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Rosuvastatin: Pediatric drug information

Rosuvastatin: Pediatric drug information
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For additional information see "Rosuvastatin: Drug information" and "Rosuvastatin: Patient drug information"

For abbreviations, symbols, and age group definitions show table
Brand Names: US
  • Crestor;
  • Ezallor Sprinkle
Brand Names: Canada
  • ACH-Rosuvastatin;
  • AG-Rosuvastatin Calcium;
  • AG-Rosuvastatin [DSC];
  • APO-Rosuvastatin;
  • Auro-Rosuvastatin;
  • BIO-Rosuvastatin;
  • Crestor;
  • DOM-Rosuvastatin [DSC];
  • JAMP Rosuvastatin Calcium;
  • JAMP-Rosuvastatin [DSC];
  • M-Rosuvastatin;
  • Mar-Rosuvastatin;
  • MINT-Rosuvastatin;
  • NRA-Rosuvastatin;
  • PMS-Rosuvastatin;
  • Priva-Rosuvastatin [DSC];
  • PRZ-Rosuvastatin;
  • RIVA-Rosuvastatin;
  • SANDOZ Rosuvastatin;
  • TARO-Rosuvastatin;
  • TEVA-Rosuvastatin
Therapeutic Category
  • Antilipemic Agent, HMG-CoA Reductase Inhibitor
Dosing: Pediatric

Dosage guidance:

Dosing: Doses should be individualized according to the baseline LDL-cholesterol levels, the recommended goal of therapy, and patient response; adjustments should be made at intervals of 4 weeks or more. A lower, conservative dosing regimen may be necessary in patient populations predisposed to myopathy, including patients of East Asian descent (Ref).

Heterozygous familial hypercholesterolemia

Heterozygous familial hypercholesterolemia (HeFH):

Children 8 to <10 years: Oral: 5 to 10 mg once daily.

Children ≥10 years and Adolescents: Oral: 5 to 20 mg once daily.

Homozygous familial hypercholesterolemia

Homozygous familial hypercholesterolemia (HoFH): Children ≥7 years and Adolescents: Oral: 20 mg once daily.

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Pediatric

Children ≥7 years and Adolescents: Oral:

CrCl ≥30 mL/minute/1.73 m2: No dosage adjustment required.

CrCl <30 mL/minute/1.73 m2 and not receiving hemodialysis: Initial: 5 mg once daily; maximum daily dose: 10 mg/day.

Dosing: Liver Impairment: Pediatric

Children ≥7 years and Adolescents: Oral: There are no dosage adjustments provided in the manufacturer's labeling; systemic exposure (increased AUC and Cmax) may be increased in patients with liver disease; monitor closely. Use is contraindicated in patients with active liver disease or decompensated cirrhosis.

Dosing: Adult

(For additional information see "Rosuvastatin: Drug information")

Dosage guidance:

Dosing: Rosuvastatin 20 to 40 mg/day is considered a high-intensity statin (generally reduces low-density lipoprotein cholesterol [LDL-C] by ≥50%). Rosuvastatin 5 to 10 mg/day is considered a moderate-intensity statin (generally reduces LDL-C by ~30% to 49%). Assess response ~1 to 3 months after therapy initiation or dose adjustment and every 3 to 12 months thereafter (Ref). In patients of East Asian descent, exposure can be ~2-fold higher compared to White patients; consider initial dosage reduction and risk versus benefit in East Asian patients not adequately controlled with rosuvastatin 20 mg once daily before increasing dose further (Ref).

Clinical considerations: Use in conjunction with lifestyle modification (eg, diet, exercise). When initiating therapy and selecting dose intensity, consider age, baseline LDL-C, 10-year atherosclerotic cardiovascular disease (ASCVD) risk, risk-enhancing factors, potential adverse effects, and drug interactions.

Atherosclerotic cardiovascular disease, primary or secondary prevention

Atherosclerotic cardiovascular disease, primary or secondary prevention:

Note: If LDL-C goal (eg, percent reduction or absolute goal) is not met with the initial dose, may consider up-titration based on estimated 10-year ASCVD risk (see American College of Cardiology ASCVD Risk Estimator Plus online), LDL-C response, and tolerability. If LDL-C goal is not met with maximally tolerated dose, additional lipid-lowering therapy may be warranted (Ref).

Primary prevention:

Patients without diabetes, 40 to 75 years of age, and with LDL-C 70 to 189 mg/dL:

ASCVD 10-year risk 5% to <7.5%:

Note: Depending on baseline LDL-C and presence of risk-enhancing factors, consider statin therapy after shared decision-making with patient. Some experts suggest shared decision-making if ASCVD 10-year risk is 5% to 10%; however, in patients with a baseline LDL-C >160 mg/dL, statin therapy is usually recommended (Ref).

Moderate-intensity therapy: Oral: 5 to 10 mg once daily to reduce LDL-C by 30% to 49% (Ref).

ASCVD 10-year risk ≥7.5% to <20%:

Note: Depending on baseline LDL-C and presence of risk-enhancing factors, consider statin therapy after shared decision-making with patient. Some experts suggest initiating moderate-intensity statin therapy in most patients if ASCVD 10-year risk is >10% to <20% and LDL-C is >100 mg/dL (Ref).

Moderate-intensity therapy: Oral: 5 to 10 mg once daily to reduce LDL-C by 30% to 49%; higher risk patients with multiple risk-enhancing factors may benefit from higher doses to reduce LDL-C by ≥50% (Ref).

ASCVD 10-year risk ≥20%:

High-intensity therapy: Oral: 20 to 40 mg once daily to reduce LDL-C by ≥50%; if unable to tolerate due to adverse effects, may reduce dose to maximum tolerated (Ref).

Patients with diabetes:

40 to 75 years of age without additional ASCVD risk factors :

Moderate-intensity therapy: Oral: 5 to 10 mg once daily to reduce LDL-C by 30% to 49% (Ref).

ASCVD risk ≥7.5% or multiple ASCVD risk factors :

High-intensity therapy: Oral: 20 to 40 mg once daily to reduce LDL-C by ≥50%; if unable to tolerate due to adverse effects, may reduce dose to maximum tolerated (Ref).

Patients with LDL-C ≥190 mg/dL and 20 to 75 years of age:

Note: High-intensity therapy is indicated regardless of ASCVD risk calculation or coexisting diabetes mellitus.

High-intensity therapy: Oral: 20 to 40 mg once daily to reduce LDL-C by ≥50%; if unable to tolerate due to adverse effects, may reduce dose to maximum tolerated (Ref).

Secondary prevention in patients with established ASCVD (eg, coronary heart disease, cerebrovascular disease [ischemic stroke or transient ischemic attack], peripheral arterial disease):

Note: Patients with high-risk ASCVD may require additional therapies to achieve LDL-C goal (eg, <70 mg/dL or <50 mg/dL if very high risk) (Ref).

High-intensity therapy: Oral: 20 to 40 mg once daily to reduce LDL-C by ≥50%; if unable to tolerate due to adverse effects, may reduce dose to maximum tolerated (Ref).

Heterozygous familial hypercholesterolemia

Heterozygous familial hypercholesterolemia:

Note: Multiple lipid-lowering therapies may be needed if statin monotherapy is not effective. Referral to a lipid specialist should be considered if treatment goals are not met (Ref).

High-intensity therapy: Oral: 40 mg once daily (Ref).

Homozygous familial hypercholesterolemia

Homozygous familial hypercholesterolemia:

Note: Multiple lipid-lowering therapies are usually needed to achieve treatment goals; treatment should be guided by an experienced lipid specialist (Ref).

High-intensity therapy: Oral: 40 mg once daily (Ref).

Transplantation

Transplantation:

Note: Certain immunosuppressive drugs can induce or exacerbate hypercholesterolemia. Significant drug interactions between statins and immunosuppressant drugs are frequent; some interactions can increase statin serum concentrations and risk of toxicity (eg, myopathy) (Ref). Consult Drug Interactions Database for more detailed information.

Transplantation, post heart (off-label use): Oral: Initial: 5 to 10 mg once daily starting 1 to 2 weeks after transplant, regardless of baseline cholesterol levels; increase to the maximum tolerated dose within 4 to 8 weeks of transplantation based on response and use of concomitant medications up to 20 mg once daily (Ref).

Transplantation, post kidney (off-label use):

Note: The decision to initiate therapy for primary or secondary prevention is similar to the nontransplant population (see "Dosing: Prevention of Atherosclerotic Cardiovascular Disease"). However, in patients who are 30 to 39 years of age, some experts suggest statin therapy post kidney transplantation for primary prevention of ASCVD. For primary prevention of ASCVD in patients 18 to 29 years of age, use shared decision making while considering risks and benefits (Ref).

Oral: Initial: 5 mg once daily; increase dose based on response, tolerability, and use of concomitant medications up to 10 mg once daily (Ref).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult Drug Interactions Database for more information.

Dosing: Kidney Impairment: Adult

The renal dosing recommendations are based upon the best available evidence and clinical expertise. Senior Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.

Altered kidney function:

CrCl ≥30 mL/minute/1.73 m2: No dosage adjustment necessary.

CrCl <30 mL/minute/1.73 m2: 5 to 10 mg once daily.

Hemodialysis, intermittent (thrice weekly): Not dialyzable: Maximum: 10 mg/day. Steady state concentrations are increased ~50% during chronic hemodialysis; however, accumulation is minimal, and rates of adverse effects are similar to placebo with a dose of 10 mg/day (Ref).

Peritoneal dialysis: Maximum: 10 mg/day; accumulation unlikely to occur at a dose of ≤10 mg/day (Ref).

CRRT: Drug clearance is dependent on the effluent flow rate, filter type, and method of renal replacement. Recommendations are based on high-flux dialyzers and effluent flow rates of 20 to 25 mL/kg/hour (or ~1,500 to 3,000 mL/hour) unless otherwise noted. Close monitoring of response and adverse reactions (eg, rhabdomyolysis) due to drug accumulation is important.

Maximum: 10 mg/day (Ref).

PIRRT (eg, sustained, low-efficiency diafiltration): Drug clearance is dependent on the effluent flow rate, filter type, and method of renal replacement. Close monitoring of response and adverse reactions (eg, rhabdomyolysis) due to drug accumulation is important.

