Crestor (Rosuvastatin)

Article Highlights

• Crestor is a statin like Zocor, Mevacor, Livalo, and the top-selling Lipitor
• Crestor works by reducing the buildup of cholesterol and fats known as triglycerides
• Do not take Crestor if you are pregnant, intend to become pregnant, or have liver or kidney issues
• Common side effects include nausea, diarrhea, heartburn and mild muscle pain

Overview

Crestor (rosuvastatin) is a statin drug like the other best-selling drug, Lipitor. In conjunction with a regimen consisting of a low-cholesterol diet and exercise, Crestor is used to lower levels of “bad” cholesterol (low-density lipoprotein, or LDL) and triglycerides in the blood, while boosting concentrations of “good” cholesterol (high-density lipoprotein, or HDL).
Cholesterol is a chemical compound that is needed as a building block for cell membranes in the body. The liver produces the body’s largest share of cholesterol, the rest being delivered to us from foods we ingest such as meat, poultry, eggs and dairy products. Triglycerides are another form of fat appearing in the bloodstream, and excess levels of cholesterol and triglycerides can lead to heart disease and strokes.

Other statins include:

• Lipitor (atorvastatin)
• Zocor (atorvastatin)
• Pravachol (pravastatin)
• Mevacor (lovastatin)
• Livalo (pitavastatin)
• Lescol (fluvastatin)

Crestor (rosuvastatin) works in two ways:

• It blocks an enzyme in the liver, causing the liver to generate less cholesterol
• It helps the liver to break down and discharge the cholesterol that already flows in the bloodstream

Excess cholesterol and triglycerides can do damage in other ways as well, including:

• They can produce a failure of skeletal muscle tissue, leading to a breakdown in kidney function
• And they can also produce potentially serious complications in people with type 2 diabetes

Statins, Alzheimer’s and dementia

So, what do we know about the relationship, if any, between statins and dementia? The quick response is that what we know is confounding, and researchers need to keep undertaking more studies. Statins include drugs like Crestor (rosuvastatin), Lipitor (atorvastatin), Mevacor (lovastatin), Livalo (pitavastatin), Zocor (simavastatin), and Pravachol (pravastatin).

The most recent research comes to us from a study that was published in 2014 in the Public Library of Science (PLOS). The study involved approximately 16,000 Taiwanese patients with type 2 diabetes who were new to statins, up against 2,400 Taiwanese diabetic patients who’d been on statins. It has to be quickly said that individuals with type 2 diabetes are already at high risk for Alzheimer’s or other types of dementia.

At any rate, the research revealed that people on statins like Lipitor or Crestor had a 25% lesser chance of acquiring Alzheimer’s dementia, but no similar effects on other types of dementia. Was that the long-awaited breakthrough? Not so fast, say other researchers into Alzheimer’s disease.

Another study involved more than 5,000 persons in their seventies and early eighties. They were split up into a group that was given a statin by the generic name of pravastatin (brand name Pravachol), while the other group received placebo, i.e. a substance with no active therapeutic effect. After more than years monitoring both groups, the researchers’ conclusion seemed definitive enough: no significant effect on cognitive function for the group that had received the statin.

In yet another larger study involving more than 20,000 persons who were split up between a placebo group and another group that was on simvastatin (brand-name Zocor, among other). After another long monitoring period, the same result was reached: both groups displayed the same propensity for developing dementia.

The negative side of statins:

Some researchers discovered that patients taking statins developed memory loss that was linked specifically to statins, although it did not occur to everyone taking statins. In a 2010 study of 600 people taking Lipitor, memory loss was identified. But despite that, a precise association between Lipitor and memory loss, i.e. a cause-and-effect relationship, has yet to be confirmed. That is the reason why physicians routinely inquire about other underlying conditions that may affect memory, for example age, heart disease, and mild cognitive impairment (MCI).

The positive side of statins:

According to research studies conducted by Dr. Tin-Tse Lin of Taiwan, and presented at the European Society of Cardiology Congress, high doses of statins prevent dementia in older individuals. The large study was conducted on 58,000 people, and the final conclusion was that high potency statins provided the strongest protection against dementia.

