From the Guidelines
Yes, rosuvastatin is classified as a high-intensity statin when prescribed at doses of 20-40 mg daily. High-intensity statins are those that can lower LDL cholesterol by ≥50% from baseline, and rosuvastatin at these doses achieves this threshold. At lower doses (5-10 mg), rosuvastatin is considered a moderate-intensity statin. According to the most recent guidelines, including the 2023 standards of care in diabetes 1, rosuvastatin 20-40 mg is listed as a high-intensity statin therapy, which lowers LDL cholesterol by >50%.
Key Points:
- Rosuvastatin is a high-intensity statin at doses of 20-40 mg daily.
- High-intensity statins lower LDL cholesterol by ≥50% from baseline.
- Rosuvastatin has greater LDL-lowering efficacy per milligram compared to other statins like atorvastatin, simvastatin, or pravastatin.
- Patients prescribed high-intensity rosuvastatin therapy should be monitored for potential side effects including muscle pain, liver enzyme elevations, and new-onset diabetes, particularly when using the maximum 40 mg dose.
Statin Intensity Classification:
The classification of statin intensity is based on the degree of LDL cholesterol lowering, with high-intensity statins achieving a ≥50% reduction, moderate-intensity statins achieving a 30-49% reduction, and low-intensity statins achieving a <30% reduction 1.
Clinical Considerations:
When prescribing rosuvastatin, it is essential to consider the patient's individual risk factors, medical history, and potential for drug interactions. Regular monitoring of LDL cholesterol levels, liver enzymes, and blood glucose is recommended to ensure the safe and effective use of high-intensity statin therapy.
From the FDA Drug Label
ROSUVASTATIN tablets, for oral use ... Adults:Recommended dosage range is 5 mg to 40 mg once daily.
The dosage range of 5 mg to 40 mg once daily for adults indicates that rosuvastatin can be considered a high-intensity statin at the higher end of this dosage range, as high-intensity statins are typically defined as those that lower LDL-C by approximately 50% or more. However, the specific intensity of rosuvastatin (high, moderate, or low) is not explicitly stated in the provided drug label text. 2
From the Research
Definition of High-Intensity Statin
A high-intensity statin is defined as a statin that reduces low-density lipoprotein (LDL) cholesterol by 50% or more [(3,4,5)].
Rosuvastatin's Efficacy
Rosuvastatin has been shown to be effective in reducing LDL cholesterol levels by 50% or more, which meets the definition of a high-intensity statin [(3,4,5)].
- In a study published in 2007, rosuvastatin 40 mg reduced LDL cholesterol by 52% 3.
- In a study published in 2011, rosuvastatin 40 mg reduced LDL cholesterol by 54% 4.
- In a study published in 2023, rosuvastatin 40 mg reduced LDL cholesterol by approximately 50% 5.
Comparison with Other Statins
Rosuvastatin has been compared to other statins, such as atorvastatin, in terms of efficacy and safety [(4,6,5)].
- A study published in 2011 found that rosuvastatin 40 mg was more effective than atorvastatin 80 mg in reducing LDL cholesterol 4.
- A study published in 2023 found that rosuvastatin 40 mg was superior to atorvastatin 80 mg in terms of efficacy and safety 5.
Safety Profile
Rosuvastatin has been shown to have a favorable safety profile, with a low incidence of adverse events [(3,4,6,5)].
- A study published in 2007 found that rosuvastatin 40 mg was well tolerated, with a low incidence of adverse events 3.
- A study published in 2011 found that rosuvastatin 40 mg had a similar safety profile to atorvastatin 80 mg 4.
- A study published in 2023 found that rosuvastatin 40 mg had a superior safety profile to atorvastatin 80 mg 5.