Maximum: 10 mg/day (Ref).

Dosing: Liver Impairment: Adult

The liver dosing recommendations are based upon on the best available evidence and clinical expertise. Senior Editorial Team: Matt Harris, PharmD, MHS, BCPS, FAST, FCCP; Jeong Park, PharmD, MS, BCTXP, FCCP, FAST; Arun Jesudian, MD; Sasan Sakiani, MD.

Note: Although use is contraindicated in patients with active liver failure or decompensated cirrhosis according to the manufacturer's labeling, baseline elevation in AST/ALT should not preclude use of statins for compelling indications in patients with chronic stable liver disease including compensated cirrhosis (Ref).

Liver impairment prior to treatment initiation:

Initial or dose adjustment in patients with preexisting liver cirrhosis:

Child-Turcotte-Pugh class A: No dosage adjustment necessary (Ref).

Child-Turcotte-Pugh class B: Oral: Initial: 5 mg once daily; may increase to 10 mg once daily based on tolerability and response; maximum recommended dose: 10 mg once daily (Ref).

Child-Turcotte-Pugh class C: Oral: Use generally not recommended. If use deemed necessary (eg, patients with compelling indications): Initial: 5 mg once daily; a maximum dose of 5 mg once daily is recommended (Ref).

Liver impairment developing in patient already receiving rosuvastatin:

Chronic disease progression (eg, outpatient):

Baseline to Child-Turcotte-Pugh class A through C: Although use is contraindicated in patients with active liver failure or decompensated cirrhosis according to the manufacturer's labeling, if rosuvastatin-induced hepatoxicity has been ruled out, may continue rosuvastatin therapy with no dosage adjustment necessary; monitor closely for signs or symptoms of rhabdomyolysis (Ref).

Adverse Reactions (Significant): Considerations
Hepatic effects

Statins are associated with increased serum transaminases and hepatotoxicity (Ref). Asymptomatic transient or persistent increases both <3 or >3 times the ULN in serum transaminases may occur with all statins; the increased serum alanine aminotransferase (ALT) is typically greater than the increase in aspartate aminotransferase (AST) (Ref). One case report of increased liver function tests has also been reported as part of drug rash eosinophilia with systemic symptoms (Ref). Acute hepatotoxicity, often presenting as a drug-induced autoimmune hepatitis, has been documented (Ref).

Upon dose reduction or discontinuation, transaminase levels return to or near pretreatment levels; although, mild elevations resolve with continued use in some cases (Ref). Chronic liver injury (defined as liver biochemical or histological abnormalities that persisted for 6 months or more after onset) has been reported (Ref).

Mechanism: Unknown; rosuvastatin undergoes minimal hepatic metabolism. Acute liver injury may be caused by immune-mediated mechanisms (Ref). Changes in the lipid components of the hepatocyte membrane may lead to increased permeability and leakage of liver enzymes (Ref).

Onset: Varied; most cases occur within the first 3 months of initiation or dose escalation (Ref). Duration of rosuvastatin prior to development of hepatotoxicity has been reported from approximately 2 months to 2 years (Ref).

Risk factors:

• Higher doses may increase the risk of liver injury (Ref)

• Concurrent medications with statin drug-drug interactions or hepatotoxic properties (Ref)

• Hepatotoxicity is more commonly associated with atorvastatin than pravastatin, rosuvastatin, and simvastatin (Ref). Fluvastatin is associated with the greatest risk of developing hepatotoxicity (Ref).

• Cross-reactivity between different statins and the susceptibility to hepatotoxicity is unknown, as data have shown conflicting results (Ref).

• Chronic hepatitis B and alcohol consumption are independent risk factors for hepatic aminotransferase elevation associated with statins in patients 80 years of age or older (Ref).

Muscle-related effects

Statins are associated with several muscle-related effects, including:

• Myalgia (muscle symptoms without significant creatine kinase [CK] elevations; also known as statin-associated muscle symptoms) (Ref)

• Myopathy (defined as unexplained muscle pain or weakness accompanied by a CK concentration >10 times the ULN) (Ref)

• Rhabdomyolysis (CK >40 times the ULN) (Ref) often with acute renal failure secondary to myoglobinuria (Ref)

• Immune-mediated necrotizing myopathy (IMNM) (elevated CK plus the presence of antibodies against HMG-CoA) (Ref)

Mechanism: Uncertain; alterations in the mevalonate pathway and changes in the electrical and structural characteristics of the sarcolemma related to calcium ion flux possibly contribute (Ref). Decreased ubiquinone, which is essential for energy production in skeletal muscle, may also contribute (Ref). Myopathy/rhabdomyolysis risk is related to circulating active drug concentrations (Ref). IMNM is considered an immune-mediated process; autoantibodies against HMG-CoA reductase (anti-HMG-CoA) have been identified (Ref).

Onset: Delayed; often presents within a few months after starting therapy (highest risk within first year of use), when the dose of the statin is increased, or when introducing an interacting drug (Ref). Muscle symptoms often appear more promptly when patients are reexposed to the same statin (Ref). Duration of statin use prior to development of IMNM is ~2 to 3 years (Ref).

Risk factors:

• First year of therapy (Ref)

• Dose increase (for myopathy and rhabdomyolysis, but not IMNM) (Ref)

• Addition of an interacting drug (eg, concurrent use of medications associated with myopathy [eg, gemfibrozil]) (Ref); since there is minimal metabolism of rosuvastatin by CYP3A4, low risk for clinically significant drug interactions with CYP3A4 inhibitors (Ref)

• Older patients (Ref)

• Hypothyroidism (Ref)

• Preexisting muscle disease (Ref)

• Kidney impairment (Ref)

• Females (Ref)

• Low body mass index (Ref)

• Heavy exercise (Ref)

• Surgery (Ref)

• Higher HMG-COA reductase inhibitory activity (Ref), rosuvastatin > atorvastatin > simvastatin > pravastatin ≈ lovastatin (Ref)

• East Asian population: Increased plasma concentrations (up to ≈ twofold with rosuvastatin) may result in increased risk of myopathy (Ref)

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

>10%: Neuromuscular & skeletal: Myalgia (2% to 13%) (table 1)

Rosuvastatin: Adverse Reaction: Myalgia

Drug (Rosuvastatin)

Placebo

Dose

Number of Patients (Rosuvastatin)

Number of Patients (Placebo)

13%

12%

40 mg once daily

700

281

8%

7%

20 mg once daily

8,901

8,901

6%

1%

20 mg once daily

64

382

3%

1%

5 mg once daily

291

382

2%

1%

10 mg once daily

283

382

2%

1%

40 mg once daily

106

382

1% to 10%:

Endocrine & metabolic: Diabetes mellitus (new onset: 3%)

Gastrointestinal: Constipation (3% to 5%), nausea (4% to 6%)

Hepatic: Increased serum transaminases (>3 × ULN; including increased serum alanine aminotransferase [2%] (table 2), increased serum alkaline phosphatase, increased serum bilirubin)

Rosuvastatin: Adverse Reaction: Increased Serum Alanine Aminotransferase

Drug (Rosuvastatin)

Placebo

Dose

Number of Patients (Rosuvastatin)

Number of Patients (Placebo)

Comments

2%

0.7%

40 mg once daily

700

281

>3 x ULN

Nervous system: Asthenia (5%) (table 3), dizziness (4%), headache (6% to 9%)

Rosuvastatin: Adverse Reaction: Asthenia

Drug (Rosuvastatin)

Placebo

Dose

Number of Patients (Rosuvastatin)

Number of Patients (Placebo)

5%

3%

20 mg once daily

64

382

3%

3%

10 mg once daily

283

382

2%

3%

5 mg once daily

291

382

0.9%

3%

40 mg once daily

106

382

Neuromuscular & skeletal: Arthralgia (4% to 10%) (table 4), increased creatine phosphokinase in blood specimen (3%) (table 5)

Rosuvastatin: Adverse Reaction: Arthralgia

Drug (Rosuvastatin)

Placebo

Dose

Number of Patients (Rosuvastatin)

Number of Patients (Placebo)

10%

7%

40 mg once daily

700

281

4%

3%

20 mg once daily

8,901

8,901

Rosuvastatin: Adverse Reaction: Increased Creatine Phosphokinase in Blood Specimen

Drug (Rosuvastatin)

Placebo

Population

Dose

Number of Patients (Rosuvastatin)

Number of Patients (Placebo)

Comments

3%

0%

Children and adolescents

10 mg to 20 mg once daily

130

46

>10 x ULN

3%

0.7%

Adults

40 mg once daily

700

281

N/A

Frequency not defined:

Endocrine & metabolic: Abnormal thyroid function test, elevated glycosylated hemoglobin, increased serum glucose

Gastrointestinal: Abdominal pain

Hepatic: Increased gamma-glutamyl transferase

Hypersensitivity: Hypersensitivity reaction

Postmarketing:

Dermatologic: Lichenoid eruption (Ref), maculopapular rash (Ref), pemphigoid (Ref), pruritus (Ref), purpuric rash (photolocalized) (Ref)

Endocrine & metabolic: Gynecomastia (Ref)

Gastrointestinal: Oral mucosa ulcer (Ref), pancreatitis (Ref)

Genitourinary: Cystitis (interstitial) (Ref), microscopic hematuria (Ref), proteinuria (Ref)

Hematologic & oncologic: Thrombocytopenia (Ref)

Hepatic: Autoimmune hepatitis (Ref), hepatic failure, hepatitis (Ref), jaundice (Ref)

Hypersensitivity: Angioedema (Ref), drug reaction with eosinophilia and systemic symptoms (Ref)

Nervous system: Cognitive dysfunction (reversible; includes amnesia, confusion, memory impairment) (Ref), depression, myasthenia (myonecrosis) (Ref), myasthenia gravis (including exacerbation of myasthenia gravis and ocular myasthenia gravis) (Ref), peripheral neuropathy (Ref), sleep disorder (including insomnia, nightmares)

Neuromuscular & skeletal: Immune-mediated necrotizing myopathy (Ref), myoglobinuria (Ref), myopathy (Ref), myositis, rhabdomyolysis (Ref)

Renal: Acute interstitial nephritis (Ref), acute kidney injury (Ref), kidney failure (Ref)

Respiratory: Interstitial lung disease (including interstitial pneumonitis) (Ref)

Contraindications

Hypersensitivity (eg, angioedema, pruritus, rash, urticaria) to rosuvastatin or any component of the formulation; active liver failure or decompensated cirrhosis.