In the final analysis:

Research into the relationship between statins and dementia remains ongoing and, until then, physicians commonly follow other paths in their attempt at preventing memory loss and other symptoms of dementia in the older population.

Crestor forms and dosage information

Before treatment is begun on this medication, the patient should be placed on a regular low-cholesterol diet, which should then be continued, together with exercise of at least 30 minutes, three times a week or more, during treatment on this stain drug.

Crestor comes in:

• 5mg, round, film-coated (yellow) tablets
• 10mg, round, film-coated (pink) tablets
• 20mg, round, film-coated (pink) tablets
• 40mg, oval, film-coated (pink) tablets

The usual starting dose for rosuvastatin is 10mg to 20mg a day, taken once daily, with or without food. If you are of Asian descent, your health care provider may start your treatment with the lowest dose since you may be more sensitive to its effects.

The Crestor tablet is meant to be taken by mouth and whole, since crushing it would yield a bitter taste. Furthermore, if you realize that you have missed a dose, take one, unless the next dose is less than 12 hours away. Do not take two doses of this medication within 12 hours of each other.

The dosage your physician will prescribe will commonly be based on your age, overall health, medical history, allergies, response to treatment, race, and other medications you may be taking at the time. It is important that you inform your health care provider and your pharmacist about all the medications you take, including herbal supplements and vitamins.

While your health care provider has you on rosuvastatin, take this medication regularly in order to get the most benefit from it. One way to better remember to take your medication is to always take it at the same time of day. Another popular method is to use a pillbox that your pharmacist can provide.

Furthermore, for optimal benefits and overall health safety concerns, keep taking this medication, even if you feel better, until your doctor guides you otherwise. Dose adjustments may typically be made by your health care provider at intervals of 2 to 4 weeks. Never change your dose of this medication without prior consultation with your doctor.

Most people with high levels of cholesterol and triglycerides do not get sick when they are started on rosuvastatin.

Warnings associated with rosuvastatin

The Federal Drug Administration (FDA) confirms that statins like Crestor provide a significant treatment option for millions of Americans at risk of heart disease, including coronary artery disease, arrhythmia, cardiomyopathy, and heart failure.

Research conducted on people taking Crestor have demonstrated that certain people who are prescribed higher doses of this medication may be at greater risk for muscle injury due to Crestor. The drug’s most recent label recommends that those at higher risk start with a dose of only 5 mg once a day. The higher-risk groups include:

• Asian-Americans
• People including organ transplant patients taking the immune suppressing drug cyclosporine (brand name sandimmune)

You should not take rosuvastatin if you have liver disease or are pregnant, intend to become pregnant, or if you are breast-feeding. Furthermore, make sure that your physician is aware of the following conditions that you may have:

• A thyroid problem
• History of kidney disease or current kidney problems that can show as shortness of breath or fatigue, muscle pain or weakness, or difficult or painful urinating
• Liver problems that can show as upper stomach pain, itching, tiredness, nausea, loss of appetite, dark-colored urine, clay-colored stool, and jaundiced or yellowish skin and eyelids
• Signs of a stroke, which can show as sudden severe headache, slurred speech, problems with vision or balance, or one side of the body feeling suddenly weak or numb
• If you drink more than 2 alcoholic beverages daily

Do not ingest grapefruit and grapefruit juice with rosuvastatin, as these may interact with Crestor and lead to potentially dangerous complications. The same goes for excess alcohol consumption, for Alcohol can raise triglyceride levels and can increase your risk of liver damage.

In addition, when taking rosuvastatin, older adults, and individuals who have kidney disease or poorly controlled hypothyroidism (underactive thyroid), may have complications that can produce a failure of skeletal muscle tissue, leading to a breakdown in kidney function.

If you must take antacids of the type that contain magnesium or aluminum, take the antacids at least two hours after taking this drug, for these minerals reduce the absorption of this medication.

Crestor side effects

Some of the side effects that patients on Crestor experience may be mild and readily tolerable. If after a few days of taking this medication you feel that you can adjust and tolerate these new and mild symptoms, the side effects may disappear. On the other hand, if you are concerned about one or more unusual physical or behavioral changes that develop, then promptly advise your health care professional. Your doctor may deem it advisable to change your medication or alter the dosage you are on. In addition, your doctor may be able to guide you in regard to ways you can reduce or prevent these side effects.

The most common side effects:

• congestion
• cough
• dry or sore throat
• runny nose
• difficulty with moving
• voice changes
• heartburn
• hoarseness
• headache
• mild muscle pain
• lower back or side pain
• pain or tenderness around the eyes and cheekbones

More serious side effects:

The following list of side effects should be promptly reported to your health care professional:

• chest tightness or heaviness
• fast, irregular, pounding, or racing heartbeat or pulse
• hemorrhagic stroke
• difficult or labored breathing
• fainting (or loss of consciousness)
• accumulation of pus, or tender area of infection near a tooth
• bladder pain, bloody or cloudy urine, and difficulty urinating
• burning, itching, numbness, or tingling feelings
• deterioration or gradual loss of muscle
• muscle breakdown (rhabdomyolysis)
• inflammation, pain with swelling of the joints (arthralgia)
• abdominal or stomach pain
• back pain
• belching or excessive gas
• heartburn, indigestion, or stomach discomfort
• shivering
• loss of appetite, vomiting
• constipation
• increased thirst or hunger
• confusion, or memory problems
• fever, drowsiness, and loss of appetite
• general feeling of discomfort or illness
• bloody or dark urine
• fruit-like breath odor
• jaundice, i.e. yellowing of the skin and eyes
• runny or stuffy nose, sneezing, coughing
• sore or scratchy throat (nasopharyngitis)
• sleep disturbance and insomnia

Rare side effects:

• continuing ringing or buzzing or other unexplained noise in the ears
• menstrual bleeding occurring earlier or lasting longer than usual
• black, tarry stools
• bloody nose
• bloody or cloudy urine
• blurred vision
• difficulty seeing at night
• excessive muscle tone or tension
• groin or scrotum pain
• increased body movements
• increased sensitivity of the eyes to light
• increased sensitivity to touch or pain
• increased urination
• loss of sexual ability, drive, or desire
• depression, nervousness, nightmares, paranoia
• pinpoint red spots on the skin
• slurred speech
• swollen or tender lymph glands in the neck, armpit, or groin
• unable to move or feel face
• unusual bleeding or bruising
• large, hive-like swelling on the face, eyelids, lips, tongue, throat,
• hands, legs, feet, or sex organs
• red skin lesions, often with a purple center sore
• red, irritated eyes
• sore throat
• sores, ulcers, or white spots in the mouth or on the lips

Warnings and interactions with Crestor

Crestor Overdose:

If think you have taken too much of this medication, go to an emergency room right away or call a poison control center at (800) 222-1222.

Crestor and pregnancy:

The FDA has issues a black-box warning regarding the use of Crestor while you are pregnant. Do not use this medication if you are pregnant, intend to become pregnant or are breast-feeding, for it is not known how much of this drug is passed onto babies in breast-feeding. Crestor can also harm an unborn baby or cause birth defects. This is not commonly a practical precaution since patients for whom Crestor is prescribed are generally older.

Muscle problems:

Medications that may raise your risk of muscle problems when taken with Crestor include:

• Gengraf, Neoral, or Sandimmune) (Cyclosporine)
• Lopid (gemfibrozil)
• Fibricor or Trilipix (Fenofibric acid)
• Antara, Fenoglide, Lipofen, Lofibra, Tricor, or Triglide (Fenofibrate)

Crestor and Alcohol:

Excessive alcohol consumption can raise the levels of triglycerides and may thus increase the risk of liver injury; drink in moderation, or not at all, when taking Crestor.

Crestor and Grapefruit:

When taking atorvastatin, you need to avoid eating grapefruit or drinking grapefruit juice and any foods containing grapefruit, as these may cause levels of rosuvastatin to rise to dangerous levels in your blood.

Crestor and antacids:

Antacids such as Mylanta and Maalox generally contain aluminum and magnesium hydroxide and should be taken at least two hours after food.

