Crestor

Rosuvastatin

Clinical data
Pronunciation	roh-SOO-və-sta-tin
Trade names	Crestor
AHFS/Drugs.com	Monograph
MedlinePlus	a603033
Pregnancy category	AU: D US: X (Contraindicated)
Routes of administration	By mouth (tablets)
ATC code	C10AA07 (WHO)
Legal status
Legal status	AU: S4 (Prescription only) UK: POM (Prescription only) US: ℞-only In general: ℞ (Prescription only)
Pharmacokinetic data
Bioavailability	20%
Protein binding	88%
Metabolism	Liver: CYP2C9 (major) and CYP2C19-mediated; ~10% metabolized
Metabolites	N-desmethyl rosuvastatin (major; 1/6–1/9 of rosuvastatin activity)
Biological half-life	19 hours
Excretion	Faeces (90%)
Identifiers
IUPAC name (3R,5S,6E)-7-[4-(4-Fluorophenyl)-2-(N-methylmethanesulfonamido)-6-(propan-2-yl)pyrimidin-5-yl]-3,5-dihydroxyhept-6-enoic acid
CAS Number	287714-41-4 Y
PubChem CID	446157
IUPHAR/BPS	2954
DrugBank	DB01098 Y
ChemSpider	393589 N
UNII	413KH5ZJ73
KEGG	D01915 N
ChEBI	CHEBI:38545 N
ChEMBL	CHEMBL1496 N
PDB ligand	FBI (PDBe, RCSB PDB)
ECHA InfoCard	100.216.011
Chemical and physical data
Formula	C22H28FN3O6S
Molar mass	481.539
3D model (Jmol)	Interactive image
SMILES OC(=O)C[C@H](O)C[C@H](O)\C=C\c1c(C(C)C)nc(N(C)S(=O)(=O)C)nc1c2ccc(F)cc2
InChI InChI=1S/C22H28FN3O6S/c1-13(2)20-18(10-9-16(27)11-17(28)12-19(29)30)21(14-5-7-15(23)8-6-14)25-22(24-20)26(3)33(4,31)32/h5-10,13,16-17,27-28H,11-12H2,1-4H3,(H,29,30)/b10-9+/t16-,17-/m1/s1 N Key:BPRHUIZQVSMCRT-VEUZHWNKSA-N N
NY (what is this?)

Rosuvastatin (INN), marketed under the tradename Crestor, is a member of the drug class of statins, used in combination with exercise, diet, and weight-loss to treat high cholesterol and related conditions, and to prevent cardiovascular disease.

It was developed by Shionogi. In 2013 Crestor was the fourth-highest selling drug in the United States, accounting for approx. $5.2 billion in sales. A generic version became available in the United States in 2016.

The primary use of rosuvastatin is for the treatment of dyslipidemia.

The effects of rosuvastatin on LDL cholesterol are dose-related. Higher doses were more efficacious in improving the lipid profile of patients with hypercholesterolemia than milligram-equivalent doses of atorvastatin and milligram-equivalent or higher doses of simvastatin and pravastatin.

Meta-analysis showed that rosuvastatin is able to modestly increase levels of HDL cholesterol as well, as with other statins. A 2014 Cochrane review determined there was good evidence for rosuvastatin lowering non-HDL levels linearly with dose. HDL increases by 7% with no dose effect noted.

Side effects are uncommon. The following side effects should be reported to the prescribing doctor if they persist or get worse:

The following rare side effects are more serious. Like all statins, rosuvastatin can possibly cause myopathy, rhabdomyolysis. Stop taking rosuvastatin and contact the prescribing doctor if any of these occur:

If any signs of an allergic reaction develop, contact an emergency medical service immediately:

Rosuvastatin has multiple contraindications, conditions that warrant withholding treatment with rosuvastatin, including hypersensitivity to rosuvastatin or any component of the formulation, active liver disease, elevation of serum transaminases, pregnancy, or breastfeeding. Rosuvastatin must not be taken while pregnant as it can cause serious harm to the unborn baby. In the case of breastfeeding, it is unknown whether rosuvastatin is passed through breastmilk, but due to the potential of disrupting the infant's lipid metabolism, patients should not breast feed while on rosuvastatin.