Canadian labeling: Additional contraindications (not in US labeling): Concomitant administration of cyclosporine or sofosbuvir/velpatasvir/voxilaprevir; patients with active liver disease or unexplained persistent elevations of serum transaminases (>3 times ULN); breastfeeding; use of 40 mg dose in Asian patients or patients with predisposing risk factors for myopathy/rhabdomyolysis.

Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Warnings/Precautions

Concerns related to adverse effects:

• Diabetes mellitus: Small increases in HbA1c (mean: ~0.1%) and fasting blood glucose have been reported with rosuvastatin; however, the benefits of statin therapy far outweigh the risk of dysglycemia.

• Hematuria/proteinuria: Hematuria (microscopic) and proteinuria have been observed; more commonly reported in adults receiving rosuvastatin 40 mg daily. Typically, transient and not associated with a decrease in renal function. Consider dosage reduction if unexplained hematuria and proteinuria persists.

Disease-related concerns:

• Liver impairment: Use with caution in patients who consume large amounts of ethanol and/or have a history of liver disease; may require dosage adjustment in some patients with liver impairment.

• Myasthenia gravis: May rarely worsen or precipitate myasthenia gravis (MG); monitor for worsening MG if treatment is initiated (AAN [Narayanaswami 2021]).

• Renal impairment: Dosage adjustment may be required in patients with renal impairment.

Special populations:

• East Asian population: Dosage adjustment should be considered for patients of East Asian descent.

• Older adult: Use with caution in patients with advanced age; these patients are more predisposed to myopathy.

• Surgical patients: Based on current research and clinical guidelines, HMG-CoA reductase inhibitors should be continued in the perioperative period for noncardiac and cardiac surgery (ACC/AHA [Fleisher 2014]; ACC/AHA [Hillis 2011]). Perioperative discontinuation of statin therapy is associated with an increased risk of cardiac morbidity and mortality.

Other warnings/precautions:

• Appropriate use: Rosuvastatin has not been studied when the primary lipid abnormality is chylomicron elevation (Fredrickson types I and V).

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Capsule Sprinkle, Oral:

Ezallor Sprinkle: 5 mg [contains fd&c blue #1 (brilliant blue), fd&c red #40 (allura red ac dye)]

Ezallor Sprinkle: 10 mg, 20 mg [contains fd&c blue #1 (brilliant blue)]

Ezallor Sprinkle: 40 mg

Tablet, Oral:

Crestor: 5 mg, 10 mg, 20 mg, 40 mg

Generic: 5 mg, 10 mg, 20 mg, 40 mg

Generic Equivalent Available: US

May be product dependent

Pricing: US

Capsule, sprinkles (Ezallor Sprinkle Oral)

5 mg (per each): $3.97

10 mg (per each): $3.97

20 mg (per each): $3.97

40 mg (per each): $3.97

Tablets (Crestor Oral)

5 mg (per each): $11.06

10 mg (per each): $11.06

20 mg (per each): $11.06

40 mg (per each): $11.06

Tablets (Rosuvastatin Calcium Oral)

5 mg (per each): $8.60 - $8.95

10 mg (per each): $8.61 - $8.95

20 mg (per each): $8.61 - $8.95

40 mg (per each): $8.61 - $26.83

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet, Oral:

Crestor: 5 mg, 10 mg, 20 mg, 40 mg

Generic: 5 mg, 10 mg, 20 mg, 40 mg

Administration: Pediatric

Oral: May be taken with or without food; may be taken at any time of the day.

Sprinkle capsule: Swallow capsule whole; do not crush or chew.

Oral administration on food: Open capsule and sprinkle contents on at least 5 mL (one teaspoonful) of soft food (eg, applesauce, chocolate/vanilla flavored pudding); stir mixture for 10 to 15 seconds. Swallow mixture within 60 minutes without chewing. Discard any unused portions.

Administration via feeding tube:

Gastric (NG) tubes ( ≥16 French): Capsule may be opened and contents emptied into a 60 mL catheter tipped syringe. Add 40 mL of water (do not use other liquids), then replace plunger and shake syringe vigorously for 15 seconds. Attach syringe to a ≥16-French NG tube and administer contents; flush NG tube with additional 20 mL of water. Mixture must be used immediately after preparation. Discard any unused portions.

Tablets: Swallow tablet whole.

Missed dose: Do not take an extra dose; resume treatment with next scheduled dose.

Administration: Adult

Capsule:

Oral: Administer with or without food. May be taken at any time of the day. Swallow capsule whole; do not crush or chew. Capsule may be opened and contents sprinkled over a small amount (teaspoonful) of soft food (eg, applesauce, chocolate/vanilla flavored pudding); stir mixture for 10 to 15 seconds. Swallow mixture within 60 minutes without chewing.

Nasogastric tube: Capsule may be opened and contents emptied into a 60 mL catheter tipped syringe. Add 40 mL of water (do not use other liquids), then replace plunger and shake syringe vigorously for 15 seconds. Attach syringe to a ≥16-French NG tube and administer contents; flush NG tube with additional 20 mL of water. Mixture must be used immediately after preparation.

Tablet: Administer with or without food. May be taken at any time of the day; swallow tablet whole.

Storage/Stability

Store between 20°C to 25°C (68°F to 77°F); excursions permitted between 15°C and 30°C (59°F and 86°F). Protect from moisture.

Use

Tablets, sprinkle capsules: Adjunct to dietary therapy to reduce LDL-C in patients with heterozygous familial hypercholesterolemia (HeFH) (FDA approved in ages ≥8 years and adults). Adjunct to other LDL-C lowering therapies (if available) to reduce LDL-C in patients with homozygous familial hypercholesterolemia (HoFH) (FDA approved in ages ≥7 years and adults). Treatment to reduce risk of stroke, myocardial infarction (MI), and arterial revascularization procedures in patients without established coronary artery disease (CAD) at increased risk of cardiovascular (CV) disease based on age, hsCRP ≥2 mg/L, and at least one additional CV risk factor (FDA approved in adults). Adjunct to dietary therapy to reduce LDL-C in patients with primary hyperlipidemia (FDA approved in adults). Adjunct to dietary therapy to reduce LDL-C and slow progression of atherosclerosis (FDA approved in adults). Adjunct to dietary therapy for primary dysbetalipoproteinemia (FDA approved in adults). Adjunct to dietary therapy for hypertriglyceridemia (FDA approved in adults).

Medication Safety Issues
Sound-alike/look-alike issues:

HMG-CoA reductase inhibitors (when referred to as "statins") may be confused with nystatin.

Rosuvastatin may be confused with atorvastatin, nystatin, pitavastatin

Older Adult: High-Risk Medication:

Rosuvastatin is identified in the Screening Tool of Older Person's Prescriptions (STOPP) criteria as a potentially inappropriate medication for primary prevention of cardiovascular disease in frail older adults ≥85 years of age with an expected life expectancy of <3 years (O’Mahony 2023).

Metabolism/Transport Effects

Substrate of BCRP, CYP2C9 (Minor), CYP3A4 (Minor), NTCP, OATP1B1/1B3; Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential;

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program

Abiraterone Acetate: May increase myopathic (rhabdomyolysis) effects of HMG-CoA Reductase Inhibitors (Statins). Risk C: Monitor

Acipimox: May increase myopathic (rhabdomyolysis) effects of HMG-CoA Reductase Inhibitors (Statins). Risk C: Monitor

Antacids: May decrease serum concentration of Rosuvastatin. Risk C: Monitor

Apalutamide: May decrease serum concentration of Rosuvastatin. Risk C: Monitor

Asciminib: May increase serum concentration of Rosuvastatin. Risk X: Avoid

Atazanavir: May increase serum concentration of Rosuvastatin. Rosuvastatin may increase serum concentration of Atazanavir. Management: Initiate rosuvastatin at 5 mg and do not exceed rosuvastatin 10 mg daily if coadministered with atazanavir alone, atazanavir/ritonavir, or atazanavir/cobicistat. If combined, monitor for signs and symptoms of myopathy and rhabdomyolysis. Risk D: Consider Therapy Modification

BCRP/ABCG2 Inhibitors: May increase serum concentration of Rosuvastatin. Risk C: Monitor

Belumosudil: May increase serum concentration of BCRP/ABCG2 Substrates (Clinically Relevant with Inhibitors). Management: Avoid coadministration of belumosudil with these substrates of BCRP for which minimal concentration increases can cause serious adverse effects. If coadministration is required, dose reductions of the BCRP substrate may be required. Risk D: Consider Therapy Modification

Bezafibrate: May increase myopathic (rhabdomyolysis) effects of HMG-CoA Reductase Inhibitors (Statins). Bezafibrate may increase serum concentration of HMG-CoA Reductase Inhibitors (Statins). More specifically, bezafibrate may increase the serum concentration of fluvastatin Management: Avoid use of bezafibrate and HMG-CoA reductase inhibitors (statins) unless strictly indicated due to the increased of muscle toxicity (including rhabdomyolysis). In patients who may be predisposed to myopathy, concomitant use is contraindicated. Risk D: Consider Therapy Modification

Bulevirtide: May increase serum concentration of NTCP Substrates. Management: Coadministration of bulevirtide with sodium taurocholate co-transporting polypeptide (NTCP) substrate should be avoided when possible. If used together, close clinical monitoring is recommended. Risk D: Consider Therapy Modification

Bulevirtide: May increase serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates (Clinically Relevant with Inhibitors). Management: Coadministration of bulevirtide with OATP1B1/1B3 (also known as SLCO1B1/1B3) substrates should be avoided when possible. If used together, close clinical monitoring is recommended. Risk D: Consider Therapy Modification

Capmatinib: May increase serum concentration of Rosuvastatin. Management: Limit the dose of rosuvastatin to 10 mg daily or rosuvastatin/ezetimibe 10 mg/10 mg daily when combined with capmatinib. Monitor closely for increased rosuvastatin effects/toxicities (eg, myalgias, rhabdomyolysis) when these agents are combined. Risk D: Consider Therapy Modification

