Patients may experience a decreased antilipemic effect elvitegravir and rosuvastatin are coadministered. If elvitegravir is boosted with cobicistat, patients may be at increased risk for side effects of rosuvastatin. Moderate Case reports exist describing the development of myotoxicity i. Statins involved in the reported cases include simvastatin, atorvastatin, fluvastatin, lovastatin, and pravastatin.

Patients receiving these agents concurrently should be monitored for myotoxicity. Major It would be prudent to avoid concurrent use of rosuvastatin and cyclosporine when possible.

Combination therapy with HMG-CoA reductase inhibitors and cyclosporine has been associated with myopathy and rhabdomyolysis. When rosuvastatin is coadministered with cyclosporine in heart transplant patients, the Cmax and AUC of rosuvastatin are increased fold and 7-fold, respectively, compared with historical data with normal volunteers.

This is the likely mechanism of the increase in rosuvastatin exposure. Use of these drugs together may result in elevated Statin serum concentrations, potentially resulting in adverse effects such as myopathy and rhabdomyolysis.

Moderate Daptomycin has been associated with elevated CPK in clinical trials. HMG-CoA reductase inhibitors are known to cause myopathy. Since data regarding co-administration of daptomycin with HMG-CoA reductase inhibitors are limited, temporary suspension of HMG-CoA reductase inhibitor therapy should be considered in patients receiving daptomycin.

Major The risk of myopathy, including rhabdomyolysis, may be increased when darunavir is given in combination with most HMG-CoA reductase inhibitors. When coadministered with darunavir in the FDA approved dosage regimen , increased rosuvastatin concentrations are seen, although the drugs can be coadministered with careful monitoring when rosuvastatin is started at the lowest possible dose; gradual dose increases may be considered based on clinical response.

Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide: Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir: Major Dosage adjustments of rosuvastatin may be required during concomitant administration with dasabuvir; ombitasvir; paritaprevir; ritonavir.

Use of these drugs together results in elevated rosuvastatin serum concentrations. The dose should be re-adjusted after completion of the 4-drug hepatitis C treatment regimen. Major Due to CYP3A4 inhibition by ritonavir, the risk of myopathy including rhabdomyolysis may be increased when ritonavir is given in combination with rosuvastatin. If coadministration is necessary, use the lowest possible dose of rosuvastatin.

Minor When coadministered with oral contraceptives during drug interaction studies, rosuvastatin produced an approximately 1. The changes are not likely to be of clinical consequence for most patients; some patients may experience increases in common side effects of hormonal contraceptives, such as breast tenderness, nausea, headache, or fluid retention. Drospirenone; Ethinyl Estradiol; Levomefolate: Moderate Elagolix may reduce the exposure AUC of rosuvastatin.

Monitor lipid panel as clinically indicated and adjust rosuvastatin dose if indicated by treatment target goal and clinical response.

Peak concentration Cmax was minimally affected. Rosuvastatin is not extensively metabolized. Elagolix does not affect CYP2C9. The mechanism of the interaction is not clear. Moderate Studies have shown plasma concentrations of rosuvastatin are increased when administered concurrently with elbasvir; grazoprevir. If these drugs are use together, the daily dose of rosuvastatin should not exceed 10 mg. Moderate Use caution and monitor for signs of rosuvastatin toxicity if this drug is coadministered with eltrombopag.

Moderate Close monitoring for adverse effects, such as rhabdomyolysis and myopathy, is advised when eluxadoline is administered concurrently with rosuvastatin. Eluxadoline is an inhibitor of the organic anion-transporting peptide OATP1B1 and the breast cancer resistance protein BCRP ; rosuvastatin is a substrate of both transporters. Administer the lowest effect rosuvastatin dose and monitor for adverse effects. This interaction is likely due to CYP3A4 inhibition of statins which are CYP3A4 substrates; however, rosuvastatin is not substantially metabolized, and is less likely to be significantly affected by CYP3A4 inhibitors such as erythromycin.

The clinical significance of this interaction has not been established, monitor for effectiveness of rosuvastatin and for myopathy and adjust treatment as clinically indicated. Ethinyl Estradiol; Ethynodiol Diacetate: Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate: Ethinyl Estradiol; Norethindrone Acetate: Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate: Ethinyl Estradiol; Norethindrone; Ferrous fumarate: The changes are not likely to be of clinical consequence for most patients; some patients may experience increases in common side effects of norgestrel, such as breast tenderness, nausea, headache, or fluid retention.

Moderate Concomitant use of etravirine and rosuvastatin has no effect on the serum concentration of rosuvastatin; however, the risk of myopathy, including rhabdomyolysis, may be increased when antiretrovirals are given in combination with HMG-CoA reductase inhibitors.

Major HMG-CoA reductase inhibitors have been administered safely with fibric acid derivatives in some patients; however the risk of potential myopathy is considerably higher during concurrent therapy. Combination therapy with HMG-CoA reductase inhibitors, such as rosuvastatin and gemfibrozil has been associated with a significantly enhanced risk of myopathy and rhabdomyolysis. When possible, avoid concurrent use of HMG-reductase inhibitors with fibrates.

