Rosuvastatin Patient Tips

Medically reviewed by Carmen Pope, BPharm. Last updated on July 24, 2025.

1. How it works

• Rosuvastatin is a statin that is used to reduce high LDL-C levels and also to reduce the risk of major cardiovascular events (such as a stroke or heart attack) in people at high risk.
• Rosuvastatin works by blocking an enzyme in the liver called HMG-CoA reductase which converts HMG-CoA to mevalonate, which is needed by our bodies to make cholesterol and coenzyme Q10. Rosuvastatin also boosts the breakdown of lipids (this is the collective term for fats and cholesterol).
• Rosuvastatin belongs to the drug class called HMG-CoA reductase inhibitors. It is also known as a statin.

2. Upsides

• Used for the primary prevention of cardiovascular disease, to lower the risk of major cardiovascular events (such as a heart attack, stroke, or arterial revascularization procedure) in adults without established coronary heart disease who are at increased risk of CV disease based on age, high-sensitivity C-reactive protein (hsCRP) >/2 mg/L, and at least one additional CV risk factor.
• Used in addition to dietary changes to reduce LDL-C in adults with primary hyperlipidemia, to reduce LDL-C and slow the progression of atherosclerosis in adults, or to reduce LDL-C in adults and children 8 years and older with heterozygous familial hypercholesterolemia (HeFH).
• Used to reduce LDL-C levels in adults and children 7 years and older with homozygous familial hypercholesterolemia (HoFH) in addition to other LDL-C lowering therapies or alone if such treatments are unavailable.
• Available as oral tablets (5 mg, 10 mg, 20 mg, 40 mg) that are taken once a day.
• May be taken any time of day or night.
• Can be taken with or without food.
• Does not interact with grapefruit juice or grapefruit products as much as atorvastatin.
• Generic rosuvastatin is available.

3. Downsides

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:

• A headache, abdominal pain, weakness, a lack of energy, constipation, or nausea, are the most common side effects reported with rosuvastatin.
• Muscle aches and pain, or muscle tenderness or weakness can also occur. Initially, this 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, itraconazole, HIV antivirals), who drink more than two alcoholic drinks per day, or with kidney disease appear more at risk of serious side effects.
• Cognitive effects (memory loss, forgetfulness, confusion) may occur with long-term use; however, these effects are usually reversible on discontinuation.
• Rosuvastatin, like other statins, may affect liver function, seen as changes to liver function tests or jaundice (yellowing of the skin), requiring dosage reduction or discontinuation.
• May also affect some diabetes markers (such as HbA1c or fasting glucose), may increase the risk of developing diabetes, and may not be suitable in those with liver or kidney disease. Transient dipstick-positive proteinuria and microscopic hematuria may also occur in rosuvastatin-treated patients.
• The dosage of rosuvastatin needs to be reduced in severe renal impairment (CL_CR < 30 mL/minute).
• Consider initiating treatment at lower dosages (5mg once daily) in Asian patients who may metabolize rosuvastatin differently.
• May interact with other drugs including cyclosporine, gemfibrozil, warfarin, and protease inhibitors.
• May not be suitable for some people including those with active liver disease (including persistent, unexplained elevations of aminotransferases), in people who drink excessively, during pregnancy, lactation, or with a known hypersensitivity to rosuvastatin or statins.
• The safety of rosuvastatin has not been established in children less than 8 years old with HeFH or 7 years old with HoFH.
• Do not use rosuvastatin during pregnancy. Suppression of cholesterol biosynthesis may cause harm to a developing baby. Discontinue immediately if pregnancy occurs and women of childbearing age should use adequate contraception. Women should not breastfeed while taking rosuvastatin.

Note: 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. View complete list of side effects

4. Bottom Line

Rosuvastatin is used to lower the risk of major cardiovascular events in adults without established coronary heart disease who are at increased risk of CV disease, and to lower LDL-C levels in adults with primary hyperlipidemia or to slow the progression of atherosclerosis. It may also be used to reduce LDL-C levels in people aged 8 and older with HeFH or 7 and older with HoFH. A headache, abdominal pain, or weakness are the most common side effects of rosuvastatin, but its use may be limited by side effects such as muscle pain. People of Asian descent may be more sensitive to the effects of rosuvastatin. Rosuvastatin does not interact with grapefruit juice or products to the same extent as atorvastatin.

5. Tips

• May be taken as a single dose daily, any time of the day, either with or without food.
• Do not take 2 doses of rosuvastatin within 12 hours of each other.
• Separate administration of rosuvastatin from antacids (give two hours apart).
• Consider temporarily withholding rosuvastatin 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.
• Asian people may be particularly sensitive to rosuvastatin and require lower dosages.
• The 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.
• Limit your alcohol intake and avoid drinking more than two glasses of alcohol per day while you are taking rosuvastatin.
• Seek urgent medical advice and consider temporarily withholding rosuvastatin if you develop any acute muscle pain or have 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.
• See your doctor straight away if you notice any yellowing of your skin or shortness of breath, unexplained cough, or general tiredness.
• Adhere to the TLC diet, designed by the National Cholesterol Education Program (NCEP), or a similar diet, while taking rosuvastatin.
• Rosuvastatin should not be taken during pregnancy or while breastfeeding. Ensure you use effective contraception while taking rosuvastatin if you are a woman of childbearing age and talk to your doctor if you intend to become pregnant before you become pregnant. Rosuvastatin should be stopped immediately if you become pregnant. Do not breastfeed while taking rosuvastatin.

6. Response and effectiveness

• Peak levels of rosuvastatin 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 rosuvastatin are apparent.

7. Interactions

Medicines that interact with rosuvastatin may either decrease its effect, affect how long it works, increase side effects, or have less of an effect when taken with rosuvastatin. 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 rosuvastatin include:

• amiodarone
• antacids containing magnesium or aluminum
• antifungals, such as itraconazole, ketoconazole, posaconazole, or voriconazole
• carbamazepine
• cimetidine
• clopidogrel
• colchicine (may enhance adverse muscle effects)
• digoxin
• dronedarone
• eltrombopag
• erythromycin
• ezetimibe
• fibric acid derivatives
• fusidic acid
• HCV protease inhibitors such as simeprevir
• HIV protease inhibitors such as ritonavir-boosted atazanavir or lopinavir/ritonavir
• niacin
• oral contraceptives
• other lipid-lowering drugs such as gemfibrozil and fenofibrate
• other strong CYP3A4 inhibitors, such as clarithromycin, cyclosporine, atazanavir, or ritonavir
• red yeast rice
• rifampin
• warfarin.

Note that this list is not all-inclusive and includes only common medications that may interact with rosuvastatin. You should refer to the prescribing information for rosuvastatin for a complete list of interactions.

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Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use rosuvastatin only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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