CarBAMazepine: May decrease serum concentration of Rosuvastatin. Risk C: Monitor

Ceftobiprole Medocaril: May increase serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates (Clinically Relevant with Inhibitors). Risk X: Avoid

Ciprofibrate: May increase adverse/toxic effects of HMG-CoA Reductase Inhibitors (Statins). Management: Avoid the use of HMG-CoA reductase inhibitors and ciprofibrate if possible. If concomitant therapy is considered, benefits should be carefully weighed against the risks, and patients should be monitored closely for signs/symptoms of muscle toxicity. Risk D: Consider Therapy Modification

Clopidogrel: May increase serum concentration of Rosuvastatin. Risk C: Monitor

Colchicine: May increase myopathic (rhabdomyolysis) effects of HMG-CoA Reductase Inhibitors (Statins). Colchicine may increase serum concentration of HMG-CoA Reductase Inhibitors (Statins). HMG-CoA Reductase Inhibitors (Statins) may increase serum concentration of Colchicine. Risk C: Monitor

CycloSPORINE (Systemic): May increase serum concentration of Rosuvastatin. Management: Limit rosuvastatin to 5 mg daily in patients who are also receiving cyclosporine, and monitor patients for increased rosuvastatin toxicities. Canadian labeling contraindicates concomitant use of rosuvastatin with cyclosporine. Risk D: Consider Therapy Modification

Daclatasvir: May increase serum concentration of HMG-CoA Reductase Inhibitors (Statins). Risk C: Monitor

Danicopan: May increase serum concentration of Rosuvastatin. Management: Limit the rosuvastatin dose to 10 mg once daily if combined with danicopan. Risk D: Consider Therapy Modification

DAPTOmycin: HMG-CoA Reductase Inhibitors (Statins) may increase adverse/toxic effects of DAPTOmycin. Specifically, the risk of skeletal muscle toxicity may be increased. Management: Consider temporarily stopping statin (HMG-CoA reductase inhibitor) therapy prior to daptomycin. If daptomycin is used with a statin, creatine phosphokinase (CPK) monitoring could be considered. Risk D: Consider Therapy Modification

Darolutamide: May increase serum concentration of Rosuvastatin. Management: Limit the dose of rosuvastatin to 5 mg daily when combined with darolutamide. Monitor closely for increased rosuvastatin effects/toxicities (eg, myalgias, rhabdomyolysis) when these agents are combined. Risk D: Consider Therapy Modification

Darunavir: May increase serum concentration of Rosuvastatin. Management: Initiate rosuvastatin at the lowest dose and titrate slowly. Monitor for increased rosuvastatin toxicities when combined. The dose of rosuvastatin should not exceed 20 mg daily when used with darunavir/cobicistat. Risk D: Consider Therapy Modification

Dasabuvir: May increase serum concentration of Rosuvastatin. Management: Limit the rosuvastatin dose to a maximum of 10 mg per day when used with the ombitasvir/paritaprevir/ritonavir/dasabuvir combination product. Labeling outside of the US recommends limiting the rosuvastatin dose to 5 mg per day. Risk D: Consider Therapy Modification

Dronedarone: May increase serum concentration of Rosuvastatin. Risk C: Monitor

Elacestrant: May increase serum concentration of BCRP/ABCG2 Substrates (Clinically Relevant with Inhibitors). Risk C: Monitor

Elafibranor: May increase adverse/toxic effects of HMG-CoA Reductase Inhibitors (Statins). Specifically, the risk of muscle toxicity may be increased. Risk C: Monitor

Elagolix, Estradiol, and Norethindrone: May decrease serum concentration of Rosuvastatin. Risk C: Monitor

Elagolix: May decrease serum concentration of Rosuvastatin. Risk C: Monitor

Elbasvir and Grazoprevir: May increase serum concentration of Rosuvastatin. Management: Initiate rosuvastatin at 5 mg daily and limit the rosuvastatin dose to a maximum of 10 mg per day during coadministration with elbasvir/grazoprevir. Monitor closely for evidence of rosuvastatin toxicities (eg, myopathy, rhabdomyolysis). Risk D: Consider Therapy Modification

Elexacaftor, Tezacaftor, and Ivacaftor: May increase serum concentration of HMG-CoA Reductase Inhibitors (Statins). Risk C: Monitor

Eltrombopag: May increase serum concentration of Rosuvastatin. Management: Consideration a preventive 50% reduction in rosuvastatin adult dose when starting this combination. Risk D: Consider Therapy Modification

Enasidenib: May increase serum concentration of Rosuvastatin. Management: Limit the dose of rosuvastatin to 10 mg once daily when combined with enasidenib. Patients treated with the rosuvastatin/ezetimibe combination product should not exceed doses of 10 mg/10 mg daily. Risk D: Consider Therapy Modification

Eslicarbazepine: May decrease serum concentration of Rosuvastatin. Risk C: Monitor

Febuxostat: May increase serum concentration of Rosuvastatin. Management: Limit the dose of rosuvastatin to 20 mg daily or rosuvastatin/ezetimibe 20 mg/10 mg when combined with febuxostat. Monitor closely for increased rosuvastatin effects/toxicities (eg, myalgias, rhabdomyolysis) when these agents are combined. Risk D: Consider Therapy Modification

Fenofibrate and Derivatives: May increase adverse/toxic effects of HMG-CoA Reductase Inhibitors (Statins). Risk C: Monitor

Fostamatinib: May increase serum concentration of Rosuvastatin. Management: Limit the dose of rosuvastatin to 20 mg daily or rosuvastatin/ezetimibe 20 mg/10 mg when combined with fostamatinib. Monitor closely for increased rosuvastatin effects/toxicities (eg, myalgias, rhabdomyolysis) when these agents are combined. Risk D: Consider Therapy Modification

Fostemsavir: May increase serum concentration of HMG-CoA Reductase Inhibitors (Statins). Management: Use the lowest possible starting statin dose and monitor patients closely for statin-related adverse effects (eg, muscle aches and pains) during coadministration with fostemsavir. Risk D: Consider Therapy Modification

Fusidic Acid (Systemic): May increase adverse/toxic effects of HMG-CoA Reductase Inhibitors (Statins). Specifically, the risk for muscle toxicities, including rhabdomyolysis may be significantly increased. Management: Avoid concurrent use whenever possible. Use is listed as contraindicated in product characteristic summaries in several countries, although UK labeling suggests that use could be considered under exceptional circumstances and with close supervision. Risk X: Avoid

Futibatinib: May increase serum concentration of BCRP/ABCG2 Substrates (Clinically Relevant with Inhibitors). Risk C: Monitor

Gemfibrozil: May increase myopathic (rhabdomyolysis) effects of Rosuvastatin. Gemfibrozil may increase serum concentration of Rosuvastatin. Management: Avoid combination if possible. If combination cannot be avoided, initiate rosuvastatin at 5 mg/day and limit rosuvastatin to 10 mg/day. Monitor for signs/symptoms of rhabdomyolysis. Risk D: Consider Therapy Modification

Gilteritinib: May increase serum concentration of BCRP/ABCG2 Substrates (Clinically Relevant with Inhibitors). Risk C: Monitor

Glecaprevir and Pibrentasvir: May increase serum concentration of Rosuvastatin. Management: Initiate rosuvastatin at 5 mg or rosuvastatin/ezetimibe at 5 mg/10 mg daily and limit doses to rosuvastatin 10 mg or rosuvastatin/ezetimibe 10 mg/10 mg daily. Risk D: Consider Therapy Modification

Itraconazole: May increase serum concentration of Rosuvastatin. Risk C: Monitor

Lanthanum: May decrease serum concentration of HMG-CoA Reductase Inhibitors (Statins). Management: Administer HMG-CoA reductase inhibitors (eg, statins) at least two hours before or after lanthanum. Risk D: Consider Therapy Modification

Ledipasvir: May increase serum concentration of Rosuvastatin. Risk X: Avoid

Leflunomide: May increase serum concentration of Rosuvastatin. Management: Limit the maximum adult rosuvastatin dose to 10 mg/day in patients receiving leflunomide, and monitor for evidence of rosuvastatin toxicity (eg, muscle toxicity, elevated transaminase concentrations). Risk D: Consider Therapy Modification

Leniolisib: May increase serum concentration of BCRP/ABCG2 Substrates (Clinically Relevant with Inhibitors). Risk X: Avoid

Letermovir: May increase serum concentration of HMG-CoA Reductase Inhibitors (Statins). Risk C: Monitor

Lopinavir: May increase serum concentration of Rosuvastatin. Management: Initiate rosuvastatin at 5 mg or rosuvastatin/ezetimibe 5 mg/10 mg daily and do not exceed rosuvastatin 10 mg or rosuvastatin/ezetimibe 10 mg/10 mg daily when used with lopinavir/ritonavir. Monitor for myopathy, and rhabdomyolysis. Risk D: Consider Therapy Modification

Maribavir: May increase serum concentration of Rosuvastatin. Risk C: Monitor

Momelotinib: May increase serum concentration of Rosuvastatin. Management: In patients who are receiving momelotinib, initiate rosuvastatin at a dose of 5 mg once daily and limit the rosuvastatin dose to a maximum of 10 mg once daily. Risk D: Consider Therapy Modification

Niacin: May increase myopathic (rhabdomyolysis) effects of Rosuvastatin. Risk C: Monitor

Nirmatrelvir and Ritonavir: May increase serum concentration of Rosuvastatin. Risk C: Monitor

Ombitasvir, Paritaprevir, Ritonavir, and Dasabuvir: May increase serum concentration of Rosuvastatin. Management: Initiate rosuvastatin at 5 mg daily and limit the rosuvastatin dose to a maximum of 10 mg per day when used with the ombitasvir/paritaprevir/ritonavir/dasabuvir combination product. Monitor for rosuvastatin toxicities (eg, myopathy, rhabdomyolysis). Risk D: Consider Therapy Modification

Pacritinib: May increase serum concentration of Rosuvastatin. Management: Limit rosuvastatin doses to 20 mg once daily during concomitant therapy with pacritinib. Risk D: Consider Therapy Modification

