What Is the Drug Crestor Used For?

Crestor (rosuvastatin) lowers so-called "bad" cholesterol and fats in blood. The drug also raises levels of "good" cholesterol and slows artherosclerosis, the buildup of plaque in blood vessels. While Crestor has not yet been approved by the U.S. Food and Drug Administration for preventing heart attacks or strokes, the drug's maker, AstraZeneca, is preparing to seek that indication for Crestor.

Uses

Crestor is one of several drugs classified as statins. The class also includes Pfizer's Lipitor (atorvastatin), Bristol-Myers Squibb's Pravachol (pravastatin) and Merck's Zocor (simvastatin), as well as the generic equivalents of Pravachol and Zocor.
A meta-analysis published in the May 2009 issue of Advances in Therapy concludes that studies involving the use of statins to improve cholesterol and lipid profiles and to curb artherosclerosis "have clearly shown that statin treatments have a favorable benefit/risk profile in a large range of patients." Crestor's labeling reflects this, listing the following five FDA-approved indications:
1. Hyperlipidemia and Mixed Dyslipidemia
Crestor is indicated as adjunctive therapy to diet to reduce elevated total cholesterol, low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (ApoB), non-high--density lipoprotein cholesterol (HDL-C), and triglycerides and to increase HDL-C in adult patients with primary hyperlipidemia or mixed dyslipidemia. Lipid-altering agents should be used in addition to a diet restricted in saturated fat and cholesterol when response to diet and non-pharmacological interventions alone has been inadequate.
2. Hypertriglyceridemia
Crestor is indicated as adjunctive therapy to diet for the treatment of adult patients with hypertriglyceridemia.
3. Primary Dysbetalipoproteinemia (Type III Hyperlipoproteinemia)
Crestor is indicated as an adjunct to diet for the treatment of patients with primary dysbetalipoproteinemia (Type III Hyperlipoproteinemia).
4. Homozygous Familial Hypercholesterolemia
Crestor is indicated as adjunctive therapy to other lipid-lowering treatments (e.g., LDL apheresis) or alone if such treatments are unavailable to reduce LDL-C, total cholesterol and ApoB in adult patients with homozygous familial hypercholesterolemia.
5. Slowing of the Progression of Atherosclerosis
Crestor is indicated as adjunctive therapy to diet to slow the progression of atherosclerosis in adult patients as part of a treatment strategy to lower total cholesterol and LDL-C to target levels.
Crestor works by blocking the expression of a liver enzyme that triggers the production of cholesterol with the body.

Doses

Most patients receive a once-daily 20 mg dose of Crestor, which can be taken with or without food. Depending on your condition or other medications, you may receive a prescription for a 5 mg dose, a 10 mg dose or a 40 mg dose.

Side Effects

Patients taking Crestor have most frequently reported side effects of headaches, muscle aches, stomachaches, muscle weakness (asthenia) and nausea. However, none of these problems occurred in more than 8.5 percent of patients taking any dose during clinical trials.
Very rarely, people taking Crestor have developed a potentially fatal breakdown in muscle tissue known as rhabdomyolysis. If you are using Crestor and you experience sudden weakness or pain that you can't immediately explain, contact your health care provider immediately.

Warnings and Contraindications

Never take Crestor if you are pregnant, breastfeeding or planning to become pregnant. You should also not take Crestor if you are suffering from liver disease. To ensure you do not experience problems, your health care provider will perform a liver function test on you before you start using the drug and occasionally while you continue to use it.
Be sure to discuss all your medications with your health care provider when he or she prescribes Crestor because the drug interacts with several other medications. According to Crestor's label, the drug should generally not be used in conjunction with gemfibrozil, which is sold by Pfizer under the brand name Lopid. Additionally, lower doses of Crestor may be best for you if you are Asian or if you are also using cyclosporine, Kaletra (lopinavir and ritonavir), niacin and warfarin.

Possible Use

The FDA first cleared Crestor for marketing in August 2003. In 2008, the drug ranked 24th in terms of worldwide sales and prescriptions. Crestor might see wider use if the FDA approves the statin for preventing major cardiovascular events such as heart attacks, strokes, and unstable angina.
AstraZeneca announced on November 9, 2008, that it would ask the FDA to consider evidence from a large clinical study that shows Crestor effectively protected people with at least one risk factor for cardiovascular problems. As reported in the online edition of the New England Journal of Medicine on November 20, 2008, people who had elevated levels of C-reactive protein and took a 20 mg tablet daily had "significantly reduced the incidence of major cardiovascular events, despite the fact that nearly all study participants had lipid levels at baseline that were well below the threshold for treatment according to current prevention guidelines."
Pending FDA's decision regarding the use of Crestor in patients without elevated LDL-C, AstraZeneca is advising prescribers and patients to only use the drug according to the existing prescribing information.

Resources

• Crestor Prescribing Information
• Statin Information