Rosuvastatin Calcium: Brands, Price & Uses in Bangladesh

Rosuvastatin Calcium is an HMG-CoA reductase inhibitor (statin) indicated for the following uses:

Established / FDA-approved uses

• Primary hyperlipidemia and mixed dyslipidemia: As an adjunct to diet, to reduce elevated total cholesterol, LDL-cholesterol, apolipoprotein B, non-HDL-cholesterol, and triglycerides, and to increase HDL-cholesterol in adult and pediatric patients.
• Hypertriglyceridemia: As an adjunct to diet for treatment of adults with elevated triglyceride levels.
• Homozygous familial hypercholesterolemia (HoFH): To reduce LDL-cholesterol, total cholesterol, and apolipoprotein B, either alone or as an adjunct to other lipid-lowering treatments (e.g., LDL apheresis) when such treatments are unavailable or inadequate.
• Heterozygous familial hypercholesterolemia (HeFH) in pediatric patients: As an adjunct to diet to reduce LDL-cholesterol.

Guideline-supported / adjunct use

• Primary prevention of cardiovascular disease: In patients without clinically evident coronary heart disease but with an increased risk based on age and the presence of specific risk factors, Rosuvastatin Calcium is used to reduce the risk of stroke, myocardial infarction, and arterial revascularization procedures.
• Slowing the progression of atherosclerosis: As part of a treatment strategy to lower total cholesterol and LDL-cholesterol in patients with hypercholesterolemia at risk of atherosclerosis.

Rosuvastatin Calcium is not indicated for the treatment of acute coronary events and does not substitute for diet, exercise, weight control, or other cardiovascular risk-factor management.

General dosing principle

The dose of Rosuvastatin Calcium should be individualized according to the indication, baseline LDL-cholesterol level, goal of therapy, and patient response, with periodic reassessment of lipid levels (generally at 2-4 week intervals) allowing dose adjustment.

Special dosing situations

• Asian patients: Because of higher plasma exposure observed in patients of Asian ancestry, a starting dose of 5 mg once daily is recommended.
• Severe renal impairment (creatinine clearance <30 mL/min, not on hemodialysis): Start at 5 mg once daily; do not exceed 10 mg once daily.
• Concomitant cyclosporine: Limit the dose of Rosuvastatin Calcium to 5 mg once daily (see Interactions).
• Concomitant certain protease inhibitors: Dose limitation is required; consult product labeling/physician for the specific combination.
• The 40 mg dose should generally be reserved for patients who have not achieved their LDL-C goal on 20 mg once daily and is not intended as a starting dose (except in HoFH), given the increased risk of myopathy at this dose.

Maximum dose should not be exceeded except under close medical supervision. Do not stop or change the dose without consulting a physician.

Most patients tolerate Rosuvastatin Calcium well. Reported adverse effects include:

Common

• Headache
• Myalgia (muscle aches)
• Abdominal pain, nausea, constipation
• Asthenia (weakness)
• Dizziness

Less common / serious (see also Precautions and Warnings)

• Elevated liver transaminases
• Myopathy, and rarely rhabdomyolysis
• Immune-mediated necrotizing myopathy (very rare)
• Hypersensitivity reactions, including rash, pruritus, urticaria, and rarely angioedema
• New-onset hyperglycemia/diabetes (small increase in fasting glucose and HbA1c has been reported, a recognized class effect)
• Proteinuria and/or microscopic hematuria (usually transient, more common at the 40 mg dose)
• Thrombocytopenia (rare)

Seek prompt medical attention for unexplained muscle pain, tenderness or weakness accompanied by fever or dark urine, or signs of an allergic reaction.