Pretomanid: May increase serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates (Clinically Relevant with Inhibitors). Risk C: Monitor

Protease Inhibitors: May increase serum concentration of Rosuvastatin. Risk C: Monitor

Raltegravir: May increase myopathic (rhabdomyolysis) effects of HMG-CoA Reductase Inhibitors (Statins). Risk C: Monitor

Red Yeast Rice: May increase adverse/toxic effects of HMG-CoA Reductase Inhibitors (Statins). Risk X: Avoid

Regorafenib: May increase serum concentration of Rosuvastatin. Management: Limit the dose of rosuvastatin to 10 mg daily when combined with regorafenib. Monitor closely for increased rosuvastatin effects/toxicities (eg, myalgias, rhabdomyolysis) when these agents are combined. Risk D: Consider Therapy Modification

Repaglinide: HMG-CoA Reductase Inhibitors (Statins) may increase serum concentration of Repaglinide. Risk C: Monitor

Resmetirom: May increase serum concentration of Rosuvastatin. Management: Limit the rosuvastatin dose to 20 mg daily during coadministration with resmetirom. Monitor for increased rosuvastatin adverse effects (eg, myalgias) during coadministration. Risk D: Consider Therapy Modification

RifAMPin: May decrease serum concentration of Rosuvastatin. Risk C: Monitor

Rupatadine: May increase adverse/toxic effects of HMG-CoA Reductase Inhibitors (Statins). Specifically, the risk for increased CPK and/or other muscle toxicities may be increased. Risk C: Monitor

Simeprevir: May increase serum concentration of Rosuvastatin. Management: Limit initial dose to rosuvastatin 5 mg or rosuvastatin/ezetimibe 5 mg/10 mg daily during treatment with simeprevir. The maximum dose should not exceed rosuvastatin 10 mg or rosuvastatin/ezetimibe 10 mg/10 mg with concurrent simeprevir. Risk D: Consider Therapy Modification

Sparsentan: May increase serum concentration of BCRP/ABCG2 Substrates (Clinically Relevant with Inhibitors). Risk X: Avoid

Tafamidis: May increase myopathic (rhabdomyolysis) effects of Rosuvastatin. Tafamidis may increase serum concentration of Rosuvastatin. Management: Avoid this combination if possible. If combined, initiate rosuvastatin 5 mg or rosuvastatin/ezetimibe 5 mg/10 mg once daily and do not exceed rosuvastatin 20 mg or rosuvastatin/ezetimibe 20 mg/10 mg daily. Monitor for signs of myopathy and rhabdomyolysis. Risk D: Consider Therapy Modification

Taurursodiol: May increase serum concentration of BCRP/ABCG2 Substrates (Clinically Relevant with Inhibitors). Risk X: Avoid

Tedizolid: May increase serum concentration of BCRP/ABCG2 Substrates (Clinically Relevant with Inhibitors). Risk C: Monitor

Teriflunomide: May increase serum concentration of Rosuvastatin. Management: Limit the maximum adult rosuvastatin dose to 10 mg/day in patients receiving teriflunomide, and monitor for evidence of rosuvastatin toxicity (eg, muscle toxicity, elevated transaminase concentrations). Risk D: Consider Therapy Modification

Ticagrelor: May increase myopathic (rhabdomyolysis) effects of Rosuvastatin. Ticagrelor may increase serum concentration of Rosuvastatin. Risk C: Monitor

Trabectedin: HMG-CoA Reductase Inhibitors (Statins) may increase myopathic (rhabdomyolysis) effects of Trabectedin. Risk C: Monitor

Trofinetide: May increase serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates (Clinically Relevant with Inhibitors). Management: Avoid concurrent use with OATP1B1/1B3 substrates for which small changes in exposure may be associated with serious toxicities. Monitor for evidence of an altered response to any OATP1B1/1B3 substrate if used together with trofinetide. Risk D: Consider Therapy Modification

Vadadustat: May increase serum concentration of Rosuvastatin. Management: Do not exceed rosuvastatin doses of 5 mg daily and monitor for rosuvastatin adverse effects (eg, myopathy) during coadministration with vadadustat. Risk D: Consider Therapy Modification

Vanzacaftor, Tezacaftor, and Deutivacaftor: May increase serum concentration of BCRP/ABCG2 Substrates (Clinically Relevant with Inhibitors). Risk C: Monitor

Velpatasvir: May increase serum concentration of Rosuvastatin. Management: Initiate rosuvastatin at 5 mg daily and limit the rosuvastatin dose to a maximum of 10 mg per day during coadministration with sofosbuvir/velpatasvir. Monitor closely for evidence of rosuvastatin toxicities (eg, myopathy, rhabdomyolysis). Risk D: Consider Therapy Modification

Vimseltinib: May increase serum concentration of BCRP/ABCG2 Substrates (Clinically Relevant with Inhibitors). Management: Avoid concomitant use of vimseltinib and BCRP substrates when possible. If combined, monitor for increased effects and toxicities of the BCRP substrate and consider dose adjustments. Risk D: Consider Therapy Modification

Vitamin K Antagonists: HMG-CoA Reductase Inhibitors (Statins) may increase anticoagulant effects of Vitamin K Antagonists. Risk C: Monitor

Voclosporin: May increase serum concentration of OATP1B1/1B3 (SLCO1B1/1B3) Substrates (Clinically Relevant with Inhibitors). Risk C: Monitor

Voxilaprevir: May increase serum concentration of Rosuvastatin. Risk X: Avoid

Dietary Considerations

Red yeast rice contains variable amounts of several compounds that are structurally similar to HMG-CoA reductase inhibitors, primarily monacolin K (or mevinolin) which is structurally identical to lovastatin; concurrent use of red yeast rice with HMG-CoA reductase inhibitors may increase the incidence of adverse and toxic effects (Lapi 2008; Smith 2003).

Reproductive Considerations

Adequate contraception is recommended if an HMG-CoA reductase inhibitor (statin) is required in patients who may become pregnant (AHA/ACC [Grundy 2019]; CCS [Pearson 2021]). Patients planning to become pregnant should discuss their lifetime risk of cardiovascular disease, as well as risks and benefits of statin therapy with their health care team (CCS [Pearson 2021]). When appropriate, statins can be discontinued 1 to 2 months prior to conception (AHA/ACC [Grundy 2019]).

When a statin is needed in a patient of reproductive potential, a more hydrophilic option (eg, pravastatin, rosuvastatin) may be preferred to limit placental transfer (CCS [Pearson 2021]).

Pregnancy Considerations

In healthy pregnancies, changes in lipid synthesis occur that are required for normal placental and fetal growth. Low-density lipoprotein cholesterol and triglycerides increase as pregnancy progresses and decline postpartum. HMG-CoA reductase inhibitors (statins) decrease the synthesis of cholesterol and substances derived from cholesterol. Therefore, based on the mechanism of action, in utero exposure may cause fetal harm (Lecarpentier 2012); however, data from available studies have not shown an increased risk of major congenital anomalies following first trimester exposure (Bateman 2015; Chang 2021; Vahedian-Azimi 2021a). Additional data are needed to evaluate other pregnancy outcomes, such as miscarriage (Vahedian-Azimi 2021b).

Because there is potential for fetal harm, statins should be discontinued once pregnancy is recognized (AHA/ACC [Grundy 2019]; Brunham 2018). If lipid-lowering therapy during pregnancy is required, it should be individualized based on the therapeutic needs of the patient, considering the lifetime risk of untreated disease, use of nonstatin therapies, as well as the known risks and benefits of statins. Based on limited data, when a statin is needed in a pregnant patient, a more hydrophilic option (eg, pravastatin, rosuvastatin) may be preferred. Lipophilic statins (eg, atorvastatin, fluvastatin, lovastatin, simvastatin, pitavastatin) may be more likely to cross the placenta and increase the risk of congenital malformations (AHA/ACC [Grundy 2019]; CCS [Pearson 2021]; Lecarpentier 2012).

Additional data are needed to clarify the role of statins for the prevention of atherosclerotic cardiovascular disease in at-risk pregnant patients (AHA/ACC [Grundy 2019]; CCS [Pearson 2021]; Parikh 2021).

Monitoring Parameters

Manufacturer's labeling: Consider neuromuscular and serologic testing if immune-mediated necrotizing myopathy is suspected

Pediatric patients:

Baseline: ALT, AST, creatine phosphokinase levels (CPK), and renal function.

During treatment: Symptoms of myopathy, renal function as clinically indicated; LDL-C and repeat ALT and AST 4 weeks after therapy initiated. If no myopathy symptoms or laboratory abnormalities, then monitor LDL-C, ALT, and AST every 3 to 4 months during the first year and then every 6 months thereafter (NHLBI 2011).

Mechanism of Action

Inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, the rate-limiting enzyme in cholesterol synthesis (reduces the production of mevalonic acid from HMG-CoA); this then results in a compensatory increase in the expression of LDL receptors on hepatocyte membranes and a stimulation of LDL catabolism. In addition to the ability of HMG-CoA reductase inhibitors to decrease levels of high-sensitivity C-reactive protein (hsCRP), they also possess pleiotropic properties including improved endothelial function, reduced inflammation at the site of the coronary plaque, inhibition of platelet aggregation, and anticoagulant effects (de Denus 2002; Ray 2005).

Pharmacokinetics (Adult Data Unless Noted)

Note: In pediatric patients (10 to 17 years of age), maximum serum concentration and AUC have been shown to be similar to adult values

Onset of action: Within 1 week; maximal at 4 weeks

Distribution: Vd: 134 L

Protein binding: 88%

Metabolism: Hepatic (10%), via CYP2C9 (1 active metabolite identified: N-desmethyl rosuvastatin, one-sixth to one-half the HMG-CoA reductase activity of the parent compound)

Bioavailability: 20% (high first-pass extraction by liver)

Half-life elimination: 19 hours

Time to peak, plasma: 3 to 5 hours

Excretion: Feces (90%), primarily as unchanged drug

Pharmacokinetics: Additional Considerations (Adult Data Unless Noted)

Altered kidney function: Plasma concentrations increase about 3-fold in patients with severe renal impairment (CrCl <30 mL/minute/1.73 m2) not requiring hemodialysis. Steady-state plasma concentrations in patients on chronic hemodialysis are ~50% higher compared with patients with normal renal function.

Hepatic function impairment: Cmax and AUC are increased in patients with Child-Pugh class A or Child-Pugh class B hepatic impairment.

Race/ethnicity: East Asian patients have ~2-fold elevation in exposure (AUC and Cmax).

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AE) United Arab Emirates: Bioroz | Caroza | Crestor | Crevastin | Favros | Ivarin | Kolros | Medystatin | Rofast | Rosalus | Rosatin | Rostagen | Rosuvas | Rosvacor | Rosval | Rovista | Roxardio | Rozat | Rozavel | Rozavi | Rozbio | Rozinor | Rustat | Xolstat | Zyrosa;
  • (AR) Argentina: Astende | Ateronova | Bilip | Colerragin | Crestor | Mesoterol | Nodis | Parasul | Rosimol | Rosucol | Rosufec | Rosufen | Rosustatin | Rosuvast | Rosuvastatina | Rosux | Rovartal | Rovastane | Sinlip | Tialipol;
  • (AT) Austria: Arosuva | Crestor | Rosuvalan | Rosuvastatin +pharma | Rosuvastatin 1A Pharma | Rosuvastatin accord | Rosuvastatin actavis | Rosuvastatin aristo | Rosuvastatin G.L. | Rosuvastatin Genericon | Rosuvastatin hexal | Rosuvastatin krka | Rosuvastatin mylan | Rosuvastatin ratiopharm | Rosuvastatin sandoz | Rosuvastatin stada;
  • (AU) Australia: Affora | Apo rosuvastatin | APX Rosuvastatin | Blooms the chemist rosuvastatin | Cavstat | Chemmart rosuvastatin | Crestor | Crosuva | Noumed rosuvastatin | Pharmacor rosuvastatin | Rostor | Rosuvastatin actavis | Rosuvastatin amneal | Rosuvastatin an | Rosuvastatin APOTEX | Rosuvastatin drla | Rosuvastatin generichealth | Rosuvastatin Lupin | Rosuvastatin rbx | Rosuvastatin sandoz | Terry white chemists rosuvastatin | Visacor;
  • (BD) Bangladesh: Bestcol | Cholcut | Corestin | Corovas | Creston | Creva | Nestor | Prestorin | Restat | Resva | Rocovas | Rolip | Ropitor | Rostab | Rostatin | Rosu | Rosugen | Rosumax | Rosutin | Rosuva | Rovast | Rovator | Rovex | Rovius | Rozavel | Rozenon | Rtv | Ruvastin | Sb rostin;
  • (BE) Belgium: Crestor | Rosuvastatin ab | Rosuvastatin krka | Rosuvastatin sandoz | Rosuvastatine apotex | Rosuvastatine eg | Rosuvastatine mylan | Rosuvastatine teva;
  • (BF) Burkina Faso: Pms rosuvastatin | Robestar | Rosukaa | Rosumac | Rosuvas | Rozan;
  • (BG) Bulgaria: Aterostad | Crestor | Neoroso | Romazic | Ropuido | Rosistat | Rossta | Rosucard | Rosuvanor | Rosuvastatin accord | Rosuvastatin mylan | Rosuvistat | Roswera | Rovasta | Rusocon | Suzastor | Tintaros | Ultravas | Vosustat | Zaranta;
  • (BR) Brazil: Creslip | Crestor | Elpenzo | Rostatin | Rosucor | Rosulib | Rosustatin | Rosuvast | Rosuvastatina calcica | Rox | Rusovas | Ruva | Ruvascor | Sancol | Trezor | Vivacor | Zinpass;
  • (CH) Switzerland: Crestastatin | Crestor | Rosuvastatin axapharm | Rosuvastatin mepha lactab | Rosuvastatin nobel | Rosuvastatin sandoz | Rosuvastatin spirig HC | Rosuvastatin viatris | Rosuvastatin zentiva | Rosuvastax;
  • (CI) Côte d'Ivoire: Crestor | Pms rosuvastatin | Robestar | Rosukaa | Rosumac | Statinpro | Superstat;
  • (CL) Chile: Crestor | Pravalip | Redistatin | Rosuvitae | Rovartal | Rux | Simcor;
  • (CN) China: Chang le ding | Crestor | Hai shu yan | Jing nuo | Ke Ding | Rui zhi | Tuo tuo | Xin tuo tuo;
  • (CO) Colombia: Biotor | Brosteril | Cardiomax | Crestor | Garmisch rosuvax | Rosucol | Rosudex | Rosumax | Rosustar | Rosutor ldl | Rosuvastatina | Rosuvastatina MK | Rosuvastin | Rosuvax | Rosuverol | Rosuvitae | Rotavin | Rovaril | Rozavel | Rustatina | Rux | Vusorex | Xineba | Xuniro;
  • (CR) Costa Rica: Deplet;
  • (CZ) Czech Republic: Apo rosuvastatin | Corvapro | Cresagen | Crestor | Mertenil | Rosi | Rosucard | Rosumop | Rosuvastatin accord | Rosuvastatin aurobindo | Rosuvastatin krka | Rosuvastatin msn | Rosuvastatin mylan | Rosuvastatin polpharma | Rosuvastatin tad | Rosuvastatin teva | Rovasyn | Roxilip | Sorvasta | Tintaros | Zahron;
  • (DE) Germany: Crestor | Rosu 1 a pharma | Rosuhexal | Rosustar | Rosuvador | Rosuvastatin 1A Pharma | Rosuvastatin accord | Rosuvastatin aristo | Rosuvastatin Astra | Rosuvastatin aurobindo | Rosuvastatin axcount | Rosuvastatin axiromed | Rosuvastatin denk | Rosuvastatin elpen | Rosuvastatin Generinobel | Rosuvastatin hec pharm | Rosuvastatin heumann | Rosuvastatin q pharm | Rosuvastatin ratiopharm | Rosuvastatin vivanta;
  • (DO) Dominican Republic: Blokimax | Cora ros | Crestatin | Crestor | Etistatin | Lesterol | Limacol | Liponor | Lustatin | Praxia | Quiralex | Regutol | Rex | Rosalta | Rosustar | Rosutin | Rosuvast | Rosuvastatina | Rosuvastatina ethical | Rosuvastatina Feltrex | Rosuvastatina Lam | Rosuvastatina MK | Rosuvastatina normon | Rosuvastatina sandoz | Rosuvina | Rovaril | Rovartal | Rovascol | Rovasta | Rucol | Rusarte 20 | Rusarte 40 | Ruxicol | Sincolex | Sinlip | Skorlat | Suvasroi | Triglicol;
  • (EC) Ecuador: Astende | Colesta | Coroval | Cresadex | Crestor | Cresvax | Deplet | Hibolipid | Roslipid | Rostat | Rostatin | Rosulip | Rosumax | Rosuson | Rosuval | Rosuvastatina | Rosuvastatina calcica | Rosuvastatina nifa | Rosuvid | Rosuvina | Rosuvitae | Rozavel | Rusovas | Rux;
  • (EE) Estonia: Crestor | Rosuvacard | Rosuvastatin | Rosuvastatin accord | Rosuvastatin krka | Rosuvastatin tad | Rosuvastatin teva | Roswera | Rovasyn | Roxardio | Zaranta;
  • (EG) Egypt: Advochol | Bemastrim | Cemicresto | Cholerose | Crestatin | Crestolip | Crestor | Deconadal | Epirovastin | Estero Map | Frositor | Gypravastin | Justechol | Merosatin | Naplema | Nexirozova | Novistoric | Pentastatin | Rositor | Rosumop | Rosuvast | Rosuvastatin | Statirose | Suvikan | Vastasiero;
  • (ES) Spain: Abemax | Alzil | Arrox | Crestor | Kastia | Provisacor | Rosuvastatina almus | Rosuvastatina alter | Rosuvastatina apotex | Rosuvastatina aristo | Rosuvastatina aurovitas | Rosuvastatina cinfa | Rosuvastatina combix | Rosuvastatina kern | Rosuvastatina krka | Rosuvastatina mabo-farma | Rosuvastatina mylan | Rosuvastatina normon | Rosuvastatina opko | Rosuvastatina Pensa | Rosuvastatina qualigen | Rosuvastatina ranbaxy | Rosuvastatina Ratiopharm | Rosuvastatina sandoz | Rosuvastatina stada | Rosuvastatina tarbis | Rosuvastatina tecnigen | Rosuvastatina teva | Rosuvastatina viso | Rosuvastatina Vivanta | Roxera | Vaxar;
  • (ET) Ethiopia: Crestor | Ivarin | Robestar | Rofast | Rosumac | Rosuvas | Rosuvastatin | Rosuvastatin atb | Turbovas;
  • (FI) Finland: Crestor | Rosuvastatin accord | Rosuvastatin actavis | Rosuvastatin krka | Rosuvastatin mylan | Rosuvastatin orion | Rosuvastatin ratiopharm | Rosuvastatin sandoz | Rosuvastatin stada | Rosuvastatin teva | Rosuvastatin xiromed;
  • (FR) France: Crestor | Rosuvastatine | Rosuvastatine accord | Rosuvastatine almus | Rosuvastatine arrow | Rosuvastatine biogaran | Rosuvastatine cristers | Rosuvastatine eg | Rosuvastatine evolugen | Rosuvastatine krka | Rosuvastatine mylan | Rosuvastatine polfa pabianice | Rosuvastatine ranbaxy | Rosuvastatine sandoz | Rosuvastatine teva | Rosuvastatine zentiva | Rosuvastatine zydus | Zelfusor;
  • (GB) United Kingdom: Crestor | Rosuvastatin | Rosuvastatin glenmark;
  • (GR) Greece: Celmantin | Crestilen | Crestor | Extrator S | Grosera | Holestatin | Platorel | Rosartia | Rossta | Rosuben | Rosupose | Rosuvador | Rosuval heremco | Rosuvastatin win medica | Rosuvastatin/mylan | Rosuvastatin/pharmazac | Rosuvastatin/sandoz | Rosuvastatin/velka | Rovastine | Sterocardin | Venex | Zircos | Zirus;
