Rosuvastatin: Price, Dosage & Where to Buy

Rosuvastatin, also sold under the brand name Crestor, is a statin medicine known as an HMG-CoA reductase inhibitor. It is most often used alongside a healthy diet to lower low-density lipoprotein cholesterol, often called LDL cholesterol, and to reduce the risk of major cardiovascular events such as heart attack and stroke. Rosuvastatin requires a prescription in the United Kingdom, and a generic version has been available since 29 April 2016.

Rosuvastatin belongs to the statin group, also described as HMG-CoA reductase inhibitors. The liver makes much of the cholesterol found in the blood, and an enzyme called HMG-CoA reductase is a key step in that process. Statins block this enzyme, so the liver produces less cholesterol of its own.

In response, liver cells draw more LDL cholesterol out of the bloodstream, which lowers the LDL level measured in a blood test. Lower LDL slows the build-up of fatty plaque inside artery walls, and that is the basis for the reduced risk of events such as heart attack and stroke. Statins also tend to lower triglycerides to some degree, which is why raised triglyceride levels appear among the listed uses.

The effect depends on continued treatment, because cholesterol production returns to its earlier pattern once the medicine is stopped, so statins are generally used long term. The change happens inside the body rather than being felt, so blood tests are used to show whether the medicine is working.

Rosuvastatin is used to lower low-density lipoprotein cholesterol, usually called LDL cholesterol, in adults with primary hyperlipidaemia, and to slow the build-up of fatty deposits in the arteries. It is also used to reduce the risk of major cardiovascular events, including cardiovascular death, non-fatal heart attack, non-fatal stroke and artery procedures, in adults who have no established coronary heart disease but who are at increased risk based on age, a high-sensitivity C-reactive protein level of 2 mg/L or more, and at least one further cardiovascular risk factor. The label also covers inherited cholesterol conditions: heterozygous familial hypercholesterolaemia in adults and children aged 8 years and older, and homozygous familial hypercholesterolaemia in adults and children aged 7 years and older, where it may be combined with other cholesterol-lowering treatment or used alone if those treatments are not available.

Two further lipid disorders are listed alongside diet changes in adults: primary dysbetalipoproteinaemia and high triglyceride levels. Treatment sits alongside diet rather than replacing it.

The label lists 5 mg, 10 mg, 20 mg and 40 mg tablets, including coated and film-coated oral tablets. The label lists a dosage range of 5 mg to 40 mg once daily for adults, with the choice depending on the reason for treatment, the LDL cholesterol level and individual cardiovascular risk. The label lists 5 mg to 10 mg once daily for children aged 8 years to under 10 years with heterozygous familial hypercholesterolaemia, and 5 mg to 20 mg once daily from 10 years of age.

The label lists 20 mg once daily for patients aged 7 years and older with homozygous familial hypercholesterolaemia. The usual starting dose is 5 mg once daily for Asian patients and for adults with severe renal impairment who are not on haemodialysis, where the label lists a maximum of 10 mg once daily. The label lists lower dose caps when certain other medicines are used at the same time, and it lists an LDL cholesterol check as early as 4 weeks after starting.

The label states storage at controlled room temperature, 20ºC to 25ºC, with excursions permitted between 15°C and 30°C. It also states that the tablets are protected from moisture.

Keeping them in the original bottle or blister pack, away from damp places such as bathrooms, helps to maintain quality. Storage out of sight and reach of children is also sensible.

Rosuvastatin works over the long term, so one missed dose is not an emergency. The label states that an extra dose should not be used to make up for a missed one, and that treatment is resumed with the next scheduled dose.

Keeping to a regular daily routine makes missed doses less likely, since the tablets may be used at any time of day, with or without food. Anyone who is unsure what to do, or who misses doses often, can ask a pharmacist or doctor for advice.

The label states that rosuvastatin is stopped when pregnancy is recognised, while also weighing the ongoing treatment needs of the individual patient. Because it reduces cholesterol production, it may cause harm to an unborn baby, and treatment of high cholesterol is not generally needed during pregnancy. Observational data from decades of statin use have not identified a drug-related risk of major birth defects, but data on miscarriage with rosuvastatin are not sufficient to draw a conclusion.

Rosuvastatin is present in human milk, and the label states that breastfeeding is not recommended during treatment. Anyone who is pregnant, planning a pregnancy or breastfeeding should discuss this with a doctor or pharmacist.