Home Drug Guide Rosuvastatin Calcium

Drug Guide

Generic Name

Rosuvastatin Calcium

Brand Names Crestor, Ezallor Sprinkle

Classification

Therapeutic: Lipid-lowering agent

Pharmacological: HMG-CoA reductase inhibitor (statin)

FDA Approved Indications

  • Hyperlipidemia
  • Homozygous familial hypercholesterolemia
  • Prevention of cardiovascular disease

Mechanism of Action

Inhibits HMG-CoA reductase enzyme, leading to decreased cholesterol synthesis in the liver and increased LDL receptor expression, which enhances clearance of LDL cholesterol from the bloodstream.

Dosage and Administration

Adult: Starting dose typically 10-20 mg once daily, with max 40 mg daily. Adjust based on response and tolerability.

Pediatric: Approved for children aged 10-17 for certain lipid disorders; dosing varies.

Geriatric: Start at lower doses due to increased risk of adverse effects, monitor closely.

Renal Impairment: Use with caution; dose adjustments may be necessary.

Hepatic Impairment: Contraindicated in active liver disease; caution in elevated liver enzymes.

Pharmacokinetics

Absorption: Well absorbed after oral administration

Distribution: Bound to plasma proteins (~88%)

Metabolism: Minimal hepatic metabolism, primarily via CYP2C9

Excretion: Excreted mainly in feces (90%), some in urine (10%)

Half Life: Approximately 19 hours

Contraindications

  • Active liver disease
  • Unexplained persistent elevations of serum transaminases
  • Pregnancy and lactation

Precautions

  • Monitor liver function and lipid levels periodically
  • Use with caution in patients on concomitant medications that can increase risk of myopathy

Adverse Reactions - Common

  • Headache (Common)
  • Myalgia (Common)
  • Abdominal pain (Common)
  • Nausea (Common)

Adverse Reactions - Serious

  • Rhabdomyolysis (Rare)
  • Myopathy progressing to rhabdomyolysis (Rare)
  • Hepatotoxicity (Rare)

Drug-Drug Interactions

  • Cyclosporine, certain antivirals (like HIV protease inhibitors), fibrates, azole antifungals, and others that increase statin levels.

Drug-Food Interactions

  • Grapefruit juice (may increase plasma concentration)

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor lipid panels, liver function tests, and for signs of muscle pain or weakness.

Diagnoses:

  • Risk for activity intolerance related to muscle adverse effects
  • Impaired skin integrity or injury risk due to myopathy.

Implementation: Administer as prescribed, usually once daily. Educate patient on importance of adherence and monitoring.

Evaluation: Assess lipid level changes, liver enzymes, and muscle symptoms periodically.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Report any muscle pain, weakness, or unusual fatigue.
  • Avoid excessive alcohol intake.
  • Inform healthcare providers of all medications and supplements.

Special Considerations

Black Box Warnings:

  • Potential for myopathy and rhabdomyolysis, especially when used with interacting drugs.
  • Pregnancy Category X - contraindicated in pregnancy.

Genetic Factors: Genetic variants affecting CYP2C9 may alter drug metabolism.

Lab Test Interference: Might slightly elevate liver enzymes or creatine kinase.

Overdose Management

Signs/Symptoms: Muscle pain, weakness, elevated liver enzymes.

Treatment: Supportive care, hydration, and monitoring; no specific antidote.

Storage and Handling

Storage: Store at room temperature, away from moisture and heat.

Stability: Stable for 2-3 years depending on packaging.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.