  • (HK) Hong Kong: Apo rosuvastatin | Crestor | Eurovastin | Hovid Rosuvastatin | Myungmoon rosuvastatin | Neusator | Pms rosuvastatin | Rosetor | Rosukaa | Rosuvas | Rosuvastatin actavis | Rosuvastatin alvogen | Rosuvastatin sandoz | Rosuvastatin stella | Vickrostor;
  • (HR) Croatia: Coupet | Crestor | Epri | Rosacol | Rosix | Rosuvastatin jgl | Rosuvex | Roswera;
  • (HU) Hungary: Cresagen | Delipid | Rosucard | Rosutec | Rosuvastatin pharma regist | Rosuvastatin sandoz | Rosuvastatin teva | Roxera | Rozuva teva | Xeter;
  • (ID) Indonesia: Crestor | Giventor | Nistrol | Pyfaros | Recansa | Robestar | Rostin | Rosuvastatin | Rovascol | Rovastar | Rovator;
  • (IE) Ireland: Crestor | Rosuva | Rosuvastatin | Rosuvastatin actavis | Rosuvastatin krka | Rosuvastatin rowa | Rosuvastatin teva;
  • (IL) Israel: Crestor;
  • (IN) India: Aboros | Acmerose | Adipostat | Advastat | Akroz | Alfastat | Alviroz | Arostat | Arvast | Ateros | Athrovas | Azuvas | Bakolip | Bestor | Cardiorostin | Cardirose | Coltro | Conistat | Consivas | Creolip | Cresov | Crestor | Crevast | Danrose | Delrose | Exeroz | Favros | Fliptor | Fortius | Glihypo Plus | Gloristat | Glyvas | Grandstat | Herocin | Ibstatin | Impurose | Jprest | Jubira | Jupiros | Ldnil | Lipigo | Lipirose | Lipitas | Lipitrack | Lodens | Mahastat | Maxvast | Multistat | Newsta | Noruva | Novastat | Osutin | R2 | Rastrol | Razel | Restolip | Retroser | Revostat | Rezara | Rolip | Roliptin | Rolistat | Ropiless | Rosact | Rosadac | Rosadil | Rosat | Rosave | Rosbest | Roseday | Rosepil | Rosetin | Rosevast | Rosidoc | Rosimit | Roslaren | Rosloy | Rosmi | Rost | Rosta | Rostar | Rosubest | Rosucad | Rosuchol | Rosucia | Rosucrest | Rosudax | Rosufit | Rosuflo | Rosugraf | Rosuhop | Rosukaa | Rosukem | Rosular | Rosuless | Rosulex | Rosuline | Rosulip | Rosumac | Rosumart | Rosumerc | Rosunex | Rosunova | Rosupack | Rosupil | Rosur | Rosushine | Rosuson | Rosutec | Rosutero | Rosuvas | Rosuvastat | Rosuvel | Rosuvib | Rosuvotin | Rosvera | Rosvin | Rosycap | Rosys | Rosytab | Rotin | Roustrin | Rovasday | Rovastat | Rovax | Rovelstat | Rovio | Rovustin | Rozanex | Rozat | Rozavel | Rozfirst | Roznova | Roznyle | Rozstyl | Rozucor | Rozudoc | Rozugus | Rozuone | Rozustat | Rozutin | Rozuxia 10 | Rozuxia 20 | Rozuxia 5 | Rozvin | Rvs | Rxtor | Saanvas r | Sanorose | Statpure | Statset | Stematin | Suvalip | Turbovas | Unizuva | Vitastat | Wyteros | Xoten | Z Stat | Zyrova;
  • (IQ) Iraq: Crestosam | Rosatin awa | Rosuvastatin mdi | Rosva | Rouvastatin kindi | Zerotin;
  • (IT) Italy: Borghes | Cirantan | Colcardiol | Colfri | Crativ | Crestor | Dilivas | Exorta | Koleros | Lipidover | Miastina | Provisacor | Rosastin | Rosuvastatina accord | Rosuvastatina adamed | Rosuvastatina almus | Rosuvastatina alter | Rosuvastatina aristo | Rosuvastatina Aurobindo | Rosuvastatina doc | Rosuvastatina eg | Rosuvastatina mylan | Rosuvastatina Pensa | Rosuvastatina sandoz | Rosuvastatina tecnigen | Rosuvastatina Teva Italia | Rosuvastatina zentiva | Simestat | Snaptag | Staros | Tekvas;
  • (JO) Jordan: Crestor | Cresuva | Cristaram | Eveness | Rosakit | Rosalus | Rosatin | Rostar | Rovasta | Roxardio | Stage | Zerova | Zyrosa;
  • (JP) Japan: Crestor | Rosuvastatin | Rosuvastatin amel | Rosuvastatin calcium kaken | Rosuvastatin chemiphar | Rosuvastatin dsep | Rosuvastatin ee | Rosuvastatin jg | Rosuvastatin kyorin | Rosuvastatin meek | Rosuvastatin nichiiko | Rosuvastatin nipro | Rosuvastatin nissin | Rosuvastatin ohara | Rosuvastatin pfizer | Rosuvastatin sandoz | Rosuvastatin sanwa | Rosuvastatin sawai | Rosuvastatin takata | Rosuvastatin takeda teva | Rosuvastatin tck | Rosuvastatin towa | Rosuvastatin tsuruhara | Rosuvastatin yd | Rosuvastatin zeria;
  • (KE) Kenya: Aurora | Bestor | Crestat | Creston | Crestor | Easetec | Jupiros | Ld berg r | Ldnil | Lipecos | Robestar | Rosave | Rostat | Rosuat | Rosucip | Rosucor | Rosugard | Rosulip | Rosumac | Rosuna | Rosuva | Rosuvas | Rosuvitae | Rovas | Rovast | Rovastin | Roviros | Rovista | Rozar | Rozatin | Rozavel | Statinor | Turbovas | X Plended | Xovat | Zoruva | Zyrova;
  • (KR) Korea, Republic of: Allstatin | Aprogen rosuvastatin calcium | Austatin | Cholesdin | Cholestop | Cholostar | Ciustar | Clestin | Clow | Cmg rosuvastatin | Cratin | Creazin | Crecheck | Crego | Crerato | Creros | Crerosue | Crerova | Cres | Cresante | Cresba | Cresno | Cresnon | Crestan | Crestar | Crestin | Crestor | Cresvan | Cretor | Crevas | Crevatin | Crevato | Crezin | Crezy | Crosta | Crostin | Crovatin | Crystal rosuvastatin | Cuistar | Cvastin | Daewoong rosuvastatin | Dongkwang rosuvastatin calcium | Dongsung rosuvastatin | Dongwha rosuvastatin | Elosuva | Elrosuva | Esrotin | Etex rosuvastatin calcium | Hanall rosuvastatin calcium | High l | Huresto | Irosta | J rosu | K rotin | Liposto | Loresto | Lovastar | Mega rosutin | Merova | Monorova | Myungmoon rosuvastatin calcium | Neustatin r | Newrostin | Newsto | Newsuvatin | Pavist | Pms rosuvastatin | Rerostar | Restar | Rojustin | Roresto | Roshuta | Rosta | Rostagen | Rostin | Rosto | Roston | Rosu v | Rosuco | Rosucor | Rosugreen | Rosulord | Rosumax | Rosumedi | Rosumin | Rosunex | Rosuridin | Rosusta | Rosustin | Rosustor | Rosuta | Rosutan | Rosutatin | Rosuterol | Rosutin | Rosutin m | Rosuto | Rosutop | Rosuva | Rosuva m | Rosuvan | Rosuvasin | Rosuvastaqual | Rosuvastatin bkw | Rosuvastin | Rosuvat | Rosuvatin | Rosuvato | Rosvatan | Rotatin | Rotrovan | Rovaid | Rovasro | Rovasto | Rovat | Rovatan | Rovaterol | Rovetin | Rovitan | Roxtan | Roxva | Samsung rosuvastatin | Shuvasta | Shuvastin | Starova | Stavastor | Sustar | Suvast | Suvastatin | Suvastin | Suvatan | Suvatin | Td rosu | Topstatin | Unirova | Vivacor | Yoorostor | Yurostin | Yurostor;
  • (KW) Kuwait: Crestor | Ivarin | Rosatin | Rozavi | Roztor;
  • (LB) Lebanon: Apo rosuvastatin | Cresotab | Crestor | Cresulip | Kolros | Lipirose obp | Pms rosuvastatin | Rostat | Rosucor | Rosuvas | Rovastin | Roxardio | Sinlip | Superstat;
  • (LT) Lithuania: Crestor | Nisatlex | Romazic | Rosuvacard | Rosuvastatin accord | Rosuvastatin actavis | Rosuvastatin krka | Rosuvastatin teva | Rosuvastatin zentiva | Roswera | Roxardio | Zaranta;
  • (LU) Luxembourg: Crestor | Rosuvastatin ratiopharm | Rosuvastatine eg | Rosuvastatine mylan;
  • (LV) Latvia: Crestor | Romazic | Rosuvacard | Rosuvastatin accord | Rosuvastatin actavis | Rosuvastatin krka | Rosuvastatin tad | Rosuvastatin teva | Rosuvastatin zentiva | Roswera | Rovasyn | Sorvasta | Zaranta;
  • (MA) Morocco: Bestor | Crestor | Decrestin | Ictaves | Rosucal | Rosustar | Rosuvas | Rozat;
  • (MX) Mexico: Colsulix | Cresabella | Crestor | Crisvi | Crostox | Divotran | Equistat | Forcoco | Gantena | Isostal | Orenda | Relastrol | Robotek | Rosuvastatin | Rosuvastatin sandoz | Rosuvastatina | Rosvaden | Rovartal nf | Rupilip | Tordia | Traustabindo | Vibrent | Zathelo;
  • (MY) Malaysia: Apo rosuvastatin | Crestor | Hovid Rosuvastatin | Novtor | Rosucor | Rosuvastatin | Rosuvastatin stada | Rosuvor | Rovastin | Roxatin | Starez | Vasticure | Vastinor | Vivacor | Xolstat;