Crestor and warfarin:

Using the blood-thinner warfarin (coumadin) together with rosuvastatin may cause you to bleed more easily and potentially excessively. Call your doctor promptly if you have any unusual bleeding or bruising, vomiting, blood in your urine or stools, headache, dizziness, or weakness.

Rosuvastatin and Drug Interactions: There are several drugs that can interact with Crestor.

• Many antacids
• Several antibiotics (for example, clarithromycin or erythromycin)
• Diltiazem (Cardizem, Cartia, Dilacor, and others)
• Telaprevir
• Warfarin
• Oral contraceptives
• Antifungal medicines (such as fluconazole, itraconazole, ketoconazole, or voriconazole)
• HIV medications (such as darunavir, fosamprenavir, ritonavir, and various others)
• Medicines that contain niacin (for example Advicor, Niaspan, Niacor, and various others)
• Drugs that weaken your immune system (such as steroids, cancer medicine and others)
• Medicines used to prevent organ transplant rejection (such as sirolimus, tacrolimus and others

Other information about Crestor and statins

Your health care provider is best able to guide your treatment decisions based on your specific circumstances and medical history. Here are some scenarios that could be of interest to those on Crestor, or those who may be wanting to ask their physician about going on Crestor:

Crestor and liver issues:

Statins, the class of drugs that includes Crestor (rosuvastatin), have been known to cause liver problems. Updated in 2012, the FDA-approved prescribing information reports rare events of fatal and non-fatal liver failure in Crestor patients. Generally, problems with liver enzymes happen within the first 3 months of starting Crestor. If you are on Crestor, make sure you get closely monitored for signs of liver dysfunction by checking liver function tests or liver enzymes. If enzyme levels are greater than 3 times the upper limit of the normal range, they should be repeated until they return to normal. If they do not return to normal levels, your doctor should take you off Crestor or reduce your dose.

Rosuvastatin and weight gain:

People often ask about Crestor in connection with weight gain. There is nothing in the medical literature on this subject. While on this medication, you should have a healthy diet to prevent gaining weight. Be sure that the gain is not from other medications that you may be taking or because of another underlying medical condition.

Rosuvastatin and muscle pain and tenderness:

Muscle pain, tenderness, or weakness may be signs of a serious side effect associated with the use of statins. Patients should quickly consult with their doctor about stopping the medication. These are serious symptoms, and you should not procrastinate or self-medicate. Your health care provider is best qualified to evaluate whether Crestor should be continued or changed to another medication.

Rosuvastatin and anxiety:

The prescribing information that is readily available for Crestor has nothing about anxiety being a particular side effect of Crestor. If you are experiencing anxiety while on a regimen of Crestor, you and your physician should check for other possible underlying medical or psychological conditions that may be producing that anxiety for you.

Crestor and vitamins:

According to the information that the Crestor manufacturer provides on the package, there are no specific drug interactions with vitamins. It is important to promptly report to your healthcare provider any unexplained muscle pain, tenderness or weakness. This may be a side effect of the Crestor and should be addressed with your healthcare provider.

Rosuvastatin and memory loss:

There is conflicting evidence about the relation of Crestor to memory loss in particular, and Alzheimer’s or dementia in general. It has not been proven whether the memory loss that is occasionally observed in older people is caused by the statin that they are taking or by other causes such as the aging process, cardiovascular issues that may be causing the beginnings of vascular dementia, or other reasons including perhaps the early onset of mild cognitive impairment (MCO). Let your physician guide you on this, as per the latest research.

Final thoughts

If you’ve had one or more cardiovascular events in the past, taking Crestor will improve your odds against having another heart-related event by 20%, according to some studies. These furthermore claim that older adults can avert cardiovascular issues by taking a statin, whether they have high cholesterol or not. Naturally, one of the negative repercussion of going on statins is that people start eating the wrong types of food and in unhealthy quantities believing that they are protected.

The best protection of all is to lead a lifestyle that is replete with low-cholesterol and non-fatty foods, regular exercise, plenty of sleep, good hydration, and good-natured, stress-mitigating social activities.