Crestor: Uses and risks
Other statins include atorvastatin, or Lipitor, and simvastatin, or Zocor.
How does it reduce cholesterol?
Crestor helps to balance the 'good' and 'bad' cholesterol in the bloodstream.
Crestor is a statin. It is used to control levels of cholesterol and triglycerides in the blood.
- reduce low-density lipoprotein (LDL), or "bad" cholesterol
- increase high-density lipoprotein (HDL), or "good" cholesterol
- lower triglycerides in the blood
LDL carries cholesterol from the liver to cells.
If it carries more cholesterol than the cells can use, too much cholesterol will accumulate, increasing the risk of arterial disease. Up to 70 percent of the cholesterol in human blood is LDL, but this can vary between individuals.
HDL has the opposite effect to LDL. It takes cholesterol away from cells and returns it to the liver.
Cholesterol is either broken down in the liver or expelled from the body as waste. In this way, HDL protects the body from arterial disease.
Crestor lowers the levels of LDL in the blood, and it increases the levels of HDL. In this way, it helps prevent coronary artery disease and other cardiovascular diseases, such as heart attack, stroke, and angina.
Like other statins, it prevents the production of LDL by suppressing HMG-CoA reductase. Reductase is an enzyme in the liver that plays a crucial role in cholesterol production. Statins are also called HMG-CoA reductase inhibitors.
The United States Food and Drug Administration (FDA) notes that a 10-milligram dose of Crestor can lower LDL production by 44 percent in children and adolescents.
Crestor and triglycerides
Triglycerides are chemicals that consist of three molecules of fatty acid combined with a molecule of the alcohol glycerol. They are the major forms of fat stored in the human body.
Triglycerides are present in blood plasma. Together with cholesterol, they form the blood fats, or plasma lipids.
When the body needs energy, and there is no food as an energy source, hormones are released. These hormones release triglycerides from fat cells, to be used as energy.
Crestor may slow down the progression of atherosclerosis when taken along with a special diet and exercise.
A 2009 study found that Crestor reduced the risk of vascular events by 43 percent when given to healthy adults.
However, a meta-analysis published in 2012 suggested that the benefit may be 20 percent.
Crestor's primary medical use is for treating dyslipidemia. Dyslipidemia is a lipoprotein metabolism disorder that results in high triglyceride and LDL concentrations, and low levels of HDL in the blood.
The FDA recommends prescribing it only if other measures have not worked, such as losing weight, changing diet, and doing exercise.
Apart from dyslipidemia, Crestor has been approved in the U.S. for the treatment of:
Crestor's main use is to moderate cholesterol levels in cases of dyslipidemia
- Hypercholesterolemia, or high total cholesterol
- Hypertriglyceridemia, or high triglycerides
It can also help prevent cardiovascular events, including:
- congenital heart disease
- disorders of the peripheral vascular system
- heart valve disease
- orthostatic hypotension
- heart failure
- diseases of the aorta and its branches
- coronary artery disease.
Crestor was first approved in the U.S. in August 2003, and by 2004, it was approved in 154 countries and marketed in 56.
How is Crestor taken?
Crestor can be used by adults to control cholesterol, and by children aged 8 to 17 years who have an inherited condition that leads to high LDL.
Crestor comes in tablet form. The manufacturers advise taking it once a day by mouth, with or without food.
If a patient misses a dose, they should take it as soon as possible, but they should not take two tablets within a 12-hour period.
The tablets are 5 milligrams (mg), 10 mg, 20 mg. A patient will normally start with a dose of 10 mg to 20 mg a day.
Adverse effects and interactions
As with most drugs, some people will have an adverse reaction to Crestor.
One study showed that 1.4 percent of patients stopped using it because of adverse reactions.
More than 2 percent of patients experienced:
- myalgia, or muscle pain
- abdominal pain
- weakness or lack of energy
People who should not use Crestor include:
- those who are allergic to rosuvastatin
- patients with liver disease
- pregnant or breastfeeding mothers
If a woman is taking Crestor and she becomes pregnant, she should inform her doctor at once, as there may be a risk to the fetus or the infant.
The following people should make sure their doctors know before being prescribed Crestor:
- patients with kidney or liver disease
- people with diabetes
- patients with a thyroid disorder
- people who consume more than two alcoholic drinks each day
Patients should tell their doctor immediately if they experience:
- unexplained weakness, muscle pain, or tiredness
- loss of appetite
- upper abdominal pain
- dark urine
All these are signs and symptoms of rare but potentially serious side effects.
Patients taking Crestor have a very slight risk of developing rhabdomyolysis. This involves a breakdown of the skeletal muscles that release certain proteins, including myoglobin into the bloodstream.
Myoglobin can damage the kidneys and cause kidney failure.
Anybody who may be developing rhabdomyolysis should stop taking Crestor immediately.
Alcohol can raise triglyceride levels and the chance of liver damage, so it should be avoided when using Crestor.
Statins will be less effective if the patient does not follow a cholesterol-lowering diet plan. Patients must avoid foods that are high in cholesterol and fat.
Other medications may increase the risk of medical problems and complications if taken together with Crestor.
Examples include cyclosporine, gemfibrozil, drugs that contain niacin, fenoribrate, and some HIV medications. Other examples include atazanavir, ritonavir, lopinavir or ritonavir, and saquinavir.
Are statins a good idea?
Statins are one of the medications that doctors find it hardest to persuade patients to adhere to.
For best effect, Crestor should be used with a healthy diet and regular exercise.
However, medical professionals are concerned that by not using statins, patients could be putting themselves at risk of heart disease.
The FDA stated in 2009 that the risks of Crestor are comparable with the risk of using other statins. Statins have been linked to a higher risk of myopathy and rhabdomyolysis, and, rarely, liver problems.
The benefits are also similar to those offered by other statins. The FDA notes that the balance between the risks and the benefits is acceptable.
For best results, patients who use statins should also follow a diet that is low in saturated fats and cholesterol, and they should get regular physical exercise.