Crestor: 7 things you should know
Medically reviewed by Carmen Fookes, BPharm. Last updated on Dec 29, 2019.
1. How it works
- Crestor is a brand (trade) name for rosuvastatin and may be used in the treatment of high cholesterol. Rosuvastatin works by blocking an enzyme, called HMG-CoA reductase, in the liver that makes different types of lipids (this is the collective term for fats and cholesterol). Rosuvastatin also boosts the breakdown of lipids.
- Crestor belongs to the class of medicines known as statins. Crestor is also known as an HMG-CoA reductase inhibitor.
- Crestor, in conjunction with dietary measures, is used to treat high lipid levels in people at increased risk of cardiovascular disease if initial dietary measures fail to lower cholesterol.
- Used to treat primary hyperlipidemia or mixed dyslipidemia, hypertriglyceridemia, and some other lipid disorders.
- Also indicated in children aged 8 and older (heterozygous), or 7 or older (homozygous) with familial hypercholesterolemia (a genetic disorder resulting in high cholesterol) in addition to dietary measures and sometimes other lipid-lowering agents. Crestor is also used to slow the progression of atherosclerosis in adult patients.
- Crestor is also used to lower the risk of coronary events (includes heart attack, stroke, and angina) in patients at high risk of these events - such as people with pre-existing coronary heart disease, diabetes, peripheral vessel disease, a previous history of stroke and stroke-like events or heart attack, or with multiple risk factors (such as older age, smoking, high blood pressure, low HDL-C, family history of heart disease).
- Grapefruit products or juice have little effect on blood levels of Crestor.
- Crestor is available as a generic under the name rosuvastatin.
If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:
- Muscle pain, tenderness, or weakness - initially needs further investigation to rule out more serious muscle effects (such as rhabdomyolysis - the destruction of muscle cells). People aged older than 65, taking certain medications (for example cyclosporine, gemfibrozil, HIV antivirals), who drink more than two alcoholic drinks per day or with kidney disease appear more at risk of serious side effects.
- Abdominal pain, nausea, headache, lack of energy, and constipation are also common.
- Cognitive effects (memory loss, forgetfulness, confusion) may occur with long-term use; however, these effects are usually reversible on discontinuation.
- May interact with other drugs including cyclosporine, gemfibrozil, warfarin, and protease inhibitors.
- Crestor, like other statins, may affect liver function, manifesting as changes in liver function tests or jaundice (yellowing of the skin) requiring dosage reduction or discontinuation. Liver function tests are recommended prior to starting therapy and at periodic intervals throughout therapy.
- May not be suitable in those with liver or kidney disease.
- Rarely, has been associated with memory loss, forgetfulness, amnesia, memory impairment, and confusion. These symptoms typically resolve with discontinuation.
Notes: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. For a complete list of all side effects, click here.
- May be taken as a single dose daily, any time of the day, either with or without food. It is best to be consistent with the time you take your tablets. Grapefruit juice or products do not appear to affect Crestor.
- Do not take 2 doses of Crestor within 12 hours of each other.
- Separate administration of Crestor from antacids (give two hours apart).
- Consider temporarily withholding Crestor and seeking urgent medical advice if you have any acute muscle pain or another condition that may increase your risk of serious muscle injury or kidney failure such as a severe infection, major surgery, trauma, uncontrolled seizures, severe electrolyte or metabolic disorders.
- Adhere to the TLC diet, designed by the National Cholesterol Education Program (NCEP), or a similar diet, while taking Crestor. Plan to exercise regularly and stop smoking if you smoke. Try to avoid second-hand smoke.
- Asian people may be particularly sensitive to Crestor and require lower dosages.
- Dosage needs to be individualized but initially should start at 10-20 mg/day (Asian/pediatric patients: 5 mg/day) and be guided by the results of cholesterol tests taken 2 to 4 weeks later.
- Report any unexplained fatigue, shortness of breath, unexplained cough, weight loss, abdominal pain, dark urine or yellowing of the skin.
- Crestor should not be taken during pregnancy or while breastfeeding. Ensure you use effective contraception while taking Crestor if you are a woman of childbearing age and talk to your doctor if you intend to become pregnant before you actually become pregnant.
6. Response and Effectiveness
- Peak levels are seen within three to five hours of oral administration; however, it may take one to two weeks of regular dosing before improvements in your cholesterol level are seen, and up to four weeks before the maximal cholesterol-lowering effects of Crestor are apparent.
- Crestor appears as effective as atorvastatin and reduces LDL cholesterol levels by around 60%.
- Crestor and atorvastatin are more effective at lowering triglycerides than simvastatin or pravastatin. Crestor is more effective in raising HDL cholesterol (“good cholesterol”) than atorvastatin, simvastatin, or pravastatin.
Medicines that interact with Crestor may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with Crestor. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.
Common medications that may interact with Crestor include:
- antacids containing magnesium or aluminum
- antifungals, such as itraconazole, ketoconazole, posaconazole, or voriconazole
- colchicine (may enhance adverse muscle effects)
- fusidic acid
- other lipid-lowering drugs such as gemfibrozil and fenofibrate
- other strong CYP3A4 inhibitors, such as clarithromycin, cyclosporine, atazanavir or ritonavir
Note that this list is not all-inclusive and includes only common medications that may interact with Crestor. You should refer to the prescribing information for Crestor for a complete list of interactions.
Crestor (rosuvastatin) [Package Insert] Revised 11/2018. AstraZeneca Pharmaceuticals LP https://www.drugs.com/pro/crestor.html
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Crestor only for the indication prescribed.
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Other brands: Ezallor