What is Crestor and when is it used?

Crestor is a brand of AstraZeneca. The basis of the drug is the medicinal substance called Rosuvastatin which is also used for the production of other medications. These products are called generic Crestor. They have the same effect but are priced cheaper.
Rosuvastatin is a substance that effectively lowers the level of “bad” cholesterol in the body which is one of the main reasons for heart diseases and deaths related to vascular occlusion.
The effect of the formulation is achieved through the increase of the number of receptors of low-density lipoproteins (“bad” cholesterol) on the liver walls and suppression of synthesis of very low density lipoproteins.
The pronounced effect of the formulation is achieved within one week and the maximum effect is reached in a month.
Crestor is effective in treating adults with hypercholesterolemia independently on race, gender, or age, and in special groups such as diabetic individuals or with family history of hypercholesterolemia.
Nearly 90% of the dose of the formulation is eliminated unchanged with the feces, the rest is washed out in the urine. Around 5% is washed out in the urine. The complete elimination occurs in 19 hours and does not elevate with raised dose.

Indications for Crestor use include:

- Treatment of hypercholesterolemia and mixed dyslipidemia in adults in children older than ten years as a supplement to the diet when low-fat diet and exercising do not provide sufficient results.
- Therapy of homozygous familial hypercholesterolemia as an addition to the diet and other cholesterol-lowering therapies or in the case when such treatment is inappropriate.
- Prophylaxis of cardiovascular diseases, prevention of a significant cardiovascular disorder in individuals who are at high risk for the first case of cardiovascular disorder. The medication is used as an addition to the avoiding of other risk factors.

When is the use of Crestor prohibited?

Even if you have the indications for the drug use you should not buy Crestor if you have one of the conditions:
- Intolerance of the main or auxiliary components of the medication;
- Active liver diseases;
- Severe kidney dysfunction;
- Myopathy;
- Use of cyclosporine;
- Pregnancy and breastfeeding
- Women of fertile age who do not use reliable contraception;
- Kids younger than 10 years.

The dosage of 40 mg is prohibited to individuals with the predisposition to myopathy/rhabdomyolysis.

The risk factors include:
- Moderate kidney dysfunction;
- Dysfunction of the thyroid;
- Family or individual history or muscle diseases;
- Severe side effects related to muscles with the use of other cholesterol-lowering drugs;
- Alcoholism;
- Situations that may lead to an elevation in plasma level of Crestor;
- Asian descent;
- Simultaneous use of fibrates.

Crestor dosing information

Before you buy generic Crestor you need to try lowering cholesterol with first-line measures such as low-fat diet and exercising. Besides, the diet should be continued during Crestor use.
The dosage is selected individually based on the goal of the therapy and individual’s response.
The pills are taken at any time of the day daily at the same time every day.
- Treatment of hypercholesterolemia is started with the initial dosage of 5 mg or 10 mg once a day for the patients who hadn’t been using statins and those who had been using other statins before Crestor.
While choosing the initial dosage the level of cholesterol, risk of cardiovascular diseases, and risk of adverse effects must be estimated for each patient individually. The dosage can be raised every month. But doctors should keep in mind that the dosage of 40 mg is more likely to cause adverse effects. Thus, it is advised to raise the dosage to the highest of 40 mg only for patients with hypercholesterolemia and a high risk of cardiovascular disorders who have failed to achieve the target of therapy with a dose of 20 mg and who will be monitored regularly.
- Prophylaxis of cardiovascular diseases is made with the daily dosage of 20 mg.

Dosages for kids

The initial dosage for kids aged 10 years and older with heterozygous familial hypercholesterolemia is 5 mg per day. The daily dosage is from 5 to 20 mg once a day. The dosage can be raised depending on the response of the kid and tolerance of the drug. The tablets of 40 mg are not used for kids.

Dosage adjustments

- The recommended initial dosage for individuals over 60 is 5 mg a day.
- Individuals with moderately impaired kidney function should be prescribed the treatment from 5 mg a day. The dose of 40 mg is prohibited for individuals with moderate kidney dysfunction.

Adverse effects of Crestor

- Headache, lightheadedness, trouble falling asleep;
- On the part of the psyche: the frequency is unknown - depression;
- From the gastrointestinal tract: often - constipation, nausea, pain in the abdomen; rarely - pancreatitis frequency unknown - diarrhea;
- On the part of the digestive system: rarely - increased levels of liver transaminases; very rarely - jaundice, hepatitis;
- On the part of the endocrine system:  diabetes;
- On the part of the respiratory system: the frequency is unknown - cough, shortness of breath;
- From the blood: rarely - thrombocytopenia;
- On the part of the immune system: rare allergic reactions can occur;
- Muscle pain and cramps;
- On the part of the urinary system: very rarely - hematuria;
- Gynecomastia;
- General disorders: often - asthenia frequency unknown - edema.

The following drugs can lead to negative interactions in combination with Crestor and should be discussed with your doctor:

- Anticoagulants: Warfarin (Marevan, Warfarex) raise the risk of bleeding;
- H2-antihistamines: Cimetidine (Belomet, Histodil, Primamet, Simezan) -raise the risk of reducing endogenous steroid hormones;
- Immunosuppressants: Cyclosporin (Consupren, Orgasporin, Panimun Bioral, Sandimmun, Ecoral) - elevate the likelihood of rhabdomyolysis and acute kidney failure;
- Antifungal agents: Ketoconazole (Livarol, Nizoral, Mikozoral, Sebozol, Perkhotal) -elevates the likelihood of developing rhabdomyolysis and acute kidney failure;
- Additional lipid-lowering drugs: Clofibrate (Atromid-S), Fenofibrate (Tricor), Lopid elevate the likelihood of side effects;
- Nicotinic acid drugs: Niacin, Niaspan, Niacor, Enduracin elevate the risk of rhabdomyolysis and acute kidney failure;
- HIV medications such as Atazanavir (Reataz), Lopinavir, Ritonavir elevate the risk of developing  rhabdomyolysis and acute kidney failure;
- Diuretics: Spironolactone elevates the risk of reducing endogenous steroid hormones.
- Alcohol consumption should be reduced while taking Crestor to reduce the risk of liver damage.
- Antacids (aluminum and magnesium hydroxides), such as Mylanta and Maalox, should not be taken within two hours after taking Rosuvastatin.
- Cardiac glycosides: Digoxin the concentration of Digoxin increases.

Precautions

- Proteinuria, detected as a result of analysis by test strips and predominantly of tubular origin, was reported by the individuals who received high doses including 40 mg, and mostly was temporary or intermittent. Proteinuria was not a harbinger of acute or progressive kidney disease. The incidence of reports of serious kidney events in postmarketing studies is higher when Crestor is used with a 40 mg dose. Individuals using the drug in a dose of 40 mg should regularly check the kidney function during the course of observation.
- On the part of the musculoskeletal system, such as myalgia, myopathy, and rarely rhabdomyolysis were reported by individuals who took Rosuvastatin in any doses, especially more than 20 mg.
- The level of CPK (QM) should not be measured after significant physical exertion or, if there are possible alternative reasons for raising the QM, they can make interpretation of the results difficult. If the initial levels of QM are significantly elevated, further analysis should be done within 5-7 days to confirm the results. If the results of the re-analysis confirm that the initial value of QA is more than 5 times higher than the PMS, the use of the formulation should not be started.

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