Rosuvastatin

HMG-CoA Reductase Inhibitor·Cardiovascular - Lipid Lowering

Severe hypercholesterolemia, high CV risk, post-MI

PBSSTATINCrestor5 mg tabletS4+1

Max Dose

40 mg/day

Half-life

19 h

Myopathy

RISK

Renal Adj.

DOSE RED.

Rapid Summary

Overview

The most potent statin available. Highly hydrophilic, meaning it penetrates muscle tissue less than atorvastatin, theoretically reducing myalgia risk.

Maximum Dose

Max 40 mg/day (Do not exceed, high risk of proteinuria/renal toxicity at higher doses).

Clinical Focus

Unlike Atorvastatin, Rosuvastatin is renally cleared. High doses in severe CKD are contraindicated.

Bottom Line

Rosuvastatin is the most potent statin for maximum LDL reduction, but requires dose adjustment in renal impairment and Asian populations due to increased myopathy risk.

Formulation & Access

Brand Names

Crestor

Oral Routes

Tablets (5 mg, 10 mg, 20 mg, 40 mg).

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Severe hypercholesterolemia, high CV risk, post-MI.

Clinical Place

First-line high-intensity statin, particularly if a patient experiences muscle pain on Atorvastatin.

Quick reference

Class & Role

HMG-CoA Reductase Inhibitor — The most potent statin available.

Route / Formulation

Tablets (5 mg, 10 mg, 20 mg, 40 mg). (Crestor)

Usual Dose & Max

PO 5-10 mg OD. Max 40 mg/day (Do not exceed, high risk of proteinuria/renal toxicity at higher doses).

Key Indication Doses

Primary Prevention: PO 5-10 mg OD. Secondary Prevention: PO 20-40 mg OD. Asian Descent: PO Max 20 mg OD (Genetically higher plasma exposures in this demographic). Renal Impairment: If eGFR < 30, Max 20 mg/day.

Best Uses

Rosuvastatin is the most potent statin for maximum LDL reduction, but requires dose adjustment in renal impairment and Asian populations due to increased myopathy risk.

Avoid / Cautions

Active liver disease. Pregnancy Category D.

Key Risks

Musculoskeletal: Myalgia, Rhabdomyolysis (Risk increases sharply at 40 mg dose). Renal: Proteinuria, hematuria (specific to high-dose rosuvastatin). Hepatic: Transaminitis.

Key Interactions

Much fewer CYP interactions than Atorvastatin/Simvastatin. Cyclosporin (increases rosuvastatin levels 7-fold).

Clinical Pearl

If a patient gets severe myalgia on Atorvastatin, stopping it, waiting for pain to clear, and trialing low-dose Rosuvastatin (5mg) is a highly successful clinical strategy due to its hydrophilicity.

Access

Crestor5 mg tablet

Brand: Crestor
Formulation: Tablets (5 mg, 10 mg, 20 mg, 40 mg)

Rosuvastatin

HMG-CoA Reductase Inhibitor·Cardiovascular - Lipid Lowering

Severe hypercholesterolemia, high CV risk, post-MI

PBSSTATINCrestor5 mg tabletS4+1

Max Dose

40 mg/day

Half-life

19 h

Myopathy

RISK

Renal Adj.

DOSE RED.

Rapid Summary

Overview

The most potent statin available. Highly hydrophilic, meaning it penetrates muscle tissue less than atorvastatin, theoretically reducing myalgia risk.

Maximum Dose

Max 40 mg/day (Do not exceed, high risk of proteinuria/renal toxicity at higher doses).

Clinical Focus

Unlike Atorvastatin, Rosuvastatin is renally cleared. High doses in severe CKD are contraindicated.

Bottom Line

Rosuvastatin is the most potent statin for maximum LDL reduction, but requires dose adjustment in renal impairment and Asian populations due to increased myopathy risk.

Formulation & Access

Brand Names

Crestor

Oral Routes

Tablets (5 mg, 10 mg, 20 mg, 40 mg).

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Severe hypercholesterolemia, high CV risk, post-MI.

Clinical Place

First-line high-intensity statin, particularly if a patient experiences muscle pain on Atorvastatin.

Quick reference

Class & Role

HMG-CoA Reductase Inhibitor — The most potent statin available.

Route / Formulation

Tablets (5 mg, 10 mg, 20 mg, 40 mg). (Crestor)

Usual Dose & Max

PO 5-10 mg OD. Max 40 mg/day (Do not exceed, high risk of proteinuria/renal toxicity at higher doses).

Key Indication Doses

Best Uses

Rosuvastatin is the most potent statin for maximum LDL reduction, but requires dose adjustment in renal impairment and Asian populations due to increased myopathy risk.

Avoid / Cautions

Active liver disease. Pregnancy Category D.

Key Risks

Musculoskeletal: Myalgia, Rhabdomyolysis (Risk increases sharply at 40 mg dose). Renal: Proteinuria, hematuria (specific to high-dose rosuvastatin). Hepatic: Transaminitis.

Key Interactions

Much fewer CYP interactions than Atorvastatin/Simvastatin. Cyclosporin (increases rosuvastatin levels 7-fold).

Clinical Pearl

If a patient gets severe myalgia on Atorvastatin, stopping it, waiting for pain to clear, and trialing low-dose Rosuvastatin (5mg) is a highly successful clinical strategy due to its hydrophilicity.

Access

Crestor5 mg tablet

Brand: Crestor
Formulation: Tablets (5 mg, 10 mg, 20 mg, 40 mg)