  • (NG) Nigeria: Ajacin | Crestor | Filroxy | Lipiros | Ocestat | Prevesta | Razel | Restoday | Rolip | Rosuglob | Rosulad | Rosunorm | Rosutor | Rosuvastatin | Rosuvastatin sandoz | Rovista | Rozcard | Sai rosuvastatin | Scolta | Statinor | X Plended;
  • (NL) Netherlands: Crestor | Rosuvastatin AstraZeneca | Rosuvastatine | Rosuvastatine accord | Rosuvastatine aristo | Rosuvastatine Aurobindo | Rosuvastatine CF | Rosuvastatine glenmark | Rosuvastatine macleods | Rosuvastatine mylan | Rosuvastatine sandoz | Rosuvastatine SUN | Rosuvastatine teva | Rosuvastatine vivanta | Rosuvastatine xiromed;
  • (NO) Norway: Crestor | Rosuvastatin glenmark | Rosuvastatin sandoz | Rosuvastatin xiromed;
  • (NZ) New Zealand: Crestor | Noumed rosuvastatin | Rosuvastatin calcium generic | Rosuvastatin viatris;
  • (PE) Peru: Aurovas | Cresadex | Crestor | Dismigras | Rostatin | Rosucol | Rosuvastor | Rovastane | Rux;
  • (PH) Philippines: Arvast | Athero | Controld | Crestor | Gostatin | Ldnil | Lipichek | Lowas | Lustatin | Preventa | Rainsuvast | Robestar | Rosadoc | Rosalta | Roselion | Rosett | Rost | Rosubolic | Rosucare | Rosucol | Rosulip | Rosumond | Rosuphil | Rosuple | Rosustat | Rosutin | Rosuvastatin | Rosuvaz | Rosuvin | Rosvascal | Roswin | Rovex | Rovista | Roztin | Ruchol | Torros | Torus | Turbovas | Vaptor | Wilovast | Zenrosu | Zyrova;
  • (PK) Pakistan: Amro | Atistatin | Aurora | Cougar | Crescor | Easetec | Exilip | Fortius | Kestore | Kovastin | Loster | Neomycodox | Neostat | Nevastatin | Omnitor | Pasage | Prevlip | Qazzo | R vastin | Rast | Ravitin | Raystatin | Regulip | Restore | Ricoda | Rolip | Ropitor | Rortos | Rosan | Rosatin | Rosca | Roscard | Roscor | Rosera | Rosimol | Rosir | Rosocard | Rostat | Rostaten | Rostatin | Rostin | Rostor | Rosubar | Rosucal | Rosugen | Rosulin | Rosulite | Rosun | Rosunext | Rosusid | Rosustar | Rosutrol | Rosuva | Rosuvast | Rosuvasure | Rosuvax | Rosuwim | Rosva | Rosvital | Rova | Rovator | Rovin | Rovip | Roviros | Rovustat | Rozavel | Rudra | Rusiam | Ruvastat | Rvastine | Savuros | Signova | Simrose | Staars | Suvet | Tri ase | Vastec | Vegarose | Vesonor | Vistin | Welrus | X Plended | Xell | Xenecor | Xovat | Xstatin | Zyrova;
  • (PL) Poland: Actarosin | Aporoza | Astrium | Crestor | Crosuvo | Ivirosina | Ridlip | Romazic | Rosucard | Rosugen | Rosutrox | Rosuvastatin aurovitas | Rosuvastatin krka | Rosuvastatin Medical Valley | Rosuvastatin ranbaxy | Rosuvastatin ratiopharm | Rosuvastatin teva | Roswera | Suvardio | Zahron | Zaranta;
  • (PR) Puerto Rico: Crestor | Ezallor | Rosuvastatin;
  • (PT) Portugal: Crestor | Rosuvastatin bisten | Rosuvastatina alter | Rosuvastatina aristo | Rosuvastatina aurovitas | Rosuvastatina azevedos | Rosuvastatina bluepharma | Rosuvastatina ciclum | Rosuvastatina generis | Rosuvastatina mylan | Rosuvastatina Pharmakern | Rosuvastatina Ratiopharm | Rosuvastatina sandoz | Rosuvastatina tecnigen | Rosuvastatina tecnilor | Rosuvastatina teva | Rosuvastatina toLife | Rosuvastatina zentiva | Visacor;
  • (PY) Paraguay: Crestor | Rosulip | Rosuvastatina sandoz | Roxicam | Rux | Sinlip;
  • (QA) Qatar: Corteza | Crestor | Ivarin | Rofast | Rosakit | Rosase | Rosatin | Rostatin | Rosuvas | Rosvacor | Rovalex | Rovasta | Roxardio | Rozitta | Roztor | Scolta | Stage | Vazatin | Vironta | Zyrosa;
  • (RO) Romania: Astrium | Crestor | Rosi | Rostat | Rosuvastatina atb | Rosuvastatina krka | Rosuvastatina mylan | Rosuvastatina teva | Roswera | Rovastamed | Rozucor;
  • (RU) Russian Federation: Akorta | Cardiolip | Crestor | Lipoprime | Mertenil | Reddistatine | Ro-statin | Rosart | Rosucard | Rosufast | Rosulip | Rosuvastatin | Rosuvastatin avexima | Rosuvastatin canon | Rosuvastatin FT | Rosuvastatin medisorb | Rosuvastatin renewal | Rosuvastatin sz | Rosuvastatin teva | Rosuvastatin vial | Rosuvastatin xantis | Roxera | Rozart | Rozistark | Rozucard | Rozulip | Rustor | Suvardio | Tevastor | Yogaros;
  • (SA) Saudi Arabia: Apo rosuvastatin | Corteza | Creschol | Crestor | Crevast | Pms rosuvastatin | Rastor | Rosalus | Rost | Rovasta | Rozavi | Rozitta | Vironta | Zyrosa;
  • (SE) Sweden: Crestor | Rosuvastatin accord | Rosuvastatin glenmark | Rosuvastatin krka | Rosuvastatin Medical Valley | Rosuvastatin mylan | Rosuvastatin orion | Rosuvastatin sandoz | Rosuvastatin stada | Rosuvastatin teva | Rosuvastatin xiromed | Rosuvastatin zentiva | Visacor;
  • (SG) Singapore: Apo rosuvastatin | Celmantin | Crestor | Rofast | Rostat | Rosucard | Rosuvastatin sandoz;
  • (SI) Slovenia: Coupet | Crestor | Ropuido | Rosuvastatin actavis | Rosuvastatin teva | Rustavo | Sorvasta | Vosustat;
  • (SK) Slovakia: Crestor | Rosucard | Rosuvastatin actavis | Rosuvastatin krka | Rosuvastatin msn | Rosuvastatin mylan | Rosuvastatin ratiopharm | Rosuvastatin sandoz | Rosuvastatin teva | Sorvasta | Zahron | Zaranta;
  • (SR) Suriname: Apo rosuvastatin | Rosokaa | Rosukaa | Rosuvastatin | Rosuvastatin biocon | Rosuvastatine Aurobindo | Rosuvastatine sandoz | Rosuvastatine SUN | Rovas;
  • (TH) Thailand: Cholestor | Crestor | K zuva | Rosucor | Rosugrix | Rosuvastatin | Rosuvastatin gpo | Rosuvastatin sandoz | Rovastor | Surotin | Vivacor;
  • (TN) Tunisia: Crestor | Neacrest | Rocor | Rosulip | Rosuvans | Rosuvascor | Rosuvast | Rosuvast 20 | Rosuvast 5 | Rosuvastatine zentiva | Rozuvie 10 | Rozuvie 20 | Rozuvie 5 | Superstat | Vissen;
  • (TR) Turkey: Colnar | Crelix | Crestor | Kolros | Livercol | Reakt | Rosucor | Rosufix | Rosugen | Rosuvas | Stage | Stata | Ultrox;
  • (TW) Taiwan: Alvostat | Apo rosuvastatin | Crestor | Kolros | Pms rosuvastatin | Robestar | Rolipostatin | Ropicin | Rostatin | Rosu | Rosulator | Rosulip | Rosutor | Rosuvastatin mylan | Rotlip | Roty | Rovastin | Rozinin | Zyrova;
  • (UA) Ukraine: Cholrest | Clivas | Mertenil | Ozalex | Preventor | Redistatin | Romazic | Romestin | Romestin 10 | Rosart | Rosastin | Rosufast | Rosulip | Rosustar | Rosuvastatin | Rosuvastatin ananta | Rosuvastatin darnitsa | Rosuvastatin ic | Rosvator | Rovamed | Rovix | Roxera | Rozister | Rozucard | Rozusta;
  • (UG) Uganda: Crestor | Ldnil | Livercol | Robestar | Rofast | Rosucor | Rosumac | Rosuna | Rosustar | Rosutab | Rosuvas | Rosuvastatin | Rosuvat | Rosuvax | Rovas | Rovista | Statinor | Turbovas | Vaptor | Zyrova;
  • (UY) Uruguay: Artomey | Brytar | Lesterol | Novostatin 10 | Novostatin 20 | Reovex | Rosulip | Rosustat;
  • (VE) Venezuela, Bolivarian Republic of: Crestor | Lodal | Racor | Regulip | Robotek | Rosulip | Rosuvastatin | Rosuvastatina | Rosuvastatina genven | Rovaril | Rovartal | Rozat | Triglival;
  • (VN) Viet Nam: Auritz | Bonzacim | Carhurol | Chemistatin | Colarosu | Courtois | Devastin | Eftirosu | Intoras | Merovast | Nafelof | Ravastel | Richstatin | Rolavast | Rossuwell | Rosuvagen | Rotinvast | Rotorlip | Rovatin | Ruvasan | Sterolow | Sunbakant | Surotadina | Vacoros;
  • (ZA) South Africa: Cresagen | Crestor | Crevas | Kolestor | Lupovas | Rocrest | Rostat | Rostor | Rosuvastatin adco | Rosuvastatin cipla | Rosuvastatin PharmC | Rosuvastatin unicorn | Rosvator | Storwin | Torolar | Trinchol | Vasrov | Vusor | Xartigen | Zuvamor;
  • (ZM) Zambia: Ldnil | Rosuvas | Rozatin;
  • (ZW) Zimbabwe: Crestor | Ldnil | Rosucor | Rovas
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