Crestor

Brand and Generic Name

Crestor is the brand name for the generic drug rosuvastatin calcium.

Therapeutic Classification

Rosuvastatin belongs to a class of drugs known as statins or HMG-CoA reductase inhibitors.

Indications and Usage

Crestor is indicated for the treatment of high cholesterol and triglycerides. It is also used in certain patients to reduce the risk of heart attack, stroke, and arterial revascularization procedures.

Available Dosage Forms

Crestor is available as film-coated tablets in strengths of 5 mg, 10 mg, 20 mg, and 40 mg.

Pharmacodynamics

Crestor selectively inhibits the enzyme HMG-CoA reductase, which plays a central role in the production of cholesterol in the liver. Its action reduces total cholesterol, LDL cholesterol, and triglycerides, and mildly increases HDL cholesterol.

Pharmacokinetics

Rosuvastatin is absorbed rapidly with the maximum plasma concentration reached in approximately 5 hours. The bioavailability is not affected by food intake. The drug has a half-life of approximately 19 hours, allowing for once-daily dosing.

Dosing Information

Starting dose for most adults is generally Crestor 10 mg once daily. Adjustments are made based on the patient’s response and tolerance, up to a maximum of 40 mg/day. Doses should be individualized according to the recommended goal of therapy.

Administration Instructions

Take Crestor orally once daily with or without food. Swallow tablets whole; do not crush or chew. Tablet splitting should be done only on the advice of a healthcare provider.

Drug Interactions

Concomitant use of Crestor with certain drugs such as cyclosporine, gemfibrozil, anticoagulants, and some antacids can increase the risk of muscular side effects or alter Crestor plasma levels. Avoid consuming large quantities of grapefruit juice.

Specific Populations

Adjustments may be needed for patients with severe kidney impairment. Use in liver disease patients should be approached with caution. It is not recommended in patients with active liver disease. Safe use in pregnant women has not yet been established; it should not be taken during pregnancy. Breastfeeding mothers are advised not to use Crestor as it is unknown whether it is excreted in breast milk.

Pharmacogenomics

Certain genetic polymorphisms can affect the metabolism and efficacy of rosuvastatin. Testing for genetic variants may be considered prior to therapy in some cases.

Monitoring Parameters

Lipid levels should be monitored periodically. Liver enzyme tests should be performed before and during treatment. Creatine kinase levels should be considered if the patient presents with muscle symptoms.

Missed Dose Management

If a dose is missed, take the missed dose as soon as remembered. However, if it is nearly time for the next scheduled dose, the missed dose should be skipped and the regular dosing schedule resumed. Do not double doses to catch up.

Overdose Management

In the event of an overdose, symptomatic and supportive measures should be started. Hemodialysis does not significantly enhance clearance of rosuvastatin due to the drug’s high level of protein binding.

Storage and Handling

Store Crestor tablets at room temperature away from light and moisture. Keep out of the reach of children and pets.

Disposal Instructions

Unused or expired Crestor tablets should be disposed of in accordance with local requirements or returned to a pharmacy take-back program, if available.

Counseling Points

Inform patients about the importance of adherence to prescribed diet and exercise regimens. Patients should be instructed to promptly report any unexplained muscle pain, tenderness, or weakness, particularly if accompanied by malaise or fever.