorvastatin)." Parke-Davis (2001):
- "Product Information. Crestor (rosuvastatin)." AstraZeneca Pharma Inc (2003):
- "Product Information. Livalo (pitavastatin)." Kowa Pharmaceuticals America (formerly ProEthic) (2010):
HMG-CoA reductase inhibitors (applies to Crestor) renal disease
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Renal Dysfunction
Some HMG-CoA reductase inhibitors such as fluvastatin, have not been studied in patients with severe renal impairment or end-stage renal disease. Some others such as pitavastatin and simvastatin, require a dose reduction when used in this group of patients. Caution and close monitoring is advised when using these drugs in patients with renal impairment.
References
- "Product Information. Mevacor (lovastatin)." Merck & Company Inc (2002):
- "Product Information. Pravachol (pravastatin)." Bristol-Myers Squibb (2001):
- "Product Information. Zocor (simvastatin)." Merck & Company Inc (2001):
- "Product Information. Lescol (fluvastatin)." Novartis Pharmaceuticals (2001):
- "Product Information. Lipitor (atorvastatin)." Parke-Davis (2001):
- "Product Information. Crestor (rosuvastatin)." AstraZeneca Pharma Inc (2003):
- "Product Information. Livalo (pitavastatin)." Kowa Pharmaceuticals America (formerly ProEthic) (2010):
Rosuvastatin (applies to Crestor) hematuria/proteinuria
Moderate Potential Hazard, Moderate plausibility.
An association between rosuvastatin and the development of proteinuria and microscopic hematuria was observed among treated patients during clinical trials. Patients with unexplained persistent proteinuria and/or hematuria during routine urinalysis testing should be instructed to reduce the dose of rosuvastatin according to clinical standards. Therapy with rosuvastatin should be administered cautiously in patients showing abnormal urinalysis. Monitoring for proteinuria and hematuria is recommended.
References
- "Product Information. Crestor (rosuvastatin)." AstraZeneca Pharma Inc (2003):
Crestor drug interactions
There are 198 drug interactions with Crestor (rosuvastatin).
Crestor alcohol/food interactions
There is 1 alcohol/food interaction with Crestor (rosuvastatin).
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Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
No interaction information available. |
Further information
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