This is the likely mechanism of the increase in rosuvastatin exposure with gemfibrozil use. Major Fosamprenavir increases rosuvastatin plasma concentrations. If these drugs are to be coadministered, use the lowest possible dose of rosuvastatin, or consider treatment with an alternative HMG-CoA reductase inhibitor such as fluvastatin or pravastatin.

Moderate Monitor for rosuvastatin toxicities that may require rosuvastatin dose reduction if given concurrently with fostamatinib. Major Do not exceed a maximum rosuvastatin dose of 10 mg when coadministered with glecaprevir due to an increased risk of myopathy, including rhabdomyolysis.

Coadministration may increase the plasma concentrations of rosuvastatin. In drug interaction studies, coadministration of rosuvastatin with glecaprevir; pibrentasvir resulted in more than a 2-fold increase in the AUC of rosuvastatin.

Major Do not exceed a maximum rosuvastatin dose of 10 mg when coadministered with pibrentasvir due to an increased risk of myopathy, including rhabdomyolysis. Moderate Use caution and the lowest rosuvastatin dose necessary if it must be coadministered with indinavir. Monitor patients for any signs or symptoms of muscle pain, weakness, or tenderness especially in the initial months of therapy and any time the dosage of either drug is titrated upward.

The risk of myopathy or rhabdomyolysis should be weighed carefully against the benefits of combined 'statin' and protease inhibitor therapy; there is no assurance that periodic monitoring of CK will prevent the occurrence of severe myopathy and renal damage. A potential mechanism for this interaction is inhibition of the breast cancer resistance protein BCRP by itraconazole; rosuvastatin is a BCRP substrate..

Major To limit absorption problems, HMG-CoA reductase inhibitors "statins" should not be taken within 2 hours of dosing with lanthanum carbonate. Oral drugs known to interact with cationic antacids, like statin cholesterol treatments, may also be bound by lanthanum carbonate.

Separate the times of administration appropriately. Monitor the patient's lipid profile to ensure the appropriate response to statin therapy is obtained. Hundreds of patients who suffered severe muscle injuries, diabetes or liver damage after taking Crestor have filed lawsuits over the drug. But in a February financial statement, AstraZeneca announced it had resolved all product liability lawsuits over Crestor. The higher the dose, the greater the risk of certain side effects.

Food and Drug Administration approved Crestor in for use in patients with bad cholesterol and a history of heart disease. By the end of , more than countries approved the drug. Major trials and studies showed a 9 to 12 percent increase in the risk of diabetes for people on statins.

It warned doctors the drug could raise blood sugar levels. Fact Studies show statins like Crestor increase the risk of diabetes by up to 12 percent. The FDA announced further label changes in March Crestor label changes included: Recommended liver enzymes be tested before prescribing Crestor and when clinically necessary thereafter Adverse event information Added side effects including memory loss or impairment, confusion, forgetfulness and amnesia Lovastatin Drug Interactions Warned that Crestor should never be taken with Mevacor lovastatin , another cholesterol medicine Blood sugar Included information that increases in blood sugar levels had been reported with use of Crestor and other statins Protease Inhibitor Drug Interactions Warned that taking Crestor or other statins with HIV or hepatitis C virus HCV medicines called protease inhibitors may raise statin levels in the blood this increases the risk for muscle injury, including rhabdomyolysis, which can result in kidney failure Crestor Recalls Public Citizen petitioned the FDA in and to recall Crestor.

Rhabdomyolysis is a severe form of muscle damage that can harm the kidneys and is sometimes fatal. Public Citizen demanded the FDA recall the drug before any further incidents of rhabdomyolysis, kidney failure or kidney damage could occur. The FDA denied the petitions. This allowed other companies to begin manufacturing generic versions of the drug if they receive FDA approval.

Since then, at least eight more manufacturers received FDA approval for their versions of generic Crestor rosuvastatin calcium. In its annual report , AstraZeneca noted that Crestor remained one of its top sellers. But that represented a 30 percent decline from the previous year. The FDA says the generic drugs it approves have the same quality and strength as brand-name versions.

Avoid eating foods that are high in fat or cholesterol. Crestor will not be as effective in lowering your cholesterol if you do not follow a cholesterol-lowering diet plan. Crestor side effects Get emergency medical help if you have any signs of an allergic reaction to Crestor: In rare cases, Crestor can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure.

Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, and dark colored urine. Also call your doctor at once if you have: Common Crestor side effects may include: This is not a complete list of side effects and others may occur.

Call your doctor for medical advice about side effects. Side effects in more detail What other drugs will affect Crestor? Using certain other drugs together with Crestor can increase your risk of serious muscle problems. It is very important to tell your doctor about all medicines you use, and those you start or stop using during your treatment with Crestor, especially: This list is not complete.

Other drugs may interact with rosuvastatin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Further information Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Copyright Cerner Multum, Inc.

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