Lipid-Lowering Agent
Pregnancy: Contraindicated
Rosuvastatin
Brand names: Crestor
Adult dose
Dose: 5–40 mg
Route: Oral
Frequency: Once daily
Max: 40 mg/day
Start 5–10 mg; 20–40 mg for high-risk or secondary prevention. More hydrophilic than atorvastatin — lower CYP3A4 interactions.
Paediatric dose
Route: Oral
Frequency: Once daily
Max: 20 mg/day
Used for familial hypercholesterolaemia in children ≥6 years under specialist guidance.
Dose adjustments
Renal
Max 20 mg/day if eGFR <30 mL/min. Avoid 40 mg dose in severe renal impairment.
Hepatic
Contraindicated in active liver disease.
Clinical pearls
- JUPITER trial: rosuvastatin reduced CV events even in normal LDL patients with elevated hsCRP
- Check urine dipstick for proteinuria before high-dose initiation
- Asian patients may need lower starting doses due to higher plasma levels
Contraindications
- Active liver disease
- Pregnancy
- Breastfeeding
- Severe renal impairment with 40 mg dose
Side effects
- Myalgia
- Rhabdomyolysis (rare)
- Proteinuria (at high doses)
- Haematuria
- Elevated LFTs
Interactions
- Ciclosporin (contraindicated — 10× increase in rosuvastatin exposure)
- Fibrates (myopathy risk)
- Antacids (reduce absorption — give 2 hours apart)
- Warfarin
Monitoring
- LFTs at baseline and 3 months
- Fasting lipid profile
- Urine dipstick at high doses
Reference: BNFc; BNF 90; NICE NG185; JUPITER Trial (NEJM 2008). Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators